HIV Related Plastic Surgery
Once a devastating disease whose diagnosis ended in death, HIV infection has been reduced to something more like a chronic, albeit very debilitating, disease.
Dr. DeWeese has had extensive experience performing surgery on HIV and AIDS patients from a time before these terms even existed. He is on the forefront of developing procedures aimed at ameliorating the ravages of this disease and the side-effects of the life-saving drugs used to treat HIV/AIDS without jeopardizing the life expectancy of the individual patients.
In collaboration with other plastic surgeons and physicians who primarily treat HIV/AIDS, Dr. DeWeese has presented his experience treating what's commonly called "buffalo hump" in both International and National Scientific Forums.
Surgical Correction of Lipoatrophy with Cheek Implants
The most stigmatizing location for lipoatrophy to occur is in the mid-face. While no one procedure can completely correct this wasting deformity once it occurs, cheek augmentation with Silastic implants is the most popular and expedient.
Fat transfer from another site on the patient's body, when available, is also an option. Injectable and implantable fillers are under development but to date there is no FDA-approved permanent injectable filler available.
This patient is seen before and three weeks after insertion of cheek implants through small incisions inside of the mouth.
Lipoaccumulation
Lipodystrophy describes "visible" changes in body shape and "hidden" changes in metabolism - the way your body turns fat and sugars into energy. Lipoatrophy or fat loss may occur in the face, legs, arms and buttocks.
Lipoaccumulation or fat build-up may occur behind the neck, insensitively named "buffalo hump," in front of the neck, deep within the belly and in the breasts.
This patient is a 48 year-old shown just before and two years after UAL of the dorsocervical region (back of the neck and upper torso).
The exact cause(s) of lipodystrophy are not known. Some risk factors include: low CD4 count, HIV infection itself, prolonged duration of HIV infection, various HIV medications, age, race, gender, weight, and diabetes mellitus. Accumulation of fat in the region behind the neck and back of the upper torso was initially described as a side-effect of steroid medication. But recently, it has been associated with the use of anti-HIV medications. Not only is it unsightly, but the accumulation of fat can also cause restriction of motion of the head and neck and discomfort or debilitating pain.
Ultrasound assisted lipectomy is one way to improve the dramatic contour irregularities affecting these patients. Dr. DeWeese has performed this procedure on more than forty patients with excellent initial results. Unfortunately nearly one-third of the patients complain of some degree of recurrence of the lipoaccumulation. Newer medications are being developed with the hope of fewer side effects.Request Consultation »