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Contemporary surgical management of HIV-associated facial lipoatrophy
E Funk1, F J Bressler, A E Brissett
1Bobby R. Alford Department of Otolaryngology/Head and Neck Surgery and Communicative Sciences, Baylor College of Medicine, Houston, Texas 77030, USA. etaif@bcm.tmc.edu
Objectives:
The purpose of this study is to describe our experience with facial volume restoration in 39 HIV-associated facial lipoatrophy patients, and formulate a treatment algorithm that can be utilized for these patients based on their disease severity.
Methods:
Preoperative and postoperative photographs were evaluated by 2 experienced facial plastic surgeons using grading scales. The reviewers' scores were then compared and the distribution of scores was analyzed.
Results:
Thirty-nine patients underwent malar silastic implantation. Seven patients required postoperative adjuvant filler injection. Most patients' results were rated good to excellent. There were 4 late complications.
Conclusion:
HIV-associated facial lipoatrophy is a socially disabling condition that causes noticeable disfigurement and stigmatizes the patient. We demonstrate the importance of combining a reliable grading scale with a strategic treatment algorithm that utilizes multiple modalities for volume restoration.
Ebm Rating:
C-4.
