Short- and Long-Term Effects of Abdominal Lipectomy on Weight and Fat Mass in Females: a Systematic Review.

Adipose tissue is considered as an endocrine organ, which is developed in specific depots, distinguished either as subcutaneous or visceral. Lipectomy, by means of liposuction or abdominoplasty, is a common plastic surgery procedure, which can remove substantial amounts of subcutaneous fat. This systematic review aims to evaluate the impact of surgical removal of abdominal subcutaneous adipose tissue on body weight and fat mass in females in the short- and long-term. A systematic review was conducted using a predetermined protocol established according to the Cochrane Handbook's recommendations. PubMed, Scopus, CENTRAL, and the Cochrane Library were searched from inception to December 2014. Eligible studies were prospective studies with ≥1 month of follow-up that included female only individuals who underwent lipectomy of the abdominal region and reported on body weight, body mass index (BMI), or fat mass. Ten studies were included in this systematic review with a total of 231 individuals. A significant weight loss and BMI improvement were reported in 4 out of 5 studies with a mean follow-up of 1-2 months, but in none of the 5 studies with a longer follow-up (3-20 months). Fat mass showed a similar to weight change. The risk of bias was low for the two clinical trials but high for the observational studies included in the review. This systematic review revealed only a transient effect of abdominal lipectomy in body fat and weight in women, which fades a few months after the operation. These results corroborate the evidence from experimental and clinical studies, which support fat redistribution and compensatory fat growth, as a result of feedback mechanisms, triggered by fat removal. Additional clinical studies, with adequate follow-up, may further elucidate the long-term effects of abdominal lipectomy in body weight and composition. Systematic review registration PROSPERO CRD42015017564 ( www.crd.york.ac.uk/PROSPERO ).