Full scope of effect of facial lipoatrophy: a framework of disease understanding.
BACKGROUND
Facial lipoatrophy has been observed to occur in a variety of patient populations, with inherited or acquired disease, or even in aging patients as a natural progression of tissue change over time. There is currently no framework from which physicians of all medical specialties can communally discuss the manifestations, diagnoses, and management of facial lipoatrophy.


OBJECTIVE
The aim of this assembly was to derive a definition of facial lipoatrophy capable of being applied to all patient populations and develop an accompanying grading system.


RESULTS
The final consensus of the Facial Lipoatrophy Panel encompasses both aging and disease states: "Loss of facial fat due to aging, trauma or disease, manifested by flattening or indentation of normally convex contours." The proposed grading scale includes five gradations (Grades 1-5; 5 being the most severe), and the face is assessed according to three criteria: contour, bony prominence, and visibility of musculature.


CONCLUSIONS
Categorizing the presentation of facial lipoatrophy is subjective and qualitative, and will need to be validated with objective measures. Furthermore, during the assembly, several topics were exposed that warrant further research, including the physiology of volume loss, age and lipoatrophy, and human immunodeficiency virus and lipoatrophy.
Ascher
Benjamin
B
Clinique Iena, Paris, France. benjaminascher@wanadoo.fr
Coleman
Sydney
S
Alster
Tina
T
Bauer
Ute
U
Burgess
Cheryl
C
Butterwick
Kimberly
K
Donofrio
Lisa
L
Engelhard
Peter
P
Goldman
Mitchel P
MP
Katz
Philippe
P
Vleggaar
Danny
D
D001284:Atrophy; D002986:Clinical Trials as Topic; D005145:Face; D006801:Humans; D008060:Lipodystrophy / Q000145:classification* / Q000209:etiology / Q000473:pathology / Q000628:therapy; D015595:Skin Aging / Q000473:pathology