title: Morcellized Omental Transfer for Severe HIV Facial Wasting.
abstract: BACKGROUND
  A novel surgical technique to reconstruct facial wasting was developed for patients with severe human immunodeficiency virus lipoatrophy and no source of subcutaneous fat for donor material. Fourteen patients underwent endoscopic harvest of omentum, extracorporeal morcellation, and autologous transfer to the face.
  
  
  METHODS
  Omental fat was harvested using a standard 3-port laparoscopic technique. A mechanical tissue processor created morsels suitable for transfer. Gold-plated, multi-holed catheters delivered living particulate fat to the subcutaneous planes of the buccal, malar, lateral cheek, and temporal regions. Results were evaluated using standardized pre- and postoperative photographs for specific anatomic criteria found along the typical progression of the disease process.
  
  
  RESULTS
  Electron microscopy confirmed that morcellized fat retained intact cell walls and was appropriate for autologous transfer. Complications were minor and transient. Patients were discharged home within 24 hours. No patient required open laparotomy. Survival of the adipose grafts was deemed good to excellent in 13 of the 14 cases.
  
  
  CONCLUSIONS
  Mechanically morcellized omental fat transfer provides a safe option to restore facial volume in those unusual patients with severe wasting and no available subcutaneous tissue for transfer. Consistent anatomic progression of facial wasting permits preoperative classification, counseling of patients, and postoperative evaluation of surgical improvement.
authors.affiliation: Department of Surgery, Section of Plastic and Reconstructive Surgery, Pritzker School of Medicine, The University of Chicago, Chicago, Ill.; The Kinsey Institute, Bloomington, Ind.; Saint Joseph Hospital, Chicago, Ill.; University of Michigan Medical School, Ann Arbor, Mich.; University of Illinois at Chicago, Chicago, Ill.; and Lung Cancer Program, Jordan Hospital, Plymouth, Mass.
authors.forename: David
authors.initials: D
authors.lastname: Teplica
authors.affiliation: Department of Surgery, Section of Plastic and Reconstructive Surgery, Pritzker School of Medicine, The University of Chicago, Chicago, Ill.; The Kinsey Institute, Bloomington, Ind.; Saint Joseph Hospital, Chicago, Ill.; University of Michigan Medical School, Ann Arbor, Mich.; University of Illinois at Chicago, Chicago, Ill.; and Lung Cancer Program, Jordan Hospital, Plymouth, Mass.
authors.forename: Marlon
authors.initials: M
authors.lastname: Bohorquez
authors.affiliation: Department of Surgery, Section of Plastic and Reconstructive Surgery, Pritzker School of Medicine, The University of Chicago, Chicago, Ill.; The Kinsey Institute, Bloomington, Ind.; Saint Joseph Hospital, Chicago, Ill.; University of Michigan Medical School, Ann Arbor, Mich.; University of Illinois at Chicago, Chicago, Ill.; and Lung Cancer Program, Jordan Hospital, Plymouth, Mass.
authors.forename: Francis J
authors.initials: FJ
authors.lastname: Podbielski