Dr. Giese's excellent literature review clearly makes her point that large-volume liposuction (LVL) does have a metabolic effect on overweight and obese women. Her pioneering work showed a substantial improvement in cardiovascular risk profiles.1, 2 It showed that not only did her standardized group of young women have an initial weight loss, but that it was sustained for two years in follow-up. Few obesity treatments, diets and other programs have such an outstanding record. Further studies are needed to better delineate those patients that will benefit from the safe, rapid removal of subcutaneous fat. While she mentions the Kline study (reference number 14 in her review) she does not mention that none of those patients actually had LVL. The patients were not standardized, and the study only went for 12 weeks. Clearly, if someone is 100 pounds overweight, and you only remove 10 pounds of subcutaneous fat, it will not have a significant difference in any measurable perimeter, whereas if they weigh 200 pounds and you remove 30 pounds, that can have a profound effect. While she mentions that "once is not enough," she does not include the possibility of serial suction and/or surgery whereby a maximum safe amount could be removed, wait six weeks, remove another safe amount, wait six weeks, remove another safe amount, and this could be continued until one reaches their desired size.3Respectfully submitted, Robert A. Ersek, M.D., F.A.C.S. 1 Giese S. The Metabolic Advantage of Liposuction. 2nd University of Naples: Naples, Italy; November 2005. 2 Giese S. Updates in Large Volume Liposuction—The Metabolic Advantage. Lenox Hill Hospital Plastic Surgery Rounds: New York, NY; October 2006. 3 Ersek RA, Salisbury M, Girling VR. Sequential (Serial) Suction. Clin Plast Surg. 2006;33:75-77. |
