Comparison of three different methods for correction of HIV-associated facial lipodystrophy

HIV-1-infected patients can have 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. Lipoatrophy causes negative psychosocial impact and an impairment of quality of life because of erosion of self-image and self-esteem, demoralization and depression, problems in social and sexual relations, and threats to locus of control. Surgical treatments for facial lipoatrophy include autologous fat transplant (AFT) from a subcutaneous abdominal graft or injections of biodegradable or nonbiodegradable fillers into the lipoatrophic areas of the face. The authors discuss how to choose from the different surgical procedures to treat HIV-related facial lipoatrophy.