Lipoabdominoplasty: What We Have Implemented and What We Have Modified over 26 Years.

Lipoabdominoplasty is one of the most commonly performed procedures in body-contouring surgery. We present a retrospective study of our 26 years of experience to improve the results and assure the greatest possible safety in lipoabdominoplasty. We include all of our female patients who underwent lipoabdominoplasty performed from July 1996 to June 2022, dividing the patients into two groups: group I underwent circumferential liposuction avoiding abdominal flap liposuction for the first 7 years, and group II underwent circumferential liposuction including abdominal flap liposuction for the subsequent 19 years, pointing out the differences in the processes, results, and complications of both groups. Over a period of 26 years, 973 female patients underwent lipoabdominoplasty: 310 in group I and 663 in group II. Ages were very similar; however, weight, BMI, amount of liposuction material, and weight of the abdominal flap removed were higher in group I. Twenty percent of patients in group I were obese compared to 7% in group II. The average amount of liposuction in group I was 4990 mL compared to 3373 mL in group II and 1120 g of abdominal flap in group I versus 676 g in group II. Minor and major complications were 11.6% and 1.2% in group I versus 9.2% and 0.6% in group II, respectively. In our more than 26 years of performing lipoabdominoplasty, we have maintained most of our initial procedures. These processes have allowed us to perform surgery safely and effectively with a low morbidity rate.

Patient Blood Management Strategies to Avoid Transfusions in Body Contouring Operations: Controlled Clinical Trial.

BACKGROUND: Anemia is a frequent process of morbidity and mortality in body contouring procedures. In aesthetic surgery, there are no standardized processes to minimize bleeding during surgery. For this reason, a study was designed to implement patient blood management strategies to reduce bleeding and transfusions in patients undergoing body contouring operations. METHODS: From January of 2017 to May of 2018, a prospective cohort-type observational study was conducted, including two groups of patients undergoing single or combined body contouring procedures. The first group did not receive patient blood management strategies, whereas the second group did receive these strategies. These measures consisted of preoperative strategies to ensure the patient had optimal hemoglobin and hematocrit levels and supportive intraoperative measures to minimize blood loss. The results were validated with different statistical tests according to the variables studied. RESULTS: A total of 409 patients were included in the study and were divided into two groups. The anthropometric and hemoglobin variables were similar in both groups. The 207 patients for whom patient blood management strategies were implemented lost an average of 1.2 g/dl less hemoglobin at 72 hours than the 202 patients for whom patient blood management strategies were not implemented (p ≤ 0.0001). CONCLUSIONS: Patient blood management strategies, such as increasing hemoglobin before surgery, and strategies to minimize blood loss during surgery, proved to be effective at reducing bleeding in patients undergoing body contouring surgery, also decreasing the need to perform postoperative blood transfusions. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.

Elective Surgery during SARS-Cov-2/COVID-19 Pandemic: Safety Protocols with Literature Review.

BACKGROUND: Health care systems worldwide have been affected by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emergence since December 2019. The coronavirus disease 2019 (COVID-19) pandemic caused a steep decrease in elective surgery scheduling, to the extent of complete cancellation without future planning of safe development. PURPOSE: We performed a review of the literature and diagnosis data analysis with the aim to reduce the risk of operating a patient infected with SARS-CoV-2/COVID-19 during the incubation period. METHODS: We searched for specific words and phrases about SARS-CoV-2 and COVID-19 in the PubMed database (US National Library of Medicine) from December 2019 to April 2020. A detailed analysis of the clinical picture and existing diagnostic tests for COVID-19 was performed to achieve the desired objectives. RESULTS: A total of 1273 out of 5930 articles about COVID-19/SARS-CoV-2 did meet the criteria for the searched terms. We reviewed 105 articles, and 60 were selected for analysis. Specific recommendations were described based on our revision. CONCLUSIONS: With the combination of immunoglobulin M and immunoglobulin G antibody tests + real-time polymerase chain reaction for SARS-CoV-2 implemented in different time periods by taking into account the natural history of the disease, it is possible to decrease the risk of operating a patient during the incubation period higher than 93%. Adding other security measures can further increase this percentage. As long as there is no immunity to COVID-19, these measures will help us to perform safer elective surgeries.

Efficacy of clindamycin compared with amoxicillin-metronidazole after a 7-day regimen in the treatment of periodontitis in patients with diabetes: a randomized clinical trial.

