9911-1814 Wolfort
Wolfort FG, Cetrulo CL Jr, Nevarre DR.
Suction-assisted lipectomy for lipodystrophy syndromes attributed to
HIV-protease inhibitor use.
Plast Reconstr Surg. 1999 Nov;104(6):1814-20; discussion 1821-2. PMID: 10541186
Beth Israel-Deaconess Medical Center, Harvard Medical School, Boston, Mass, USA.
The addition of HIV-protease inhibitors to the arsenal of therapies for the
treatment of HIV infection has resulted in significant suppression of viral load
such that HIV-positive individuals experience reduced morbidity and extended
life expectancy. Recently, a number of syndromes have been described involving
abnormal fat distribution that may be associated with prolonged HIV-protease
inhibitor therapy. These syndromes include hypertrophy of the cervicodorsal fat
pad ("buffalo hump"); a tendency toward increased central adiposity ("protease
paunch"); adiposity in the submental, mandibular, and lateral cheek regions of
the face; and hypertrophy of adipose tissue in the breast in women. A peripheral
lipodystrophy, or fat-wasting, in the extremities and face (particularly the
malar and nasolabial fold regions) has also been observed. As these patients
live longer and healthier lives, many are beginning to seek surgical correction
of the disfigurements. In this regard, we present a review of the literature
regarding these recently described syndromes to familiarize plastic and
reconstructive surgeons with the unique deformities encountered in this
ever-increasing patient population. We also present our results with
suction-assisted lipectomy for treatment of these deformities. Physical
findings, pathogenesis, and surgical management are discussed.
Publication Types:
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