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Excisional lipectomy for HIV-associated cervicodorsal lipodystrophy.

Anne G Warren¹, Loren J Borud

¹Harvard Medical School, Boston, MA, USA.

Aesthetic Surgery Journal

|December 17, 2008

Summary

Excisional lipectomy effectively corrects cervicodorsal lipodystrophy, a side effect of HIV protease inhibitor therapy. This surgical approach offers improved aesthetic and functional outcomes for patients experiencing buffalo hump deformity.

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Area of Science:

Plastic and Reconstructive Surgery
HIV/AIDS Treatment Complications
Metabolic Disorders

Background:

Antiretroviral therapy (ART) for HIV has improved patient longevity but can cause lipodystrophy syndromes.
Cervicodorsal lipodystrophy, or "buffalo hump," is a disfiguring side effect of HIV medications.
Surgical intervention is the primary treatment for this condition.

Observation:

Seven patients (six male, one female) with HIV-associated cervicodorsal lipodystrophy underwent excisional lipectomy.
Patients presented with aesthetic concerns, neck pain, and sleep disturbances.
The average duration of deformity prior to presentation was 4.75 years.

Findings:

Excisional lipectomy, with or without suction-assisted lipoplasty (SAL), was performed on all patients.

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Average operative time was 2.7 hours.

Minor complications (seroma, wound dehiscence) occurred but did not require reoperation. At 26.6 months follow-up, patients reported high satisfaction with no recurrences.

Implications:

Excisional lipectomy is a viable surgical option for cervicodorsal lipodystrophy secondary to HIV protease inhibitor use.
This technique may offer superior long-term results compared to SAL alone due to the fibrous nature of the fat deposit.
Plastic surgeons can effectively address the aesthetic and functional morbidity associated with this condition.