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Published on: March 14, 2019
Morcellized Omental Transfer for Severe HIV Facial Wasting
David Teplica1, Marlon Bohorquez1, Francis J Podbielski1
1Department 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.
This study presents a novel technique using mechanically morcellized omental fat for facial reconstruction in patients with severe lipoatrophy. This safe and effective method restores facial volume when subcutaneous fat is unavailable.
Area of Science:
- Plastic Surgery
- Regenerative Medicine
- Microsurgery
Background:
- Facial wasting due to severe human immunodeficiency virus (HIV) lipoatrophy presents a reconstructive challenge, especially when subcutaneous fat is unavailable.
- A novel surgical approach was developed to address this deficit using autologous omental tissue.
Purpose of the Study:
- To evaluate the safety and efficacy of mechanically morcellized omental fat transfer for facial reconstruction in patients with severe HIV-associated lipoatrophy.
- To assess graft survival and patient outcomes.
Main Methods:
- Endoscopic harvest of omentum using a standard 3-port laparoscopic technique.
- Extracorporeal mechanical morcellation of omental fat into particulate grafts.
- Autologous transfer of living particulate fat to facial subcutaneous planes via specialized catheters.
Main Results:
- Electron microscopy confirmed the viability of morcellized omental fat grafts.
- 13 out of 14 patients experienced good to excellent adipose graft survival.
- Complications were minor and transient, with all patients discharged within 24 hours and no need for open laparotomy.
Conclusions:
- Mechanically morcellized omental fat transfer is a safe and effective option for facial volume restoration in patients with severe wasting and limited donor tissue.
- The predictable progression of facial wasting allows for standardized preoperative classification and postoperative evaluation.
