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Lipodystrophy and WastingLipodystrophy and Wasting
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Fat abdomen - truncal obesity
May 5, 2001

Hi. I have been HIV+ for 5 years. Was on HAART for 3 years. During that time, I gained a lot of fat in my abdomen. I have been off HAART for 2 years and my Tcell count is 500+, but the fat in my abdomen remains, despite a vigorous diet and exercise regimen. Now my buttocks are starting to "waste" or lose fat. I am considering liposuction and a tummy tuck for my fat abdomen. My question is this -will the fat return to my abdomen after the surgery? Do you know of any other HIV+ men who have had fat removed from their abdomen....does the fat return? Thanks for your help.

Response from Dr. Fisher

Don't know. However, liposuction seems contraindicated for HIV-associated abdominal fat accumulation. This fat is accumulated inside the abdomen where a liposuction sucker cannot go (don't want your liver sucked out after all). But if you have fat in the subcutaneous area (below the skin, above the abdominal muscles) then liposuction should be safe and effective. But this kind of fact accumulation -subcutaneous - is what is very common in men as we get older and not, probably not, due to HIV or to antiretrovirals. After liposuction in non HIV settings, the fat does not generally come back but the surgeon should inform you of the likely results. Indeed demand to know the likely results before doing this. You can have a buttocks lift as well. Talk to the surgeon; this is not a real major procedure and should have good results. BUT...none of this is certain in men with HIV (with or without antiretrovirals). There simply has not been enough reported (as opposed to anecdotal) experience with any of these techniques in HIV+ men (or women). So be careful. Make sure you have reputable/competent surgeon. Don't accept promises - promises can't be made in these circumstances. AF

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