human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVES In animal models , fat removal results in compensatory weight gain . No study has reported measurement of weight following lipectomy in humans . We have examined changes in weight in patients who underwent lipectomy .  METHODS In a retrospective analysis , 16 patients who had abdominoplasty and 17 patients who underwent bilateral breast reduction were compared with 16 patients who had carpal tunnel syndrome release . Following this , a prospect i ve study was carried out on 7 subjects awaiting abdominoplasty and 12 subjects awaiting bilateral breast reduction surgery .  RESULTS In the retrospective study , all three patient groups gained weight following surgery . The abdominoplasty group was heavier before surgery and showed greatest weight gain but there was no statistically significant difference in weight gain between the groups . In the prospect i ve study , the abdominoplasty group had a mean fat removal of 1.77 kg and breast reduction group had a mean of 3.22 kg . Eighteen months following surgery the abdominoplasty group showed a significant mean increase in body weight ( mean increase : 4.82 kg ) and body mass index ( BMI ) ( mean increase : 1.66 kg/m(2 ) ) . In the bilateral breast reduction group , there was a non-significant mean gain in weight ( mean increase : 0.67 kg ) and BMI ( mean increase : 0.21 kg/m(2 ) ) . CONCLUSIONS Patients undergoing lipectomy during abdominoplasty and bilateral breast reduction will gain weight in the long term . This weight gain probably reflects the expected gain in weight without surgery as a similar finding is observed in patients who have undergone surgery without lipectomy  . These results highlight the limitation of lipectomy as a weight control measure Objective Obesity is a major risk factor for coronary heart disease , and surgical treatment of obese patients as part of a multidisciplinary approach seems to provide faster results than diet therapy . The aim of this study was to evaluate the effect of  dermolipectomy  on insulin action and inflammatory markers in 20 obese women Background : There are no published studies of liposuction or abdominoplasty in a large number of patients using measurements of body dimensions . In the absence of rigorous data , some investigators have proposed that fat returns after liposuction . Methods : A prospect i ve study was undertaken among predominantly nonobese consecutive patients undergoing 301 liposuction and abdominoplasty procedures meeting the study criteria ( inclusion rate , 70.7 percent ) .  Lower body dimensions were measured using st and ardized photographs taken before and at least 3 months after surgery . Upper body measurements were compared between women who underwent simultaneous cosmetic breast surgery ( n = 67 ) and a group of women who had breast surgery alone ( n = 78 ) to investigate the possibility of fat redistribution . Results : The average weight change was a loss of 2.2 lbs after lower body liposuction ( p < 0.01 ) and 4.6 lbs when combined with abdominoplasty ( p < 0.001 ) . Liposuction significantly reduced abdominal , thigh , knee , and arm width ( p < 0.001 ) . Midabdominal and hip width were more effectively reduced by lipoabdominoplasty than liposuction alone ( p < 0.001 ) . There was no difference in upper body measurements when comparing patients who had simultaneous liposuction and /or abdominoplasty with patients who had cosmetic breast surgery alone . Measurements in patients with at least 1 year of follow-up ( n = 46 ) showed no evidence of fat reaccumulation . Conclusions : Both liposuction and abdominoplasty are valid techniques for long-term fat reduction and improvement of body proportions . There is no evidence of fat regrowth . CLINICAL QUESTION /LEVEL OF EVIDENCE : Therapeutic , III CONTEXT Liposuction is suggested to result in long-term body fat regain that could lead to increased cardiometabolic risk . We hypothesized that physical activity could prevent this effect . OBJECTIVE Our objective was to investigate the effects of liposuction on body fat distribution and cardiometabolic risk factors in women who were either exercise trained or not after surgery . DESIGN , SETTING , AND PARTICIPANTS Thirty-six healthy