A comparison of lipoatrophy and aging: volume deficits in the face.

Abstract:

BACKGROUND:Insight into the physical processes of aging can be gained by comparing the loss of facial volume that occurs during aging with the dramatic fat loss resulting from acquired lipoatrophy, including human immunodeficiency virus (HIV) treatment-associated lipoatrophy. The superficial effects of aging, such as rhytid formation, often are the focus of investigations into this phenomenon. However, age-related volume loss often is ignored. METHODS:A review of the relevant literature was conducted to provide an overview of age-related lipoatrophy and its etiology and to compare it by facial region with HIV-associated facial lipoatrophy. RESULTS:As a side effect of highly active antiretroviral therapy, HIV-associated lipoatrophy results in fat lipodystrophy (including both lipoatrophy and lipohypertrophy) and progresses toward nearly complete subdermal facial fat loss. Aging is accompanied by changes in the soft tissues of the face, leaving atrophic regions of generalized tissue ptosis. Some facial regions are affected differently by fat loss, depending on its cause. In the aging patient, certain parts of the face display only minimal fat loss. CONCLUSIONS:The role of fat loss in facial aging is slight compared with its considerable role in HIV-associated lipoatrophy. The losses of various facial tissues and the ptosis of some soft tissues are strong contributors to the appearance of the aged face. This regional anatomic assessment of the face engenders a more thorough understanding of the progression that characterizes volume changes associated with aging.

journal_name

Aesthetic Plast Surg

authors

Coleman S,Saboeiro A,Sengelmann R

doi

10.1007/s00266-008-9258-z

subject

Has Abstract

pub_date

2009-01-01 00:00:00

pages

14-21

issue

1

eissn

0364-216X

issn

1432-5241

journal_volume

33

pub_type

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