Association of post-liposuction edema on body composition and weight reduction efficiency.

[UNLABELLED] Edema following liposuction can obscure surgical outcomes and increase the risk of complications, emphasizing the need for quantitative evaluation. This study aimed to evaluate the association between postoperative edema severity and changes in weight and body composition, as well as to assess fat reduction efficiency across different edema severity groups in patients undergoing local anesthetic minimally invasive liposuction (LAMS). This study analyzed multicenter cohort data collected in 2024 from 20 branches of the 365MC Hospital in South Korea, including 3832 patients who underwent LAMS. Postoperative edema severity was assessed using a standardized self-report questionnaire and patients were classified into three groups: no edema, mild, and moderate to severe edema. The primary outcome was postoperative changes in body weight and total body water (TBW), using bioelectrical impedance analysis. The Kruskal-Wallis and Dunn’s tests were used to compare changes across edema groups, while multivariable linear regression evaluated associations between aspirated fat volume and postoperative outcomes. Weight reduction efficiency (per 50 cc of aspirated fat) was also assessed. Subgroup analyses were conducted by seven anatomical regions: abdomen, arms, back, buttocks, calves, flanks, and thighs. Of the 3832 patients (3825 females [99.82%]), the majority were classified into the mild edema group (90.34%), followed by moderate to severe (5.61%) and no edema (4.04%). Aspirated fat volume was associated with reductions in body weight across all groups, although the strength of this association declined with increasing edema severity, from an adjusted β of -0.06 (95% CI, -0.07 to -0.05) kg/cc in the no edema group to − 0.05 (-0.09 to -0.01) kg/cc in the moderate to severe group. In contrast, TBW showed the weakest and non-significant association, suggesting that postoperative fluid retention may obscure the weight-reducing effect of aspirated fat. Regional analysis indicated that the buttocks showed the highest efficiency (-11.41 [95% CI, -26.76 to 3.93] kg/50 cc in the no edema group; -5.89 [-17.64 to 5.87] kg/50 cc in moderate to severe), while the thighs showed the lowest (-5.74 [-9.82 to -1.68] kg/50 cc and -2.02 [-3.85 to 0.19] kg/50 cc, respectively). This study investigates the potential association of edema severity on postoperative body composition changes and fat reduction efficiency following LAMS. These findings highlight the clinical impact of edema on surgical outcomes and the importance of tailored postoperative management to enhance recovery and patient satisfaction.

[SUPPLEMENTARY INFORMATION] The online version contains supplementary material available at 10.1038/s41598-025-29903-5.