OBJECTIVE: To determine the efficacy of clindamycin compared with amoxicillin-metronidazole after a 7-day regimen during nonsurgical treatment of periodontitis in patients with type 2 diabetes mellitus. RESEARCH DESIGN AND METHODS: In this double-blind, randomized clinical trial, a total of 42 patients with chronic periodontitis and type 2 diabetes were included. Patients were randomly assigned to treatment with either clindamycin or amoxicillin-metronidazole three times a day during 7 days. Clinical determinations (probing depth, bleeding on probe, and plaque index) were performed to determine the extent and severity of periodontitis before and after the pharmacological treatment. RESULTS: After 7 days of administration of clindamycin or amoxicillin-metronidazole, no differences were observed between the clinical determinations, probing depth (0.44 vs 0.50 mm, p=0.624), plaque index (17.62 vs 15.88%, p=0.910), and bleeding on probing (16.12 vs 22.17%, p=0.163), respectively. There were no adverse events in either group. CONCLUSION: The administration during 7 days of clindamycin or amoxicillin/metronidazole showed the same efficacy for the reduction of probing depth, plaque index, and bleeding on probing in patients with periodontitis and type 2 diabetes.

Fasting triglycerides and glucose index: a useful screening test for assessing insulin resistance in patients diagnosed with rheumatoid arthritis and systemic lupus erythematosus.

BACKGROUND: Insulin resistance (IR) is frequently observed in patients with rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE). In clinical practice, IR assessment is limited to a low proportion of patients due to cost and equipment and technical expertise requirements. The surrogate index of triglycerides and glucose (TyG index) has been validated in non-rheumatic populations, showing adequate sensitivity and specificity for IR, although this index has not yet been used in connective tissue disorders. The aim of this study was to evaluate the frequency of insulin resistance (IR) using the validated surrogate index of triglycerides and glucose (TyG index) and to explore factors associated with IR in Mexican women with RA or SLE. METHODS: Ninety-five female RA and 57 SLE patients were included in a cross-sectional study. Clinical and epidemiological variables were evaluated. IR was assessed using the TyG index with a cutoff value of > 4.68. Logistic regression analysis was performed to identify factors associated with IR excluding confounders. RESULTS: IR frequency in the entire sample was 50%, higher than the 10% observed in non-rheumatic controls (p < 0.001). The frequency of IR was similar in SLE (49.1%) and RA (50.5%, p = 0.8) patients. IR was associated with a longer duration of hypertension and higher total cholesterol and low density lipoprotein cholesterol levels. Based on multivariate analysis, the duration of hypertension (OR: 1.06; 95% CI 1.002-1.12, p = 0.04), waist circumference (OR: 1.04; 95% CI 1.01-1.08, p = 0.007), uric acid levels (OR: 1.46; 95% CI 1.08-1.97, p = 0.01), RA (OR: 4.87; 95% CI 1.31-18.78, p = 0.01) and SLE (OR: 4.22; 95% CI 1.06-16.74, p = 0.04) were the main risk factors for IR. CONCLUSIONS: This study shows that the TyG index is a useful screening test for IR in RA and SLE patients. Future longitudinal studies should be performed with the aim of identifying the predictive value of TyG index results for identifying complications linked to IR.

Macro Fat Embolism After Gluteal Augmentation With Fat: First Survival Case Report.

Gluteal augmentation with fat has become one of the most common cosmetic procedures worldwide. Gluteal augmentation is designed to increase the volume and contour of the gluteal region. Intramuscular lipoinjection has been linked to multiple reports of severe complications, including death due to macro fat embolism (MAFE). The authors present the first reported case of survival and successful recovery after MAFE secondary to gluteal augmentation with fat. A 41-year-old woman, ASA II, was scheduled for augmentation mammaplasty, liposuction, and gluteal augmentation with fat. The patient was operated under general anesthesia with a total intravenous anesthesia technique. A total of 3.5 liters of fat was liposuctioned with no complications. The patient was then positioned in a lateral decubitus position for gluteal augmentation with fat. Right after the last injection, the anesthesiologist noticed a sudden change in capnography followed by hypotension, bradycardia, and hypoxemia. The first reaction in the operating room was to consider that the patient was experiencing a severe episode of fat embolism. She was then resuscitated and transferred to a tertiary facility for intensive care management. To our knowledge, this is the first case report of successful resuscitation in a patient experiencing severe MAFE after gluteal augmentation with fat. We believe that this patient survived the event due to early detection, aggressive management, and proper transfer to an intensive care unit. Level of Evidence: 5.

