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Dr. Barry Eppley

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Does Large Volume Liposuction Have Medical Benefits?


Liposuction is a well known subcutaneous fat removing technique that has proven to be very effective. It can be so effective that large volume liposuction became commonly practiced until its potential adverse effects and complication rates came to light and safe amounts of maximum removal became established. (5 liters) While not a weight loss technique, removal of large fat amounts does raise the question of whether it may have medical benefits as well. Since fat is a very metabolically active tissue does its reduction have any positive benefits on metabolic and cardiovascular health.

In the December 2017 issue of the Annals of Plastic Surgery an article was published entitled ‘Influence of Large-Volume Liposuction on Metabolic and Cardiovascular Health: A Systematic Review’. In this review paper the authors looked at published reports of studies where large volume liposuction was performed (as defined as greater than 3.5 liters) as well as patient’s cardiovascular risk factors, inflammatory cytokines and insulin resistance/sensitivity measured. Twelve (12) studies were identified that were prospectively conducted. A total of over 350 patients were included in these studies of which the mean body mass was around 30. The mean volume of fat removed was over 7 liters. Seven of the studies showed a decrease in total cholesterol levels with an overall mean reduction of 0.2  mmol/L from 4.6 to 4.4 mmol/L. Leptin was shown to significantly decrease in 4 studies, and TNF-? was reported to be lower in  two studies. Adiponectin was show to significantly increase in two studies. IL-6 in two studies. Most of the studies evaluated insulin sensitivity, two included patients with type II diabetes. Six of the ten studies reported improvement in insulin sensitivity.

Ultimately the question being posed/studied is whether liposuction improves one’s health? Does removing a large volume of fat in a very short period of time have medical benefits? It is tempting to think (hope) so. But the evidence to support that contention is tenuous at best. Some of these studies offer conflicting data or positive changes that are relatively small. Certainly an immediate reduction in one’s fat volume would improve some of the metabolic markers studied. But whether those changes lead to a lower risk of cardiovascular disease or the need for less insulin in diabetics remains to be definitively proven. These potential benefits must be weighed against the risks of surgery which are increased in these larger volume liposuction patients.

Dr. Barry Eppley

Indianapolis, Indiana

Dr. Barry EppleyDr. Barry Eppley

Dr. Barry Eppley is an extensively trained plastic and cosmetic surgeon with more than 20 years of surgical experience. He is both a licensed physician and dentist as well as double board-certified in both Plastic and Reconstructive Surgery and Oral and Maxillofacial Surgery. This training allows him to perform the most complex surgical procedures from cosmetic changes to the face and body to craniofacial surgery. Dr. Eppley has made extensive contributions to plastic surgery starting with the development of several advanced surgical techniques. He is a revered author, lecturer and educator in the field of plastic and cosmetic surgery.

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