How is Fat Discharged from the Body?

When patients lose weight, their fat is metobolized away. The body uses the fat as energy when it doesn't get enough calories. It is not excreted in any way.
When urine fat is measured after mesotherapy, there is no fat there, hence my scepticism of the metabolic explanations of how fat "disappears" from the body after mesotherapy. There is good evidence that it is eaten away by macrophages, the scavenger cells of the body, over a long period of time, and then metabolized. Hence the prolonged lumpiness and pain in many patients.
When liposuction is performed, the fat is removed directly and put into a bucket of medical waste.
Being morbidly obese can actually cause nonalcoholic steatohepatitis, or damage to the liver. this tends to improve as people lose a lot of weight, so losing weight is probably actually good for the liver.

Any dead fat cells that remain after liposcution will be broken down by enzymes discharged by the white blood cells and then removed by the lymphatic system.  There is no harm to the body that I am aware of.

Hi Hotlanta,
According to Dr. Franz Hasengschwandtner, a mesotherapy physician in Europe, fat is mainly metabolized by the liver. When fat cells break down, there is "simultaneously, a release of enzymes, stored in the mitochondria’s of the adipocite´s nucleus, takes place which break down the triglycerides into monoglycerides by means of an active enzyme cascade in the tissue over a period of eight weeks. The final step is the transportation into the liver, mostly over high density lipoproteins (HDL) and metabolization via the citric acid cycle through beta-oxidation. The end product is CO 2 and H 2O, a small amount (less than 1%) is excreted via the renal system in the form of very short-chained fatty acids."
Welcome to biochemistry class in pre-med and medical school. Oftentimes, patients will experience oily stools from fat breakdown for a few days (hence the above reference to Bob Eubanks and the answer that was given to him on "The Newlywed Game" when a newlywed couple was asked, "Where is the most unusual place that you have made whoopee?").
We have not had patients experience this with their Accent XL treatments. I have not seen or heard of any studies showing that it is damaging to the liver. Be well.
Dr. P