Understanding Fatal Fat Embolism in Gluteal Lipoinjection: A Review of the Medical Records and Autopsy Reports of 16 Patients.

BACKGROUND: Deaths secondary to gluteal lipoinjection are relatively recent events of major importance. However, little is known in relation to their behavior and clinical evolution. Therefore, an analysis was performed of case records from clinical cases that encountered this problem, correlating the results with the findings during autopsies. METHODS: An analysis was performed of records from patients who died secondary to gluteal lipoinjection. Patient-specific data, surgical procedure, clinical picture, evolution, and outcome were analyzed. The findings of the autopsies and the involvement of other organs were also analyzed and correlated. RESULTS: From 2000 to 2009, 16 files were obtained that fulfilled the indicated requirements. There were no statistically significant differences in the general characteristics of the patients, such as age, body mass index, or volume lipoinjected or liposuctioned. The clinical pictures were similar in all cases, and the autopsy findings showed the presence of microembolism in all cases and macroembolism in the most severe cases. CONCLUSIONS: The most significant parameter of severity in patients who undergo gluteal lipoinjection is the presence of fat in macroscopic form in the circulation. The volumes of liposuctioned or lipoinjected fat have little influence. Hypoxemia, hypotension, and bradycardia are the characteristic clinical features. Although there is no specific treatment, immediate aggressive vital support to attempt to stabilize the patient is crucial. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V.

Microscopic and Macroscopic Fat Embolism: Solving the Puzzle with Case Reports.

BACKGROUND: The frequency of fat embolism mortality after liposuction has increased. As the only dependable evidence for this problem is that available in the medical literature, a study of clinical case reports is warranted. METHODS: The authors reviewed the medical literature by searching for case reports of fat embolism after liposuction in humans who manifested either of the variants of the condition: microscopic fat embolism or macroscopic fat embolism. The authors performed a literature search of the PubMed and PubMed Central databases from the first case of fat embolism syndrome associated with liposuction reported until March of 2017; keywords Fat Embolism (Fat Embolism Syndrome), Liposuction, and Case (((fat embolism) AND liposuction) AND case) were used. A detailed analysis of the data contained in the clinical case reports was conducted. RESULTS: In total, 39 and 98 articles were found in PubMed and PubMed Central, respectively, using the keywords (((Fat + Embolism) + AND + Liposuction) + AND + Case). After analysis, only 15 reports corresponded to cases of macroscopic or microscopic fat embolism after liposuction, and the basic statistics of the two proposed variants were examined. CONCLUSIONS: This work provides relevant information regarding very important characteristics of microscopic and macroscopic fat embolism. Despite the diagnostic difficulty, clinical diagnosis remains the gold standard for identifying microscopic and macroscopic fat embolism. The establishment of a rapid and timely diagnosis is of great help for appropriate treatment.

Critical Differences between Microscopic (MIFE) and Macroscopic (MAFE) Fat Embolism during Liposuction and Gluteal Lipoinjection.

BACKGROUND: Liposuction and gluteal lipoinjection are two of the most frequent surgical procedures in body contouring surgery, and two of the most important complications are microscopic (MIFE) and macroscopic (MAFE) fat embolism. Despite a high index of morbidity and mortality, few reports exist about these complications, and although they have the same causal agent, their etiopathogenesis, clinical evolution, treatment, prognosis, and prevention are totally different. Therefore, the authors performed a comprehensive review of the literature to exhaustively analyze both pathologic conditions and present the differences between them. METHODS: A detailed search was carried out in PubMed of studies on humans from 1946 to March of 2017 in any language and including the keywords microscopic fat embolism and macroscopic fat embolism with either liposuction or gluteal lipoinjection. The articles found were selected according to the search criteria and were analyzed to provide the final data and recommendations. RESULTS: Of the 1245 and 26 articles that were found on complications related to liposuction and gluteal lipoinjection, respectively, only 41 on liposuction and microscopic fat embolism and seven on gluteal lipoinjection and microscopic fat embolism met the specific criteria for inclusion in the analysis. Only two articles on liposuction and two on gluteal lipoinjection referred to macroscopic fat embolism as a complication. CONCLUSION: Although microscopic fat embolism and macroscopic fat embolism are pathologic conditions with high morbidity and mortality rates in association with liposuction and gluteal lipoinjection, few reports about them exist; therefore, the authors made recommendations based on this study for their diagnosis, prevention, and treatment.

