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Times Of India.
07 Aug 2012

Pune: Doctors at a city hospital recently performed liposuction on a 45–year–old Yemeni woman, weighing 130 kg, and removed 24.5 kg fat from her body in one sitting.

In usual liposuction (surgical withdrawal of excess fat from local areas under the skin by means of a small incision and vacuum suctioning), doctors remove fat weighing 10% of the total weight of the body. Removal of more fat is done only in cases with medically valid reasons and requires full medical back up and a cosmetic surgeon experienced in large volume fat reduction.

The doctors who performed the procedure here claimed that this was perhaps for the first time in Pune that fat in such a large volume was removed.

"The 5.5 ft tall woman had undergone a gastric bypass (bariatric surgery) around five years ago. But, after two years, she started gaining weight again. She was having problems in her knee and was unable to walk. Since her diet was semi–solid, she had a lot of gastric complaints also. She came to India to find relief," said consultant plastic and cosmetic surgeon Sumit Saxena who had carried out the fat removal procedure at Inamdar hospital on July 19.

The woman was discharged after five days. There was significant reduction in problems like knee pain and friction in the thighs, with good improvement in her quality of life.

The usual side–effects of massive liposuction such as skin infection and skin loosening were managed with appropriate medical care. "Besides skin loosening, the patient encountered no other sideeffects," Saxena said.

Removal of massive quantity of fat from one area usually results in the skin becoming loose. Hence, to remove the excess skin and tighten the area doctors had to perform abdominoplasty on the patient.

"Aspiration of more than 10 kg fat in one sitting is termed massive liposuction. The proportion of massive liposuctions being performed is increasing worldwide as it is now considered a safe procedure in well trained hands. Up to 20 kg fat can be aspirated in one sitting in well–selected cases and in a hospital setting with good infrastructure," Saxena said.

Massive liposuction is not a surgery to be undertaken in small clinics or nursing homes. It is probably better done under general anesthesia as most of these cases require circumferential liposuction, he added.

"During liposuction procedure, the patient is anesthetized and injected a tumescent solution. Then fat cells suctioned out of the body with a cannula inserted through incisions in the skin. Patients may be sore and bruised for several days to weeks afterward," Saxena said, adding, "Results are permanent on the treated areas as long as patients maintain stable weight."

Anesthetists Nikhil Hiremath and Anmol Maindarkar were part of the team that conducted the procedure.

Bariatric surgery is advisable in patients with extremely morbid obesity. "Massive liposuction offers a safe alternative as, unlike bariatric surgery, this procedure does not interfere with the patient’s normal physiology. But maintaining a healthy lifestyle is must after undergoing the procedure," Saxena said.

After the operation, most people can return to work within a week and begin light exercise in around two weeks. Studies report that the operation could produce significant decrease in systolic blood pressure, fasting insulin levels and total body weight that could possibly improve the patient’s cardiovascular risk profile.

Research suggests that the metabolic benefits of weight loss come from losing fat throughout the body, including areas like the tissues of the heart, pancreas and liver. Removing localised fat deposits may or may not be as beneficial.

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