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Liposuction: The Fat Came Back, Thought It Was a Goner, But The Fat Came Back...

Liposuction is often billed as a permanent surgical solution to unwanted fat deposits. Various types of fat-sucking surgery have been available for over three decades, but these procedures have rarely been scrutinized by controlled clinical trials.

A new controlled trial suggests the promise is a half-truth, the fat stays off the suctioned area, but it re-accumulates elsewhere:

In the study, the researchers randomly assigned nonobese women to have liposuction on their protuberant thighs and lower abdomen or to refrain from having the procedure, serving as controls. As compensation, the women who were control subjects were told that when the study was over, after they learned the results, they could get liposuction if they still wanted it. For them, the price would also be reduced from the going rate.

The result, published in the latest issue of Obesity, was that fat came back after it was suctioned out. It took a year, but it all returned. But it did not reappear in the women’s thighs. Instead, Dr. Eckel said, “it was redistributed upstairs,” mostly in the upper abdomen, but also around the shoulders and triceps of the arms. [NYT]

This is further evidence that the body closely monitors its fat stores and compensates accordingly.

It's also a sad reminder that body contouring plastic surgery isn't held to the same standards of evidence as other surgical specialties. The New York Times article blames the "hands on culture" of surgery where plastic surgeons publish anecdotes instead of controlled trials and generally promote themselves in a style worthy of the old time medicine shows.

I'm not convinced that the culture of surgery itself is to blame. Brain and heart surgeons don't let each other get away with publishing mostly heartwarming anecdotes and striking "before and after" pictures in major journals. Surgeons are a competitive bunch, and if they can prove that their method works better, they rush to do so. So, it makes you wonder about the state of the liposuction field that so few practitioners are even trying to publish rigorous research.

I predict some enterprising plastic surgeon will start promoting Truly Comprehensive Liposuction as an alternative to breast implants. If you suction fat from everywhere else on the body, the fat will only have one place to return to. I can see the late night TV commercials now.

[Photo credit: Robert S. Donovan, Creative Commons.]

 

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