title: Facelift- and circum-occipital incision placement for fat extirpation of the neck in Madelung's disease - a two-case report.
abstract: Benign symmetric lipomatosis (Madelung's disease) is a rare disorder of fat metabolism that is characterized by progressive symmetrical formation of unencapsulated and painless excess fat masses around the neck and trunk that result in cosmetic disfiguration and functional impairment. Since the disorder is incompletely understood and causal therapy is unavailable, surgical removal of fatty masses is the mainstay of treatment. In this paper the authors describe their use of the classical facelift incision placement as well as a horizontal circum-occipital incision to approach and excise excess fat of the anterior and posterior neck in two patients. This method yielded satisfying results with a combination of good access to fat masses, smooth trimming and redraping of redundant skin, in addition to fairly inconspicuous scarring post-operatively. After removal of 1.5 kg of fat from each patient and a period of uncomplicated wound healing, both patients showed no signs of relapsing fatty growth. Although more challenging than most conventional approaches, the authors' technique has shown good outcomes in those treated with this condition.
authors.affiliation: Department for Oral and Maxillofacial Surgery/Plastic Surgery, Greifswald University, Greifswald, Germany.
authors.forename: Gregor
authors.initials: G
authors.lastname: Hundeshagen
authors.affiliation: Klinikum Braunschweig, Department of General Surgery, Brunswick, Germany. Electronic address: gabrielhundeshagen@gmail.com.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Hundeshagen
authors.affiliation: Department for Plastic Surgery, Medas Clinic, Tashkent, Uzbekistan.
authors.forename: Khamidulla F
authors.initials: KF
authors.lastname: Assadov
authors.affiliation: Department for Oral and Maxillofacial Surgery/Plastic Surgery, Greifswald University, Greifswald, Germany.
authors.forename: Fred
authors.initials: F
authors.lastname: Podmelle
mesh_terms: D002921:Cicatrix / Q000473:pathology; D062109:Dermatologic Surgical Procedures / Q000379:methods; D004210:Dissection / Q000379:methods; D004724:Endoscopy / Q000379:methods; D005145:Face / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D015187:Lipectomy / Q000379:methods*; D008069:Lipomatosis, Multiple Symmetrical / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D009333:Neck / Q000601:surgery*; D009777:Occipital Bone; D012535:Scalp / Q000601:surgery; D050151:Subcutaneous Fat / Q000601:surgery; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology
keywords: Benign symmetric lipomatosis; Facelift; Madelung; Madelung's disease; Rhytidectomy