normal-weight women participated in this 6-month r and omized controlled trial at the University of Sao Paulo , Sao Paulo , Brazil . INTERVENTIONS Patients underwent a small-volume abdominal liposuction . Two months after surgery , the subjects were r and omly allocated into two groups : trained ( TR , n = 18 , 4-month exercise program ) and nontrained ( NT , n = 18 ) . MAIN OUTCOME MEASURES Body fat distribution ( assessed by computed tomography ) was assessed before the intervention ( PRE ) and 2 months ( POST2 ) , and 6 months ( POST6 ) after surgery . Secondary outcome measures included body composition , metabolic parameters and dietary intake , assessed at PRE , POST2 , and POST6 , and total energy expenditure , physical capacity , and sc adipocyte size and lipid metabolism-related gene expression , assessed at PRE and POST6 . RESULTS Liposuction was effective in reducing sc abdominal fat ( PRE vs. POST2 , P = 0.0001 ) . Despite the sustained sc abdominal fat decrement at POST6 ( P = 0.0001 ) , the NT group showed a significant 10 % increase in visceral fat from PRE to POST6 ( P = 0.04 ; effect size = -0.72 ) and decreased energy expenditure ( P = 0.01 ; effect size = 0.95 ) when compared with TR . Dietary intake , adipocyte size , and gene expression were unchanged over time . CONCLUSION Abdominal liposuction does not induce regrowth of fat , but it does trigger a compensatory increase of visceral fat , which is effectively counteracted by physical activity Background Abdominal skin overhang is not unusual after massive weight loss induced by antiobesity interventions , and poor quality of life should be feared in such circumstances , especially in women . However , long-term results of quality of life have not been often documented in this setting . With the purpose of addressing this question , a prospect i ve study was design ed . Methods Patients ( n = 16 , 100 % females , age 40.1 ± 8.0 years ) su bmi tted to st and ard or combined circumferential abdominoplasty  were recruited for this study . All had undergone open Roux-en-Y gastric bypass between 24 and 48 months earlier with stable weight in the last 12 months . Quality of life was assessed by a trained psychologist employing of a semistructured interview , the Adaptative Operationalized Diagnostic Scale ( AODS ) , covering affectivity/personal relations , productivity , social/cultural performance , and organic/somatic health . Results Circumferential abdominoplasty was followed by few problems ( serous fluid collection s in 18.8 % , anemia because of blood loss in 6.3 % ) . The best overall response to the AODS question naire corresponded to the social and cultural domain where 81.3 % of the patients had excellent adaptation ( level 1 ) . For the other three domains , results were remarkably similar with 62.5 % of the tests displaying the highest value of adaptation and rare total failures . Conclusions ( 1 ) The current operation corresponded to the expectations of the patients with few complications and favorable body contouring result . ( 2 ) Quality of life , quantified by means of adaptation and social adjustment scores , was adequate in most circumstances . ( 3 ) Outst and ing responses for social/cultural performance were registered with encouraging findings for affectivity/personal relations , productivity , and organic/somatic health as well In a prospect i ve study , indices of glucose homeostasis , lipid profile , and systemic inflammation were monitored after an  aesthetic abdominoplasty  , aim ing to scrutinize the possible metabolic benefits for abdominal fat removal . Premenopausal females with substantial weight loss ( N = 40 ) undergoing circumferential abdominoplasty ( index group , n = 20 ) or augmentation mammoplasty with mastopexy ( controls , n = 20 ) were recruited . All of them originally underwent Roux-en-Y gastric bypass .  