[Surgical treatment of facial lipoatrophy]

The lipodystrophy syndrome is one of the major event of potent antiretroviral therapy. This treatment results in lipoatrophy, lipohypertrophy or mixed syndrome. Lipoatrophy is characterized by a loss of subcutaneous fat. The psychological impact may be severe when it is localized at the face. The aim of this study was to show the possibilities of improve lipoatrophy by autologuous fatty tissue transplantation with the Coleman method. Since december 1999 we have a plastic surgery consultation for lipodystrophy. From December 1999 to march 2002 we have seen 87 patients in consultation and 29 patients have been treated for facial lipoatrophy with Coleman method. The patients were evaluated clinically and with serial photography at 1 and 6 months post operatively. Coleman method is the ideal treatment for facial lipoatrophy in HIV infected patients. This technique is reliable and preliminary results show durability of fat graft after 6 months. Nevertheless, Coleman method is restricted by fat availability and can not be used for all lipoatrophy.