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Aesthetic Outcomes Of Fat Processing Techniques In Facial Fat Grafting For Human Immunodeficiency Virus (HIV) Lipodystrophy: A Systematic Review And Meta-Analysis
Mia J. Carrarini
José Antonio Arellano
Hilary Y. Liu
Benjamin B. Scott
J. Peter Rubin
Francesco M. Egro
University of Pittsburgh School of Medicine
2025-01-10
Presenter: Mia Carrarini
Affidavit:
I agree
Director Name: Vu T. Nguyen
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Aesthetics
HIV-associated lipodystrophy, a common co-morbidity in patients undergoing highly active antiretroviral therapy, often leads to facial fat loss. Facial fat grafting has become a key therapeutic method to restore volume and enhance aesthetics in individuals with HIV-related facial fat loss. This study aimed to identify the most effective fat process technique for facial fat grafting in these patients.
A systematic review and meta-analysis were conducted following PRISMA guidelines. English-language articles published between 2002-2024 with extractable data on autologous fat processing and patient satisfaction, following surgical intervention for facial fat grafting in patients with HIV lipodystrophy, were included. Meta-analysis was performed using a random-effects model.
Of 5,270 articles, 73 underwent full-text review and 10 met inclusion criteria, representing 903 patients (mean age: 41.4 years, 95% CI: 30.68–52.12). The mean fat graft volume was 9.96 mL (95% CI: -30.16–50.09), with the abdomen as the predominant harvest site (77.8%). Grafts were primarily distributed to the malar region (71.4%), followed by the temporal (14.3%), zygomatic (7.1%), and nasolabial sulcus (7.1%) sites. The analysis of physician (p = 0.67) and patient (p = 0.55) satisfaction ratings based on fat process techniques (centrifugation vs. decantation) showed no significant difference.
The choice of fat process technique, whether centrifugation or decantation, does not significantly affect satisfaction ratings from either physicians or patients. This suggests that factors beyond the fat processing method, including harvest and graft site, may play a larger role in determining patient satisfaction, physician satisfaction, and fat retention in the context of HIV lipodystrophy.