Variables included BMI , white blood cell count , C-reactive protein , hemoglobin , total cholesterol and fractions , triglycerides , glucose , and HbA1c . Follow-up reached 20.3 ± 13.6 months for index cases and 29.5 ± 17.4 months for controls . The metabolic and inflammatory indices improved after the bariatric surgery . Subsequent monitoring indicated a stable body weight and biochemical profile in both groups . The exceptions were HDL cholesterol and C-reactive protein , which respectively increased and diminished after the abdominoplasty , consistent with an inflammatory and metabolic advantage for this operation . This is the first long-term study in a weight-stable population to point out such a pattern after abdominoplasty The aim of this study was to identify the effect of surgically removing subcutaneous fat by abdominoplasty on leptin concentrations and insulin sensitivity . An open clinical trial with a noninterventional parallel group was carried out in 12 obese women . After r and omization , 6 volunteers were selected for abdominoplasty  , and the other 6 women were considered as the noninterventional group . A metabolic profile , including leptin concentrations , and insulin tolerance test to assess insulin sensitivity were performed on all volunteers before intervention or nonintervention and 40–50 days afterward . A significant reduction in body mass index ( 30.7 ± 0.9 versus 29.6 ± 0.7 kg/m2 ; P = 0.02 ) and in leptin concentrations ( 41.3 ± 10.6 versus 32.0 ± 10.2 ng/mL ; P = 0.02 ) was observed after abdominoplasty . Insulin sensitivity did not change after intervention . In conclusion , surgically removing subcutaneous fat by abdominoplasty  decreased leptin concentrations , with no change in insulin sensitivity No r and omized studies in humans have examined whether fat returns after removal or where it returns . We undertook a prospect i ve , r and omized-controlled trial of  suction lipectomy in nonobese women to determine if adipose tissue ( AT ) is defended and if so , the anatomic pattern of redistribution . Healthy women with disproportionate AT depots ( lower abdomen , hips , or thighs ) were enrolled . Baseline body composition measurements included dual-energy X-ray absorptiometry ( DXA ) ( a priori primary outcome ) , abdominal/limb circumferences , subcutaneous skinfold thickness , and magnetic resonance imaging ( MRI ) ( torso/thighs ) . Participants ( n = 32 ; 36 ± 1 year ) were r and omized to small-volume liposuction ( n = 14 , mean BMI : 24 ± 2 kg/m(2 ) ) or control ( n=18 , mean BMI : 25 ± 2 ) following baseline . Surgery group participants underwent liposuction within 2 - 4 weeks . Identical measurements were repeated at 6 weeks , 6 months , and 1 year later . Participants agreed not to make lifestyle changes while enrolled . Between-group differences were adjusted for baseline level of the outcome variable . After 6 weeks , percent body fat ( % BF ) by DXA was decreased by 2.1 % in the lipectomy group and by 0.28 % in the control group ( adjusted difference ( AD ) : -1.82 % ; 95 % confidence interval ( CI ) : -2.79 % to -0.85 % ; P = 0.0002 ) . This difference was smaller at 6 months , and by 1 year was no longer significant ( 0.59 % ( control ) vs. -0.41 % ( lipectomy ) ; AD : -1.00 % ; CI : -2.65 to 0.64 ; P = 0.23 ) . AT reaccumulated differently across various sites . After 1 year the thigh region remained reduced ( 0.77 % ( control ) vs. -1.83 % ( lipectomy ) ; AD : -2.59 % ; CI : -3.91 to -1.28 ; P = 0.0001 ) , but AT reaccumulated in the abdominal region ( 0.64 % ( control ) vs. 0.42 % ( lipectomy ) ; AD : -0.22 ; CI : -2.35 to 1.91 ; P = 0.84 ) . Following suction lipectomy , BF was restored and redistributed from the thigh to the abdomen Background : Triglyceride levels of 150 mg/dL or greater are known to be associated with an increased cardiovascular risk and metabolic syndrome . This study investigated the effect of liposuction and abdominoplasty on lipid levels , complete blood count , and other parameters . Methods : A prospect i ve study was undertaken among 322 consecutive patients ( 270 women and 52 men ) who presented for liposuction ( n = 229 ) , abdominoplasty with liposuction ( n = 87 ) , and abdominoplasty without liposuction ( n = 6 ) . The mean body mass index was 26.6 kg/m2 ( range , 18.6 to 44.1 kg/m2 ) . Ultrasonic liposuction using a superwet infusion technique was used in all cases , usually treating the lower body in women ( 64.4 percent ) and the trunk in men ( 86.5 percent ) . Results : Mean weight loss 3 months after liposuction was 2.2 lbs for liposuction alone 
    Output:
    
agent
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 .
