Contemporary surgical management of HIV-associated facial lipoatrophy

Otolaryngol Head Neck Surg. 2006 Jun;134(6):1015-22. doi: 10.1016/j.otohns.2006.01.005.


Objectives: The purpose of this study is to describe our experience with facial volume restoration in 39 HIV-associated facial lipoatrophy patients, and formulate a treatment algorithm that can be utilized for these patients based on their disease severity.

Methods: Preoperative and postoperative photographs were evaluated by 2 experienced facial plastic surgeons using grading scales. The reviewers' scores were then compared and the distribution of scores was analyzed.

Results: Thirty-nine patients underwent malar silastic implantation. Seven patients required postoperative adjuvant filler injection. Most patients' results were rated good to excellent. There were 4 late complications.

Conclusion: HIV-associated facial lipoatrophy is a socially disabling condition that causes noticeable disfigurement and stigmatizes the patient. We demonstrate the importance of combining a reliable grading scale with a strategic treatment algorithm that utilizes multiple modalities for volume restoration.

Ebm rating: C-4.

MeSH terms

  • Adipose Tissue / pathology*
  • Adult
  • Atrophy
  • Biocompatible Materials
  • Dimethylpolysiloxanes
  • Face / pathology
  • Face / surgery*
  • Female
  • HIV Infections / complications*
  • HIV-Associated Lipodystrophy Syndrome / surgery*
  • Humans
  • Male
  • Middle Aged
  • Prostheses and Implants*
  • Silicones
  • Surgery, Plastic / methods*
  • Treatment Outcome


  • Biocompatible Materials
  • Dimethylpolysiloxanes
  • Silicones
  • baysilon