Excisional lipectomy versus liposuction in HIV-associated lipodystrophy

Background Human immunodeficiency virus (HIV)-associated lipodystrophy is a known consequence of long-term highly active antiretroviral therapy (HAART). However, a significant number of patients on HAART therapy were left with the stigmata of complications, including fat redistribution. Few studies...

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Autores principales:	Natalie Barton, Ryan Moore, Karthik Prasad, Gregory Evans
Formato:	article
Lenguaje:	EN
Publicado:	Korean Society of Plastic and Reconstructive Surgeons 2021
Materias:	lipodystrophy liposuction lipectomy hiv Surgery RD1-811
Acceso en línea:	https://doaj.org/article/2bbb1ec7a5cd4629a63fa4a29d10d4b3
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spelling	oai:doaj.org-article:2bbb1ec7a5cd4629a63fa4a29d10d4b32021-11-25T06:04:37ZExcisional lipectomy versus liposuction in HIV-associated lipodystrophy2234-61632234-617110.5999/aps.2020.02285https://doaj.org/article/2bbb1ec7a5cd4629a63fa4a29d10d4b32021-11-01T00:00:00Zhttp://www.e-aps.org/upload/pdf/aps-2020-02285.pdfhttps://doaj.org/toc/2234-6163https://doaj.org/toc/2234-6171Background Human immunodeficiency virus (HIV)-associated lipodystrophy is a known consequence of long-term highly active antiretroviral therapy (HAART). However, a significant number of patients on HAART therapy were left with the stigmata of complications, including fat redistribution. Few studies have described the successful removal of focal areas of lipohypertrophy with successful outcomes. This manuscript reviews the outcomes of excisional lipectomy versus liposuction for HIV-associated cervicodorsal lipodystrophy. Methods We performed a 15-year retrospective review of HIV-positive patients with lipodystrophy. Patients were identified by query of secure operative logs. Data collected included demographics, medications, comorbidities, duration of HIV, surgical intervention type, pertinent laboratory values, and the amount of tissue removed. Results Nine male patients with HIV-associated lipodystrophy underwent a total of 17 procedures. Of the patients who underwent liposuction initially (n=5), 60% (n=3) experienced a recurrence. There were a total of three cases of primary liposuction followed by excisional lipectomy. One hundred percent of these cases were noted to have a recurrence postoperatively, and there was one case of seroma formation. Of the subjects who underwent excisional lipectomy (n=4), there were no documented recurrences; however, one patient’s postoperative course was complicated by seroma formation. Conclusions HIV-associated lipodystrophy is a disfiguring complication of HAART therapy with significant morbidity. Given the limitations of liposuction alone as the primary intervention, excisional lipectomy is recommended as the primary treatment. Liposuction may be used for better contouring and for subsequent procedures. While there is a slightly higher risk for complications, adjunctive techniques such as quilting sutures and placement of drains may be used in conjunction with excisional lipectomy.Natalie BartonRyan MooreKarthik PrasadGregory EvansKorean Society of Plastic and Reconstructive SurgeonsarticlelipodystrophyliposuctionlipectomyhivSurgeryRD1-811ENArchives of Plastic Surgery, Vol 48, Iss 6, Pp 685-690 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	lipodystrophy liposuction lipectomy hiv Surgery RD1-811
spellingShingle	lipodystrophy liposuction lipectomy hiv Surgery RD1-811 Natalie Barton Ryan Moore Karthik Prasad Gregory Evans Excisional lipectomy versus liposuction in HIV-associated lipodystrophy
description	Background Human immunodeficiency virus (HIV)-associated lipodystrophy is a known consequence of long-term highly active antiretroviral therapy (HAART). However, a significant number of patients on HAART therapy were left with the stigmata of complications, including fat redistribution. Few studies have described the successful removal of focal areas of lipohypertrophy with successful outcomes. This manuscript reviews the outcomes of excisional lipectomy versus liposuction for HIV-associated cervicodorsal lipodystrophy. Methods We performed a 15-year retrospective review of HIV-positive patients with lipodystrophy. Patients were identified by query of secure operative logs. Data collected included demographics, medications, comorbidities, duration of HIV, surgical intervention type, pertinent laboratory values, and the amount of tissue removed. Results Nine male patients with HIV-associated lipodystrophy underwent a total of 17 procedures. Of the patients who underwent liposuction initially (n=5), 60% (n=3) experienced a recurrence. There were a total of three cases of primary liposuction followed by excisional lipectomy. One hundred percent of these cases were noted to have a recurrence postoperatively, and there was one case of seroma formation. Of the subjects who underwent excisional lipectomy (n=4), there were no documented recurrences; however, one patient’s postoperative course was complicated by seroma formation. Conclusions HIV-associated lipodystrophy is a disfiguring complication of HAART therapy with significant morbidity. Given the limitations of liposuction alone as the primary intervention, excisional lipectomy is recommended as the primary treatment. Liposuction may be used for better contouring and for subsequent procedures. While there is a slightly higher risk for complications, adjunctive techniques such as quilting sutures and placement of drains may be used in conjunction with excisional lipectomy.
format	article
author	Natalie Barton Ryan Moore Karthik Prasad Gregory Evans
author_facet	Natalie Barton Ryan Moore Karthik Prasad Gregory Evans
author_sort	Natalie Barton
title	Excisional lipectomy versus liposuction in HIV-associated lipodystrophy
title_short	Excisional lipectomy versus liposuction in HIV-associated lipodystrophy
title_full	Excisional lipectomy versus liposuction in HIV-associated lipodystrophy
title_fullStr	Excisional lipectomy versus liposuction in HIV-associated lipodystrophy
title_full_unstemmed	Excisional lipectomy versus liposuction in HIV-associated lipodystrophy
title_sort	excisional lipectomy versus liposuction in hiv-associated lipodystrophy
publisher	Korean Society of Plastic and Reconstructive Surgeons
publishDate	2021
url	https://doaj.org/article/2bbb1ec7a5cd4629a63fa4a29d10d4b3
work_keys_str_mv	AT nataliebarton excisionallipectomyversusliposuctioninhivassociatedlipodystrophy AT ryanmoore excisionallipectomyversusliposuctioninhivassociatedlipodystrophy AT karthikprasad excisionallipectomyversusliposuctioninhivassociatedlipodystrophy AT gregoryevans excisionallipectomyversusliposuctioninhivassociatedlipodystrophy
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Excisional lipectomy versus liposuction in HIV-associated lipodystrophy

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