Insulin resistance in adult primary care patients with a surrogate index, Guadalajara, Mexico, 2012.

INTRODUCTION: Insulin resistance (IR) is a key molecular disorder related with diabetes mellitus, obesity, and cardiovascular disease. The objective of this study was to determine IR in adult primary care patients using the triglyceride/glucose (TyG) index [(Ln TG (mg/dL) × FG (mg/dL))/2]. METHODS: We conducted a cross-sectional secondary analysis and identified IR subjects according to the TyG index. RESULTS: There were 1500 patients included. Significant differences were found between the IR group versus the insulin-sensitive group, respectively: age (in years), 46.4 ± 9.34 versus 40.24 ± 11.27 (P < 0.001); fasting glucose (mg/dL), 99.87 ± 11.95 versus 84.62 ± 6.59 (P < 0.001); total cholesterol (mg/dL), 203.21 ± 37.38 versus 173.91 ± 33.99 (P < 0.001); triglycerides (mg/dL), 226.40 ± 96.66 versus 111.27 ± 23.44 (P < 0.001); uric acid (mg/dL), 6.09 ± 1.59 versus 4.77 ± 1.40 (P < 0.001); and TyG index, 4.96 ± 0.21 versus 4.48 ± 0.13 (P < 0.001). The cutoff of the TyG index for IR was 4.68 or greater. CONCLUSIONS: The TyG index allows for early diagnosis of IR in primary health care.

Buttocks fat grafting: 14 years of evolution and experience.

BACKGROUND: Fat infiltration for gluteal contour improvement is a procedure that is gaining more advocates. This has caused the application technique and the amount of fat infiltrated to change over time. The authors present their buttocks fat grafting technique evolution that occurred over a 14-year period. METHODS: From April of 1995 to March of 2009, 789 patients underwent liposuction and buttocks fat grafting. Patients were divided into three stages according to chronologic evolution and amount of fat infiltrated. RESULTS: During the first period (April of 1995 to January of 2004), 120 to 320 cc of fat was infiltrated in the upper gluteal area. During the second period (February of 2004 to February of 2006), 210 to 460 cc of fat was infiltrated in the upper and lower gluteal area. In the third period (March of 2006 to March of 2009), 220 to 1160 cc of fat was infiltrated in the aforementioned areas and in the trochanteric and subgluteal areas. Complications such as fat necrosis, gluteal erythema, infection, and fat embolism syndrome were more frequent and serious in the first stage, despite the authors having infiltrated smaller volumes. CONCLUSIONS: Increasing the volume of fat infiltration in the buttocks has resulted in better contour results in the whole area, and distribution of that larger volume in more extensive areas and in different layers has decreased the index and number of complications. Therefore, to obtain better aesthetic results, it is necessary to keep in mind that these larger amounts must be distributed in larger areas and layers to decrease postsurgical morbidity. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.

Aesthetic plastic surgery training at the Jalisco Plastic and Reconstructive Surgery Institute: a 20-year review.

BACKGROUND: Teaching aesthetic surgery within the different training programs worldwide sometimes presents significant challenges. The main difficulty lies in providing resident physicians with sufficient exposure to all of the conditions that they will likely encounter once their training ends. In many places, exposure to a totally comprehensive array of operations is almost nonexistent. METHODS: To analyze the work that residents perform in aesthetic surgery at the Instituto Jalisciense de Cirugía Reconstructiva "José Guerrerosantos" (Jalisco Plastic and Reconstructive Surgery Institute), a hospital affiliated with the University of Guadalajara in Jalisco, Mexico, the surgical records of 30 residents who finished their plastic surgery training between 1990 and 2009 were chosen at random and reviewed retrospectively. Only surgical procedures performed in operating rooms, in which residents acted as the primary surgeon or first assistant, were analyzed. RESULTS: Each resident performed an average of 309 aesthetic surgical procedures: 167 as surgeon and 142 as first assistant. The surgical procedures were divided into three general categories: body contouring procedures, breast procedures, and facial procedures. The numbers of procedures performed by residents as surgeons or first assistants according to each category were 55 and 37 (body contouring), 34 and 31 (breast), and 78 and 74 (facial). CONCLUSIONS: The experience is gratifying. At the Jalisco Plastic and Reconstructive Surgery Institute, all residents have an opportunity to perform a comparable number of aesthetic procedures of the most varied nature and complexity under the supervision of experienced plastic surgeons. It is therefore possible to teach aesthetic surgery to residents.

