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Cosmetic Surgeny
Oct 20, 2008

Dr Robert,

I had lipo two yrs ago and since switching my health is fantastic as in my CD4 is above 880 and Viral load undetectable.I am considering having liposuction and body sculpting would you recommend or oppose this procedure.I want the fat on my belly and back be taken to my butt and legs.Please advise and thanks in advance

Response from Dr. Frascino

Hello,

Lipohypertrophy, the abnormal accumulation of visceral fat, and lipoatrophy, the loss of fat in the face and extremities, are two distinct processes. We still do not have a complete understanding of the pathophysiological mechanisms underlying these conditions, nor do we have good treatments for them.

Lipohypertrophy that occurs in the abdomen is deep and located around the internal organs (viscera). It can be associated with fatty infiltration of the liver as well. The abdomen protrudes forward because of the outward pressure of the intra-abdominal fat pushing the abdominal wall. Unfortunately, this type of intra-abdominal fat is not amenable to liposuction, due to the location of the visceral fat. The "buffalo hump" is somewhat more amenable to liposuction.

For lipoatrophy, fat injections have not proven to be beneficial. However, there are a variety of synthetic fillers that can be used. Check out the information in The Body's Lipoatrophy Resource Center as well as in the expert forum on facial wasting.

The bottom line is that your plan to body sculpt by using your lipohypertrophy to correct your lipoatrophy won't work.

Dr. Bob



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