title: HIV-Associated Facial Lipodystrophy: Experience of a Tertiary Referral Center With Fat and Dermis-Fat Compound Graft Transfer.
abstract: Objectives:HIV-associated lipodystrophy is a common comorbidity in HIV-infected patients, having a profound impact on every aspect of patients' lives, particularly when involving the face. Hence, it is of the utmost importance to evaluate the result of any potential therapies that may help solve HIV-associated facial lipodystrophy. The aim of this article was to evaluate the outcome of patients undergoing facial lipodystrophy correction surgery within our institution.Methods:A retrospective analysis of the clinical charts and iconographic information of patients regarding demographics, morphologic changes, surgical option, postoperative complications, results, and patient satisfaction assessed by a 1- to 10-point scale and by the Assessment of Body Change and Distress questionnaire.Results:Twenty-three patients were operated on from March 2011 to April 2015. Seventy-five percent of cases were treated with fat graft injection, whereas dermis-fat grafts were applied in 25% of patients. The former had their fat harvested more commonly from the abdomen, whereas in the latter case, the graft was harvested mostly from the inner aspect of arms. The mean volume of fat injected on each side of the face was 28.5 ± 22.7 mL. On a scale from 1 to 10, mean patient satisfaction was 7.7 ± 2.8. The Assessment of Body Change and Distress questionnaire revealed statistically significant improvements. Complications occurred in 25% of cases, the most frequent being significant reabsorption. No major complications occurred.Conclusions:Treatment of HIV-associated facial lipodystrophy with autologous fat or dermis-fat compound graft is a safe procedure with long-lasting results and unquestionable aesthetic and social benefits.
authors.affiliation: Plastic, Reconstructive and Aesthetic Surgery Department and Burn Unit, Centro Hospitalar de Lisboa Central, Hospital de São José, Lisbon, Portugal.
authors.forename: Francisco
authors.initials: F
authors.lastname: Martins de Carvalho
authors.affiliation: Plastic, Reconstructive and Aesthetic Surgery Department and Burn Unit, Centro Hospitalar de Lisboa Central, Hospital de São José, Lisbon, Portugal.
authors.forename: Diogo
authors.initials: D
authors.lastname: Casal
authors.affiliation: Plastic, Reconstructive and Aesthetic Surgery Department and Burn Unit, Centro Hospitalar de Lisboa Central, Hospital de São José, Lisbon, Portugal.
authors.forename: Joaquim
authors.initials: J
authors.lastname: Bexiga
authors.affiliation: Plastic, Reconstructive and Aesthetic Surgery Department and Burn Unit, Centro Hospitalar de Lisboa Central, Hospital de São José, Lisbon, Portugal.
authors.forename: Juliana
authors.initials: J
authors.lastname: Sousa
authors.affiliation: Plastic, Reconstructive and Aesthetic Surgery Department and Burn Unit, Centro Hospitalar de Lisboa Central, Hospital de São José, Lisbon, Portugal.
authors.forename: João
authors.initials: J
authors.lastname: Martins
authors.affiliation: Hospital de Santo António dos Capuchos, Immunodeficiency Clinics, Centro Hospitalar de Lisboa Central, Lisbon, Portugal.
authors.forename: Eugénio
authors.initials: E
authors.lastname: Teófilo
authors.affiliation: Hospital Curry Cabral, Immunodeficiency Clinics, Centro Hospitalar de Lisboa Central, Lisbon, Portugal.
authors.forename: Fernando
authors.initials: F
authors.lastname: Maltez
authors.affiliation: Hospital de São José, Immunodeficiency Clinics, Centro Hospitalar de Lisboa Central, Lisbon, Portugal.
authors.forename: Isabel
authors.initials: I
authors.lastname: Germano
authors.affiliation: Plastic, Reconstructive and Aesthetic Surgery Department and Burn Unit, Centro Hospitalar de Lisboa Central, Hospital de São José, Lisbon, Portugal.
authors.forename: José
authors.initials: J
authors.lastname: Videira E Castro
keywords: AIDS; HIV; fat graft; lipodystrophy; surgery