Behavior of visfatin in nonobese women undergoing liposuction: a pilot study.

INTRODUCTION: The adipocyte has recently begun to be considered not just as a fat deposition tissue, but also as a true endocrine organ. Adipose tissue produces a wide variety of adipocytokines, of which visfatin is one. OBJECTIVE: Since visfatin has recently been described as a mimic of insulin action, the authors evaluate visfatin behavior in women undergoing liposuction. MATERIALS: Nineteen nonobese women underwent liposuction of abdominal fat. Patient visfatin levels and a lipid profile were obtained preoperatively, and the results were compared with the results of the same tests immediately postoperatively and one month postoperatively. RESULTS: The mean age of the 19 study participants was 33 years; mean body mass index was 24.7±2.2 kg/m2. The amount of subcutaneous fat obtained was an average of 4468±1403 kg. Visfatin increased from 51.8±24.4 ng/mL preoperatively to 76.3±39.8 ng/mL (P=.02). Pre- and postoperative lipid profiles reflected, respectively, the following: total cholesterol, 159.1±37.1 vs 164.6±31.7 mg/dL (P=.420); high-density cholesterol, 41.4±8.6 vs 39.3±9.9 mg/dL (P=.421); low-density cholesterol, 97.1±25.4 vs 100±19.2 mg/dL (P=.507); and triglycerides, 92.3±57.1 vs 126.3±72.5 mg/dL (P=.058). CONCLUSIONS: Visfatin levels were shown to increase after liposuction of subcutaneous fat. The authors conclude that this adipocyte may play an important role as a regulatory reciprocal mechanism.

Behavior of insulin sensitivity and its relation to leptin and tumor necrosis factor-alpha in obese women undergoing liposuction: 6-month follow-up.

BACKGROUND: Metabolic syndrome is a group of pathological processes which involve insulin resistance, a biochemical and molecular disorder. Obesity appears to be the most frequent clinical component in metabolic syndrome. Subcutaneous fat, independent from visceral fat, is still controversial as a marker of the pathophysiology of insulin resistance. METHODS: An open parallel-group clinical trial was performed of 12 women (age 30-40 years), with BMI from 30-33 kg/m2 and fasting glucose < or =110 mg/dl. 6 women were included in the "liposuction plus diet" group, and 6 were included in the "diet-only" group. Metabolic profile, including insulin tolerance test (ITT), leptin and tumor necrosis factor alpha (TNFalpha), was performed at baseline, 1 and 6 months in both groups. Subcutaneous and visceral fat was quantified with spiral tomography at baseline and after 6 months. Friedman and Wilcoxon test were used for intra-group differences, Mann-Whitney U for differences between groups, and Spearman test for correlation, with significance set at P<0.05. RESULTS: No difference existed between groups regarding clinical characteristics and metabolic profile. In the liposuction group, the increase in insulin sensitivity was (3.8+/-0.86, 3.1+/-0.85, 4.5+/-1.02 %/min, P=0.08. Insulin sensitivity did not correlate with subcutaneous fat, leptin, or TNFalpha. Leptin diminished at 1 month (52.7+/-6.04 vs 31.6+/-11.9), P=0.028, and correlated with the subcutaneous fat (r=0.957). In the diet-only group, TNFalpha diminished at 6 months, P=0.046. CONCLUSION: Subcutaneous abdominal fat correlates with leptin; nevertheless, it is a weak marker for TNFalpha and insulin sensitivity.

Dehydroepiandrosterone behavior and lipid profile in non-obese women undergoing abdominoplasty.

