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Ultrasound-assisted
Liposuction Reduces HIV-associated Buffalo Hump
By Karla Gale
Enlargement of the dorsocervical fat pad observed in patients infected
with HIV can be successfully treated with ultrasonography-assisted
liposuction (UAL), according to a report in the November 15th issue
of Clinical Infectious Diseases.
However, recurrence of lipodystrophy after the procedure is common.
UAL is especially helpful when removing fat from fibrous areas,
Dr. Peter J. Piliero and colleagues at Albany Medical College in
New York explain. UAL involves the use of ultrasonic energy, applied
with a cannula inserted into the subcutaneous adipose tissue. The
process targets and liquefies fat cells without affecting the surrounding
connective tissue and neurovascular structures.
The investigators report that UAL treatment of dorsocervical lipodystrophy
in 10 patients between 1994 and 2002 was well tolerated, although
two patients developed pneumococcal bacteremia and pneumonia 1 to
3 months later. The size of the hump was at least partially reduced
in all cases.
Five patients developed recurrence, and two of them underwent a
second UAL.
UAL is the treatment of choice for patients with a buffalo hump,
according to Dr. Rod Rohrich, chief of plastic surgery at University
of Texas Southwestern in Dallas and president of the American Society
of Plastic Surgeons.
"I've treated about 15 patients this way," he told Reuters
Health, "and only in one patient did a small amount come back."
But even for this patient, re-treatment was not necessary. "The
key is you have to treat it fairly aggressively, and have the patient
wear a compression garment to maintain pressure on the treated area
for 2 weeks after the procedure."
And by reserving UAL for "fairly healthy individuals,"
he added, adverse effects are no more likely to be encountered than
in the general population.
12/03/03
Clin Infect Dis 2003;37:1374-1377.
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