Aesthetic Plastic Surgery

, Volume 38, Issue 5, pp 1050–1056 | Cite as

Metabolic Effects of Large-Volume Liposuction for Obese Healthy Women: A Meta-Analysis of Fasting Insulin Levels

  • Filippo BorianiEmail author
  • Riccardo Villani
  • Paolo Giovanni Morselli
Review Experimental/Special Topics



Obesity is increasingly frequent in our society and is associated closely with metabolic disorders. As some studies have suggested, removal of fat tissue through liposuction and dermolipectomies may be of some benefit in the improvement of metabolic indices. This article aimed to review the published literature on this topic and to evaluate metabolic variations meta-analytically after liposuction, dermolipectomy, or both.


Through a literature search with the PubMed/Medline database, 14 studies were identified. All articles were analyzed, and several metabolic variables were chosen in the attempt to meta-analyze the effect of adipose tissue removal through the various studies. All statistical calculations were performed with Review Manager (RevMan), version 5.0.


Several cardiovascular and metabolic variables are described as prone to variations after body-contouring procedures when a significant amount of adipose tissue has been excised. Four of the studies included in the analysis reported improvements in all the parameters examined. Seven articles showed improvement in some variables and no improvement in others, whereas three studies showed no beneficial variation in any of the considered indicators after body-contouring procedures. Fasting plasma insulin was identified as the only variable for which a meta-analysis of five included studies was possible. The meta-analysis showed a statistically significant reduction in fasting plasma insulin resulting from large-volume liposuction in obese healthy women.


Many beneficial metabolic effects resulting from dermolipectomy and liposuction procedures are described in the literature. In particular, fasting plasma insulin and thus insulin sensitivity seem to be positively influenced. Further research, including prospective clinical studies, is necessary for better exploration of the effects that body-contouring plastic surgery procedures have on metabolic parameters.

No Level Assigned

This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors


Obesity Large-volume liposuction Dermolipectomy Metabolic disorders Adipose tissue removal Body-contouring procedures 


Conflict of interest

The authors declare that they have no conflict of interest to disclose. No financial or material support has been received


