Evaluation of Coleman lipostructure for treatment of facial lipoatrophy in patients with human immunodeficiency virus and parameters associated with the efficiency of this technique

Objective: To evaluate the efficiency of Coleman lipostructure in patients infected with human immunodeficiency virus (HIV). Design: Open-label study and survey. Setting: Ambulatory dermatosurgery department of a university hospital. Patients: Thirty-three consecutive HIV-infected patients undergoing Coleman lipostructure between 2000 and 2001. Interventions: Clinical examination, blood tests, and standardized photographs at baseline and 1 year after the lipostructure. Mean Outcome Measures: Efficiency was assessed by the agreement of 3 independent medical specialists on facial lipodystrophy improvement after surgery and by patient satisfaction. Results: Facial lipoatrophy was improved in 12 patients (36%; 95% confidence interval, 20%-52%) as judged by all 3 evaluators. Quantity of fat injected (P=.01) and a low serum triglyceride level before surgery (P=.03) were significantly associated with improvement of facial lipoatrophy. Of the 33 patients, 14 (43%) were very satisfied, 17 (50%) were partly satisfied, and 27 (81%) had a better quality of life. The most common comment was that the patient looked better and appeared less ill. Conclusion: Our 1-year evaluation of Coleman lipostructure for correction of facial lipoatrophy in HIV-infected patients proved the efficiency of this treatment when measured conservatively by agreement on improvement by 3 independent specialists and demonstrated a patient satisfaction rate of 93%.