IPRAS

S U R V E Y SHonoured with the award of “Ivo Pitanguy”during the 48th Brazilian congress of plastic surgeryLiposuction induces a compensatory increase of visceralfat which is effectively counteracted by physical activityAuthor: Eduardo Montag aSub-authors: Fabiana Braga Benatti b ; Fábio Lopes Saito a ; RolfGemperli a ; Antonio Herbert Lancha Junior ba) Division of Plastic Surgery and Breast Surgery Group,University of São Paulo School of Medicineb) School of Physical Education and Sport –University of Sao PauloLiposuction is one of the most popular aesthetic surgeriesperformed worldwide, but its long-term impact on bodycomposition and on the metabolic profile remains unclear.It has been speculated that the immediate decrease in bodyfat may trigger feedback mechanisms of body-fat regain.In several species, surgical fat removal is accompanied byfat regain within a few weeks, mostly due to compensatoryfat growth in the intact depots. Recent data has confirmedthat women undergoing liposuction gain upper-bodyfat within six months, which may be associated withincreased cardiovascular risk. Importantly, no studyof the long-term effects of liposuction has controlledfor the subjects’ physical activity levels which may beconsidered an important confounder because exerciseper se is believed to improve body composition. Thus,the purpose of this study was to investigate the effectsof small-volume abdominal liposuction on body fatdistribution in normal-weight women, who were eitherexercise-trained or not after surgery. We hypothesizedthat liposuction surgery would cause body-fat regain inphysically inactive subjects, whereas a supervised exercisetraining program would counteract such detrimentaloutcomes. A six-month randomized controlled trial wasconducted. Thirty-six women underwent a small-volumeabdominal liposuction (20 to 35 years old; BMI: 23,8 ±2.2 Kg/m2). Two months after surgery, the subjects wererandomly allocated into one of the two groups (trained,T, n=18; or non-trained, NT, n=18). Trained subjectsundertook a four-month exercise program. Non-trainedsubjects remained physically inactive throughout thestudy period. Prior to the intervention (PRE), immediatelybefore the beginning of the exercise program (i.e., twomonths after surgery, or POST2) and at the end of thestudy (POST6), food intake and body composition wereassessed. Energy expenditure, dynamic strength andaerobic fitness were assessed at PRE and POST6. POST6 assessments were performed 60 to 72 hours after thelast training session in the trained group. Subjects wereinstructed to maintain their food intake pattern throughoutthe study. Liposuction was effective in reducing bodyweight, fat mass, and subcutaneous abdominal fat (SAT)(PRE vs. POST2, p=0.0001). Despite the sustained SATdecrease at POST6 (p=0.0001), body weight returned tobaseline values in both groups. The NT group showeda significant 10% increase in visceral fat (p=0.04) anddecreased energy expenditure (p=0.01) when comparedwith TR. TR showed an increased fat-free mass (p=0.03)and improved physical capacity (p