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVES In animal models , fat removal results in compensatory weight gain . No study has reported measurement of weight following lipectomy in humans . We have examined changes in weight in patients who underwent lipectomy .  METHODS In a retrospective analysis , 16 patients who had abdominoplasty and 17 patients who underwent bilateral breast reduction were compared with 16 patients who had carpal tunnel syndrome release . Following this , a prospect i ve study was carried out on 7 subjects awaiting abdominoplasty and 12 subjects awaiting bilateral breast reduction surgery .  RESULTS In the retrospective study , all three patient groups gained weight following surgery . The abdominoplasty group was heavier before surgery and showed greatest weight gain but there was no statistically significant difference in weight gain between the groups . In the prospect i ve study , the abdominoplasty group had a mean fat removal of 1.77 kg and breast reduction group had a mean of 3.22 kg . Eighteen months following surgery the abdominoplasty group showed a significant mean increase in body weight ( mean increase : 4.82 kg ) and body mass index ( BMI ) ( mean increase : 1.66 kg/m(2 ) ) . In the bilateral breast reduction group , there was a non-significant mean gain in weight ( mean increase : 0.67 kg ) and BMI ( mean increase : 0.21 kg/m(2 ) ) . CONCLUSIONS Patients undergoing lipectomy during abdominoplasty and bilateral breast reduction will gain weight in the long term . This weight gain probably reflects the expected gain in weight without surgery as a similar finding is observed in patients who have undergone surgery without lipectomy  . These results highlight the limitation of lipectomy as a weight control measure Objective Obesity is a major risk factor for coronary heart disease , and surgical treatment of obese patients as part of a multidisciplinary approach seems to provide faster results than diet therapy . The aim of this study was to evaluate the effect of  dermolipectomy  on insulin action and inflammatory markers in 20 obese women Background : There are no published studies of liposuction or abdominoplasty in a large number of patients using measurements of body dimensions . In the absence of rigorous data , some investigators have proposed that fat returns after liposuction . Methods : A prospect i ve study was undertaken among predominantly nonobese consecutive patients undergoing 301 liposuction and abdominoplasty procedures meeting the study criteria ( inclusion rate , 70.7 percent ) .  Lower body dimensions were measured using st and ardized photographs taken before and at least 3 months after surgery . Upper body measurements were compared between women who underwent simultaneous cosmetic breast surgery ( n = 67 ) and a group of women who had breast surgery alone ( n = 78 ) to investigate the possibility of fat redistribution . Results : The average weight change was a loss of 2.2 lbs after lower body liposuction ( p < 0.01 ) and 4.6 lbs when combined with abdominoplasty ( p < 0.001 ) . Liposuction significantly reduced abdominal , thigh , knee , and arm width ( p < 0.001 ) . Midabdominal and hip width were more effectively reduced by lipoabdominoplasty than liposuction alone ( p < 0.001 ) . There was no difference in upper body measurements when comparing patients who had simultaneous liposuction and /or abdominoplasty with patients who had cosmetic breast surgery alone . Measurements in patients with at least 1 year of follow-up ( n = 46 ) showed no evidence of fat reaccumulation . Conclusions : Both liposuction and abdominoplasty are valid techniques for long-term fat reduction and improvement of body proportions . There is no evidence of fat regrowth . CLINICAL QUESTION /LEVEL OF EVIDENCE : Therapeutic , III CONTEXT Liposuction is suggested to result in long-term body fat regain that could lead to increased cardiometabolic risk . We hypothesized that physical activity could prevent this effect . OBJECTIVE Our objective was to investigate the effects of liposuction on body fat distribution and cardiometabolic risk factors in women who were either exercise trained or not after surgery . DESIGN , SETTING , AND PARTICIPANTS Thirty-six