Friday, April 27, 2012

Where does sucked out fat go?

Liposuction is a surgical procedure that involves the local removal of relatively small volumes of fat.When the procedure was first initiated, overenthusiastic surgeons tended to remove too much fat, resulting in a few severe side effects, including death.But over the years, liposuction, also known as "lipoplasty," has been perfected so that in the hands of a competent surgeon, it's a safe procedure.The most common areas worked on are the thighs, abdomen, and buttocks.Removing too much fat is not only dangerous, but can often lead to an unsightly dimpled look that makes you appear to have developed a new case of cellulite.In the past, some people have had as much as 50 pounds of fat removed. One of the early pioneers of liposuction, a French surgeon, screwed up the procedure on a French model, resulting in the model getting gangrene.The modern version of liposuction was also developed by a French surgeon in 1982.Today, liposuction is the most common plastic surgery procedure.
     Contrary to popular belief,liposuction is not a substitute for exercise and diet.In fact, it's suggested that obese people are not candidates for liposuction.Instead, it's more of a contouring procedure to help get rid of stubborn  fat  deposits that are said to be resistant to diet and exercise. In fact, it's still an easy way out, since exercise and diet is capable of reducing all excess fat if patience is part of the equation.
      People who are considering liposuction are often told by doctors that fat removed will not return, at least not in the area "sucked." But a recent study of women who had the procedure found that upper body fat returned within six months of the surgery. Some speculate that the sudden removal of fat triggers a compensatory effect in the body, triggering feedback mechanisms that result in a regain of lost fat. Indeed, in animals, fat that is surgically removed does return within a short time.What happens here is that fat stores in other areas of the body enlarge to compensate for the fat removed in another area.
     A recent study examined what happens to women who have had abdominal liposuction. The subjects consisted of 36 women, who two months after the surgery were randomly assigned to either an exercise group or a group that did not exercise. Those in the exercise group worked out for four months on a program that included three times a week of weight-training, followed by 30-40 minutes of aerobics done on a treadmill at an intensity level of 75% of maximum oxygen intake.The food intake didn't differ between the two groups.The study lasted six months. During that time, genes in the thighs that are related to fat regain decreased 50% only in the exercise group.Those who didn't exercise showed a compensatory gain of fat in the visceral or deep-lying fat stores in the abdomen. The subcutaneous or just under the skin fat stores, which were removed during the liposuction, didn't change. Visceral fat is considered the most dangerous of all bodyfat stores because it's linked to the onset of diabetes and cardiovascular disease.Those in the non-exercise group didn't show any compensatory fat gains in their thighs or pelvis. Note that this occurred  six months after the liposuction. Since the study authors didn't measure upper body fat, whether the women gained fat in their upper bodies wasn't known.
    The study authors think that the increase in bodyfat that happens after liposuction may be the result of a decreased energy expenditure triggered by the loss of fat. They base this on the findings of no changes in the amount of food consumed, lean mass, or leptin levels in the untrained women. The story was different in the women who exercised. The exercise totally prevented any apparent fat regain, including in the visceral fat area. Other studies have illustrated that exercise is particularly effective in reducing visceral fat stores. The exercise clearly eliminated the decreased energy expenditure that normally occurs after liposuction.The lean mass gain alone from lifting weights is enough to counter this problem.Those in the exercise group also showed beneficial changes in insulin sensitivity, as well as strength and aerobic conditioning.
     This study involved women who were not  obese, so the findings are not applicable to obese women.But obesity is considered a contraindication of liposuction, anyway. Based on these findings, it would seem to be e prudent idea for women--and men--to ensure that they engage in regular exercise that features both strength and aerobic components following liposuction procedures.


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Benatti, F,et al. Liposuction induces a compensatory increase of visceral fat which is effectively counteracted by physical activity: A randomized trial.J Clin Endocrin Metab 2012: in press.
©,2012, Jerry Brainum.Any reprinting in any type of media, including electronic and foreign is expressly prohibited.

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