Deep and superficial fat ratio in dietary and surgically induced weight loss patients

Architecture of abdominal fat above and below Scarpa's fascia is morphologically different. Little information is available about the relative distribution patterns of deep and superficial fat layers in massive weight loss (MWL) patients. This study aimed to evaluate the relative distribution patterns of deep and superficial abdominal fat layers in two groups of MWL patients presenting for abdominoplasty: (1) MWL via nutritional management and (2) MWL via bariatric surgery.

All MWL patients with stable body weight for a minimum of 24 months presenting for abdominal body contouring at Lausanne University Hospital, Department of Plastic Surgery between July 2008 and June 2009 were included. Patients with preexisting metabolic diseases were excluded. Patients with nutritional deficiencies were deferred until corrected.

Nineteen consecutive patients were included in the study, 7 post-bariatric patients and 12 patients after dietary-induced weight loss (5 were males and 14 were females; average age 45.5 years, range 36-64 years), with an average weight loss of 48 kg (57 kg post-bariatric, 28 kg dietary induced) and a mean body mass index of 29.2 kg/m(2) (range 24.0-40.7) at the time of abdominoplasty. Morphologic evaluation yielded a relative distribution of deep to superficial fat layers of 42 to 58 % in the post-bariatric group versus 31 to 69 % (p < 0.05) in the nutritionally induced group.

These data show that the morphologic distribution patterns of deep and superficial abdominal fat layers differ with regards to mode of weight loss.