healthy normal-weight women participated in this 6-month r and omized controlled trial at the University of Sao Paulo , Sao Paulo , Brazil . INTERVENTIONS Patients underwent a small-volume abdominal liposuction . Two months after surgery , the subjects were r and omly allocated into two groups : trained ( TR , n = 18 , 4-month exercise program ) and nontrained ( NT , n = 18 ) . MAIN OUTCOME MEASURES Body fat distribution ( assessed by computed tomography ) was assessed before the intervention ( PRE ) and 2 months ( POST2 ) , and 6 months ( POST6 ) after surgery . Secondary outcome measures included body composition , metabolic parameters and dietary intake , assessed at PRE , POST2 , and POST6 , and total energy expenditure , physical capacity , and sc adipocyte size and lipid metabolism-related gene expression , assessed at PRE and POST6 . RESULTS Liposuction was effective in reducing sc abdominal fat ( PRE vs. POST2 , P = 0.0001 ) . Despite the sustained sc abdominal fat decrement at POST6 ( P = 0.0001 ) , the NT group showed a significant 10 % increase in visceral fat from PRE to POST6 ( P = 0.04 ; effect size = -0.72 ) and decreased energy expenditure ( P = 0.01 ; effect size = 0.95 ) when compared with TR . Dietary intake , adipocyte size , and gene expression were unchanged over time . CONCLUSION Abdominal liposuction does not induce regrowth of fat , but it does trigger a compensatory increase of visceral fat , which is effectively counteracted by physical activity Background Abdominal skin overhang is not unusual after massive weight loss induced by antiobesity interventions , and poor quality of life should be feared in such circumstances , especially in women . However , long-term results of quality of life have not been often documented in this setting . With the purpose of addressing this question , a prospect i ve study was design ed . Methods Patients ( n = 16 , 100 % females , age 40.1 ± 8.0 years ) su bmi tted to st and ard or combined circumferential abdominoplasty  were recruited for this study . All had undergone open Roux-en-Y gastric bypass between 24 and 48 months earlier with stable weight in the last 12 months . Quality of life was assessed by a trained psychologist employing of a semistructured interview , the Adaptative Operationalized Diagnostic Scale ( AODS ) , covering affectivity/personal relations , productivity , social/cultural performance , and organic/somatic health . Results Circumferential abdominoplasty was followed by few problems ( serous fluid collection s in 18.8 % , anemia because of blood loss in 6.3 % ) . The best overall response to the AODS question naire corresponded to the social and cultural domain where 81.3 % of the patients had excellent adaptation ( level 1 ) . For the other three domains , results were remarkably similar with 62.5 % of the tests displaying the highest value of adaptation and rare total failures . Conclusions ( 1 ) The current operation corresponded to the expectations of the patients with few complications and favorable body contouring result . ( 2 ) Quality of life , quantified by means of adaptation and social adjustment scores , was adequate in most circumstances . ( 3 ) Outst and ing responses for social/cultural performance were registered with encouraging findings for affectivity/personal relations , productivity , and organic/somatic health as well In a prospect i ve study , indices of glucose homeostasis , lipid profile , and systemic inflammation were monitored after an  aesthetic abdominoplasty  , aim ing to scrutinize the possible metabolic benefits for abdominal fat removal . Premenopausal females with substantial weight loss ( N = 40 ) undergoing circumferential abdominoplasty ( index group , n = 20 ) or augmentation mammoplasty with mastopexy ( controls , n = 20 ) were recruited . All of them originally underwent Roux-en-Y gastric bypass .  