  1. 1.
    Dandona P, Aljada A, Bandyopadhyay A (2004) Inflammation: the link between insulin resistance, obesity, and diabetes. Trends Immunol 25:4–7PubMedCrossRefGoogle Scholar
  2. 2.
    Rashid MN, Fuentes F, Touchon RC, Wehner PS (2003) Obesity and the risk for cardiovascular disease. Prev Cardiol 6:42–47PubMedCrossRefGoogle Scholar
  3. 3.
    Bouchard C, Bray GA, Hubbard VS (1990) Basic and clinical aspects of regional fat distribution. Am J Clin Nutr 52:946–950PubMedGoogle Scholar
  4. 4.
    Gasteyger C, Tremblay A (2002) Metabolic impact of body fat distribution. J Endocrinol Invest 25:876–883PubMedCrossRefGoogle Scholar
  5. 5.
    Kalkhoff RK, Hartz AH, Rupley D, Kissebah AH, Kelber S (1983) Relationship of body fat distribution to blood pressure, carbohydrate tolerance, and plasma lipids in healthy obese women. J Lab Clin Med 102:621–627PubMedGoogle Scholar
  6. 6.
    Ohlson LO, Larsson B, Svärdsudd K, Welin L, Eriksson H, Wilhelmsen L, Björntorp P, Tibblin G (1985) The influence of body fat distribution on the incidence of diabetes mellitus: 13.5 years of follow-up of the participants in the study of men born in 1913. Diabetes 34:1055–1058PubMedCrossRefGoogle Scholar
  7. 7.
    Widgren BR, Urbanavicius V, Attvall S, Persson B (1994) Insulin sensitivity is more related to fat distribution than to heredity for hypertension in normotensive men. Metabolism 43:883–886PubMedCrossRefGoogle Scholar
  8. 8.
    Matarasso A, Hutchinson OH (2001) Liposuction. JAMA 285:266–268PubMedCrossRefGoogle Scholar
  9. 9.
    Stroup DF, Berlin JA, Morton SC et al (2000) Meta-analysis of observational studies in epidemiology: a proposal for reporting. JAMA 283:2008–2012PubMedCrossRefGoogle Scholar
  10. 10.
    Giugliano G, Nicoletti G, Grella E, Giugliano F, Esposito K, Scuderi N, D’Andrea F (2004) Effect of liposuction on insulin resistance and vascular inflammatory markers in obese women. Br J Plast Surg 57:190–194PubMedCrossRefGoogle Scholar
  11. 11.
    Cazes L, Deitel M, Levine RH (1996) Effect of abdominal lipectomy on lipid profile, glucose handling, and blood pressure in patients with truncal obesity. Obes Surg 6:159–166PubMedCrossRefGoogle Scholar
  12. 12.
    Rizzo MR, Paolisso G, Grella R, Barbieri M, Grella E, Ragno E, Grella R, Nicoletti G, D’Andrea F (2005) Is dermolipectomy effective in improving insulin action and lowering inflammatory markers in obese women? Clin Endocrinol Oxf 63:253–258PubMedCrossRefGoogle Scholar
  13. 13.
    Swanson E (2011) Prospective clinical study reveals significant reduction in triglyceride level and white blood cell count after liposuction and abdominoplasty and no change in cholesterol levels. Plast Reconstr Surg 128:182e–197ePubMedCrossRefGoogle Scholar
  14. 14.
    González-Ortiz M, Robles-Cervantes JA, Cárdenas-Camarena L, Bustos-Saldaña R, Martínez-Abundis E (2002) The effects of surgically removing subcutaneous fat on the metabolic profile and insulin sensitivity in obese women after large-volume liposuction treatment. Horm Metab Res 34:446–449PubMedCrossRefGoogle Scholar
  15. 15.
    Samdal F, Birkeland KI, Ose L, Amland PF (1995) Effect of large-volume liposuction on sex hormones and glucose and lipid metabolism in females. Aesthet Plast Surg 19:131–135CrossRefGoogle Scholar
  16. 16.
    Ybarra J, Blanco-Vaca F, Fernández S, Castellví A, Bonet R, Palomer X, Ordóñez-Llanos J, Trius A, Vila-Rovira R, Pérez A (2008) The effects of liposuction removal of subcutaneous abdominal fat on lipid metabolism are independent of insulin sensitivity in normal-overweight individuals. Obes Surg 18:408–414PubMedCrossRefGoogle Scholar
  17. 17.
    Davis DA, Pellowski DM, Davis DA, Donahoo WT (2006) Acute and 1-month effect of small-volume suction lipectomy on insulin sensitivity and cardiovascular risk. Int J Obes London 30:1217–1222CrossRefGoogle Scholar
  18. 18.
    Hernandez TL, Kittelson JM, Law CK, Ketch LL, Stob NR, Lindstrom RC, Scherzinger A, Stamm ER, Eckel RH (2011) Fat redistribution following suction lipectomy: defense of body fat and patterns of restoration. Obes Silver Spring 19:1388–1395. doi: 10.1038/oby.2011.64 CrossRefGoogle Scholar
  19. 19.
    Klein S, Fontana L, Young VL, Coggan AR, Kilo C, Patterson BW, Mohammed BS (2004) Absence of an effect of liposuction on insulin action and risk factors for coronary heart disease. N Engl J Med 350:2549–2557PubMedCrossRefGoogle Scholar
  20. 20.
    Hu G, Qiao Q, Tuomilehto J, Eliasson M, Feskens EJ, Pyörälä K, DECODE Insulin Study Group (2004) Plasma insulin and cardiovascular mortality in nondiabetic European men and women: a meta-analysis of data from eleven prospective studies. Diabetologia 47:1245–1256PubMedGoogle Scholar
  21. 21.
    Giese SY, Bulan EJ, Commons GW, Spear SL, Yanovski JA (2001) Improvements in cardiovascular risk profile with large-volume liposuction: a pilot study. Plast Reconstr Surg 108:510–519; discussion 520–521PubMedCrossRefGoogle Scholar
  22. 22.
    Giese SY, Neborsky R, Bulan EJ, Spear SL, Yanovski JA (2001) Improvements in cardiovascular risk profile after large-volume lipoplasty: a 1-year follow-up study. Aesthet Surg J 21:527–531PubMedCrossRefGoogle Scholar
  23. 23.
    Busetto L, Bassetto F, Zocchi M, Zuliani F, Nolli ML, Pigozzo S, Coin A, Mazza M, Sergi G, Mazzoleni F, Enzi G (2008) Effects of the surgical removal of subcutaneous adipose tissue on energy expenditure and adipocytokine concentrations in obese women. Nutr Metab Cardiovasc Dis 18:112–120 Epub 30 March 2007PubMedCrossRefGoogle Scholar
  24. 24.
    D’Andrea F, Grella R, Rizzo MR, Grella E, Grella R, Nicoletti G, Barbieri M, Paolisso G (2005) Changing the metabolic profile by large-volume liposuction: a clinical study conducted with 123 obese women. Aesthetic Plast Surg 29:472–478; discussion 479–480, 481PubMedCrossRefGoogle Scholar
  25. 25.
    Mohammed BS, Cohen S, Reeds D, Young VL, Klein S (2008) Long-term effects of large-volume liposuction on metabolic risk factors for coronary heart disease. Obes Silver Spring 16:2648–2651CrossRefGoogle Scholar
  26. 26.
    Eckel RH, Grundy SM, Zimmet PZ (2005) The metabolic syndrome. Lancet 365:1415–1428. Neuhauser HK (2005) The metabolic syndrome. Lancet 366:1922–1923; author reply 1923–1924Google Scholar
  27. 27.
    Benatti FB, Lira FS, Oyama LM, do Nascimento CM, Jr Lancha AH (2011) Strategies for reducing body fat mass: effects of liposuction and exercise on cardiovascular risk factors and adiposity. Diabetes Metab Syndr Obes 4:141–154PubMedCrossRefPubMedCentralGoogle Scholar
  28. 28.
    Balagué N, Combescure C, Huber O, Pittet-Cuénod B, Modarressi A (2013) Plastic surgery improves long-term weight control after bariatric surgery. Plast Reconstr Surg 132:826–833PubMedCrossRefGoogle Scholar
  29. 29.
    Datta G, Boriani F, Obbialero FD, Verga M (2006) Body contouring after weight loss in morbid obesity: gain in health and leap in psychosocial functioning. Obes Surg 16:673PubMedCrossRefGoogle Scholar
  30. 30.
    Datta G, Cravero L, Margara A, Boriani F, Bocchiotti MA, Kefalas N (2006) The plastic surgeon in the treatment of obesity. Obes Surg 16:5–11PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York and International Society of Aesthetic Plastic Surgery 2014

Authors and Affiliations

  • Filippo Boriani
    • 1
    • 3
    Email author
  • Riccardo Villani
    • 2
    • 3
  • Paolo Giovanni Morselli
    • 2
    • 3
  1. 1.Laboratory of Orthopaedic Pathophysiology and Regenerative Medicine & First DepartmentRizzoli Orthopaedic InstituteBolognaItaly
  2. 2.Department of Plastic SurgeryS. Orsola HospitalBolognaItaly
  3. 3.Alma Mater StudiorumUniversity of BolognaBolognaItaly

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