Evidence from epidemiologic and experimental studies has shown that regular exercise protects against the development and progression of numerous diseases such as heart diseases, diabetes, and obesity. The beneficial effects of exercise are well known. This innovation, together with the knowledge that adipose tissue is a very metabolically active organ, 3 led scientists to believe that liposuction could be a viable method for improving metabolic profile through the immediate loss of body fat mass, thus functioning as a possible coadjuvant in the treatment of obesity and comorbidities. 2 The development of the tumescent technique allowed the removal of greater amounts of fat in a much safer environment. It was only in 1987, however, that Jeffrey Klein innovated the field by developing the tumescent technique, which eliminated the high risk of excessive bleeding that is usually observed during liposuction surgeries, making it a much safer procedure. The field of modern liposuction was initiated in 1974 by Arpad and Giuliano Fischer in Italy. However, all of these techniques resulted in undesirable hematomas and/or scars. During subsequent years, other physicists and scientists developed different techniques to remove subcutaneous body fat. The disastrous outcome was the amputation of the dancer’s leg. The first attempt was performed in France in 1921, when Charles Dujarrier removed the subcutaneous fat of the calves and knees of a female dancer using a uterine curette. The idea of the surgical removal of body fat mass from specific regions of the body is not recent. Consequently, one could suggest that liposuction and exercise appear to be safe and effective strategies for either the treatment of metabolic disorders or aesthetic purposes. Nonetheless, one could suggest that exercise training associated with liposuction could attenuate or even block the possible compensatory fat deposition in intact depots or regrowth of the fat mass and exert an additive or even a synergistic effect to liposuction on improving insulin sensitivity and the inflammatory balance, resulting in an improvement of cardiovascular risk factors. To our knowledge, no studies have reported the associated effects of liposuction and exercise in humans. Thus, liposuction and exercise appear to directly affect metabolism in similar ways, which suggests a possible interaction between these two strategies. Exercise training improves insulin sensitivity, inflammatory balance, lipid oxidation, and adipose tissue distribution increases or preserves the fat-free mass and increases total energy expenditure. In addition, animal studies have demonstrated a compensatory growth of intact adipose tissue in response to lipectomy, although studies with humans have reported inconsistent results. The results of studies investigating the effects of liposuction on the metabolic profile are inconsistent, however, with most studies reporting either no change or improvements in one or more cardiovascular risk factors. However, the immediate liposuction-induced increase in the proportion of visceral to subcutaneous adipose tissue could be detrimental to metabolism, because a high proportion of visceral to subcutaneous adipose tissue is associated with risk factors for cardiovascular disease. Evidence showing that adipose tissue is a metabolically active tissue has led to the suggestion that liposuction could be a viable method for improving metabolic profile through the immediate loss of adipose tissue. Liposuction is the most popular aesthetic surgery performed in Brazil and worldwide.
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