Facial fat hypertrophy in patients who receive autologous fat tissue transfer

HIV-1-infected patients may develop lipodystrophy characterized by peripheral fat loss or lipoatrophy of the face, limbs, and buttocks and central fat accumulation within the abdomen, breast, and the dorso-cervical spine both of which may be present in the same individual. Facial lipoatrophy is undoubtedly the most frequent and distressing sign of this clinical syndrome. The authors believe that autologous fat transplant should be the preferred option for the treatment of facial lipoatrophy when an appropriate graft site is available. Nevertheless, this major surgery technique may have minor and major complications. Minor complications include pain, edema, and superficial bleeding. Major complications may be represented by disfiguring facial fat graft hypertrophy. Four patients who had fat transferred from the dorsocervical fat pad or from subcutaneous abdominal tissue developed a disfiguring fat graft hypertrophy of the face that occurred at the same time as recurrent fat accumulation in the tissue harvest site. A clinical implication is that when autologous fat transplant is chosen for face atrophy treatment, the preferred subcutaneous adipose graft site should be abdomen or groin. © 2010 Springer-Verlag Berlin Heidelberg.