A Dangerous Concept: Childhood Obesity and Liposuction

Board-certified plastic surgeons express concerns with patient safety, long-term effects and psychological factors

The American Society for Aesthetic Plastic Surgery (ASAPS) believes there is no scientific evidence to support the safety or efficacy of large-volume lipoplasty (liposuction) for weight loss in obese children. Further, the Society contends that liposuction is not an effective treatment for obesity in any patient—adult or child.

Clinical studies have demonstrated that (lipoplasty) does not have the same health benefits (e.g., reduced risk of heart disease, diabetes or benefits to metabolism) as diet and exercise. It does not address the important lifestyle and diet issues necessary for long term weight loss success. The best liposuction candidates are close to their ideal body weight and have discrete fat deposits that, when treated, will result in a positive change in contour, not obese patients looking for weight loss.

“Childhood obesity is one of our nation's growing health problems and there are a number of widely accepted treatments for children and adolescents who struggle with their weight. Liposuction and abdominoplasty are not among them,” said Dr. David Sarwer, Associate Professor of Psychology at the University of Pennsylvania's Center for Human Appearance and Director of Clinical Services at the Center for Weight and Eating Disorders and noted authority on the subject. “There is no evidence to suggest that these procedures lead to improvements in health conditions affected by obesity.”

Most experts agree that for appropriately selected younger patients, cosmetic plastic surgery can have a positive impact, but only after they have reached physical development and only if they are psychologically healthy. However, all patients need to:

    * Explore risks and expected recovery times: Teens and their parents should understand the risks of surgery, postoperative restrictions on activity, and typical recovery times.

    * Assess physical maturity: Operating on a feature that has not yet fully developed could interfere with its growth, or negate the benefits of surgery in later years.

    * Explore emotional maturity and expectations: As with any patient, the young person should appreciate the benefits and limitations of the proposed surgery, and have realistic expectations.

    * Check credentials: State laws permit any licensed physician to call themselves a “plastic” or “cosmetic” surgeon, even if not trained as a surgeon. Look for certification by The American Board of Plastic Surgery. If the doctor operates in an ambulatory or office-based facility, the facility should be accredited. Additionally, the surgeon should have operating privileges in an accredited hospital for the same procedure being considered.

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