Insulin-Induced Lipohypertrophy Treated With Liposuction: A Review of Case Reports

Introduction: Lipohypertrophy is the most reported cutaneous complication of insulin injection. In cases refractory to conservative management, liposuction has been proposed as a treatment. This review aims to evaluate the use of liposuction for the treatment of insulin-induced lipohypertrophy. Methods: A literature search was conducted to identify case reports and case series that met inclusion criteria. Demographic, procedural, and outcome data were collected and summarized. Results: Ten case reports and 1 case series met eligibility criteria; 18 patients (16 female) with a mean age of 31 years were included for analysis. The primary indication for lipectomy was cosmetic (100%), followed by pain (16.7%), injection difficulty (16.7%), and poor glycemic control (11.1%). Ten patients (55.6%) underwent general anesthesia for their procedure, while 8 (44.4%) received local anesthesia. Thighs (53.8%) were the most common anatomical site of liposuction, followed by the upper arm (19.2%), abdomen (15.4%), buttocks (7.7%), and the flank (3.8%). The median volume of adipose tissue removed per site was 300 mL (range: 25-600 mL), while the total volume per patient was 910.8 mL (range: 200-2900 mL). The average postoperative follow-up time was 5.3 months (range: 2-10 months). Three patients reported postoperative improvement of glycemic control; 100% of patients were satisfied with their procedure. Small surface irregularities were reported in 2 patients. Conclusion: Although future investigations are warranted, these results may indicate that the use of liposuction to treat insulin-induced lipohypertrophy is a safe and effective procedure that achieves improved cosmetics with high patient satisfaction and enhanced glycemic control.