Variables included BMI , white blood cell count , C-reactive protein , hemoglobin , total cholesterol and fractions , triglycerides , glucose , and HbA1c . Follow-up reached 20.3 ± 13.6 months for index cases and 29.5 ± 17.4 months for controls . The metabolic and inflammatory indices improved after the bariatric surgery . Subsequent monitoring indicated a stable body weight and biochemical profile in both groups . The exceptions were HDL cholesterol and C-reactive protein , which respectively increased and diminished after the abdominoplasty , consistent with an inflammatory and metabolic advantage for this operation . This is the first long-term study in a weight-stable population to point out such a pattern after abdominoplasty The aim of this study was to identify the effect of surgically removing subcutaneous fat by abdominoplasty on leptin concentrations and insulin sensitivity . An open clinical trial with a noninterventional parallel group was carried out in 12 obese women . After r and omization , 6 volunteers were selected for abdominoplasty  , and the other 6 women were considered as the noninterventional group . A metabolic profile , including leptin concentrations , and insulin tolerance test to assess insulin sensitivity were performed on all volunteers before intervention or nonintervention and 40–50 days afterward . A significant reduction in body mass index ( 30.7 ± 0.9 versus 29.6 ± 0.7 kg/m2 ; P = 0.02 ) and in leptin concentrations ( 41.3 ± 10.6 versus 32.0 ± 10.2 ng/mL ; P = 0.02 ) was observed after abdominoplasty . Insulin sensitivity did not change after intervention . In conclusion , surgically removing subcutaneous fat by abdominoplasty  decreased leptin concentrations , with no change in insulin sensitivity No r and omized studies in humans have examined whether fat returns after removal or where it returns . We undertook a prospect i ve , r and omized-controlled trial of  suction lipectomy in nonobese women to determine if adipose tissue ( AT ) is defended and if so , the anatomic pattern of redistribution . Healthy women with disproportionate AT depots ( lower abdomen , hips , or thighs ) were enrolled . Baseline body composition measurements included dual-energy X-ray absorptiometry ( DXA ) ( a priori primary outcome ) , abdominal/limb circumferences , subcutaneous skinfold thickness , and magnetic resonance imaging ( MRI ) ( torso/thighs ) . Participants ( n = 32 ; 36 ± 1 year ) were r and omized to small-volume liposuction ( n = 14 , mean BMI : 24 ± 2 kg/m(2 ) ) or control ( n=18 , mean BMI : 25 ± 2 ) following baseline . Surgery group participants underwent liposuction within 2 - 4 weeks . Identical measurements were repeated at 6 weeks , 6 months , and 1 year later . Participants agreed not to make lifestyle changes while enrolled . Between-group differences were adjusted for baseline level of the outcome variable . After 6 weeks , percent body fat ( % BF ) by DXA was decreased by 2.1 % in the lipectomy group and by 0.28 % in the control group ( adjusted difference ( AD ) : -1.82 % ; 95 % confidence interval ( CI ) : -2.79 % to -0.85 % ; P = 0.0002 ) . This difference was smaller at 6 months , and by 1 year was no longer significant ( 0.59 % ( control ) vs. -0.41 % ( lipectomy ) ; AD : -1.00 % ; CI : -2.65 to 0.64 ; P = 0.23 ) . AT reaccumulated differently across various sites . After 1 year the thigh region remained reduced ( 0.77 % ( control ) vs. -1.83 % ( lipectomy ) ; AD : -2.59 % ; CI : -3.91 to -1.28 ; P = 0.0001 ) , but AT reaccumulated in the abdominal region ( 0.64 % ( control ) vs. 0.42 % ( lipectomy ) ; AD : -0.22 ; CI : -2.35 to 1.91 ; P = 0.84 ) . Following suction lipectomy , BF was restored and redistributed from the thigh to the abdomen Background : Triglyceride levels of 150 mg/dL or greater are known to be associated with an increased cardiovascular risk and metabolic syndrome . This study investigated the effect of liposuction and abdominoplasty on lipid levels , complete blood count , and other parameters . Methods : A prospect i ve study was undertaken among 322 consecutive patients ( 270 women and 52 men ) who presented for liposuction ( n = 229 ) , abdominoplasty with liposuction ( n = 87 ) , and abdominoplasty without liposuction ( n = 6 ) . The mean body mass index was 26.6 kg/m2 ( range , 18.6 to 44.1 kg/m2 ) . Ultrasonic liposuction using a superwet infusion technique was used in all cases , usually treating the lower body in women ( 64.4 percent ) and the trunk in men ( 86.5 percent ) . Results : Mean weight loss 3 months after liposuction was 2.2 lbs for liposuction alone 
    Output:
    