BACKGROUND: The aim of this study was to determine any change in dehydroepiandrosterone (DHEA) and lipid profile in non-obese women after abdominoplasty. METHODS: An auto-controlled clinical trial was carried out. 9 women aged 35 to 40 years with BMI 22-25 kg/m2 were studied. Basal lipid profile and DHEA were performed and repeated 1 month postoperatively. Statistical analysis used Wilcoxon signed-ranks test (two-tailed). RESULTS: Weight of resected specimen was 606.11 +/- 143.4 grams. No significant changes were observed in high-density cholesterol (48.0 +/- 9.6 vs 48.8 +/- 11.0 mg/dl; P=0.106) or in triglycerides (119.2 +/- 50.9 vs 148.4 +/- 45.8 mg/dl; P = 0.139). Significant increases were obtained in DHEA (3.69 +/- 3.05 vs 11.09 +/- 6.3 ng/ml; P<0.008), low-density cholesterol (LDL) (87.4 +/- 23.5 vs 108.5 +/- 28.3 mg/dl; P<0.008 and total cholesterol (155.1 +/- 30.6 vs 186.6 +/- 33.1 mg/dl; P<0.008). CONCLUSION: Excision of subcutaneous abdominal fat in studies 1 month later increased DHEA, whose role is controversial in visceral fat distribution, and increased LDL cholesterol and total cholesterol, both risk markers for cardiovascular illness.

Effect of surgically removing subcutaneous fat by abdominoplasty on leptin concentrations and insulin sensitivity.

The aim of this study was to identify the effect of surgically removing subcutaneous fat by abdominoplasty on leptin concentrations and insulin sensitivity. An open clinical trial with a noninterventional parallel group was carried out in 12 obese women. After randomization, 6 volunteers were selected for abdominoplasty, and the other 6 women were considered as the noninterventional group. A metabolic profile, including leptin concentrations, and insulin tolerance test to assess insulin sensitivity were performed on all volunteers before intervention or nonintervention and 40-50 days afterward. A significant reduction in body mass index (30.7 +/- 0.9 versus 29.6 +/- 0.7 kg/m; P = 0.02) and in leptin concentrations (41.3 +/- 10.6 versus 32.0 +/- 10.2 ng/mL; P = 0.02) was observed after abdominoplasty. Insulin sensitivity did not change after intervention. In conclusion, surgically removing subcutaneous fat by abdominoplasty decreased leptin concentrations, with no change in insulin sensitivity.

Heating infiltration solutions used in tumescent liposuction: minimizing surgical risk.

BACKGROUND: Liposuction, one of the most common operations performed by plastic surgeons, is not free of complications. One of the most common factors is patient hypothermia, a factor little studied but one capable of producing severe arrhythmias and cardiac arrest. A comparative clinical study was conducted to determine what effect using tumescent infiltration solutions at room temperature and at body temperature has on vital signs. METHODS: Two similar groups of 15 healthy female subjects were studied. In the first group (group A), subcutaneous solutions were infiltrated at room temperature (24 degrees C), and in the second group (group B), solutions were infiltrated at body temperature (37 degrees C). Vital signs (i.e., heart rate, respiratory rate, temperature, and blood pressure) were monitored every 15 minutes until the basal vital signs were attained. Variables such as age, body mass index, infiltrated and aspirated liquids, and surgery time were very similar for both groups. RESULTS: Although there were differences in heart rate, respiratory rate, and arterial pressure, they were not statistically significant. Nevertheless, the differences between groups A and B for body temperature (34.9 +/- 1.1 degrees C versus 35.7 +/- 1.3 degrees C, respectively) and for the time necessary to attain basal vital signs (120 +/- 8 minutes versus 69 +/- 4 minutes, respectively) were statistically significant (p < 0.05). CONCLUSIONS: Despite the existence of a significant change in the body temperature in healthy female subjects during manipulation of the temperature of the infiltration solution, this change had no important effect on the intraoperative hemodynamic values. Nevertheless, it could have a more significant effect on patients with greater surgical risk.

Modification of insulin, glucose and cholesterol levels in nonobese women undergoing liposuction: is liposuction metabolically safe?

An open autocontrolled clinical study was performed on 15 healthy nonobese women who underwent liposuction to establish how metabolic profiles are modified in the short-term postsurgical period. Preoperative glucose, insulin, and cholesterol levels were determined. Also, impedancometry was used to determinate body composition. After 3 postoperative weeks, the levels and determinations were again tested. The results demonstrated a significant difference in glucose, cholesterol, insulin secretion, and adiposity, but insulin levels, glucose-insulin relationship, and insulin sensitivity remained unaltered. From the results of this study, we consider liposuction to be a safe surgical procedure from a metabolic point of view because it improves the levels of cholesterol, glucose, and insulin secretion and at the same time decreases adiposity. Therefore, in the short term, liposuction can modify important markers for the development of type II diabetes mellitus and cardiovascular disease.