Surgical removal of adipose tissue is a widely practised form of plastic surgery most often aimed at correcting cosmetic defects after extreme weight reduction such as a pendulous abdomen. However, it has not been proposed as a cure for obesity. Evidence for an interaction between the adipose tissue mass and regulation of food intake and energy balance might suggest that a reduction of body fat could favorably influence obesity. This study presents body composition data on five patients with a mean body weight of 136 kg with hyperplastic obesity who after a mean weight reduction of 46 kg by conventional therapy were subjected to extensive plastic surgery aimed at removing supernumerary fat cells. Analysis of adipose tissue cellularity revealed that 12-18% of the total number of fat cells were removed by combinations of abdominoplasty and lumbar and femoral adipectomy. There were no indications that this reduction of adipose tissue mass could prevent the recurrence of obesity in these patients, though there was no evidence for regeneration of adipose tissue in situ.