Background Patients with male-to-female gender dysphoria (GD) require multidisciplinary assessment and management. Nowadays, more and more patients decide to undergo genital reassignment surgery (GRS) to have aesthetic and functional external female genitalia. Different techniques of this procedure have been described. Orchiectomy, penile disassembly, creation of a neovaginal cavity, repositioning of urethral meatus, and clitorolabioplasty may be identified as the five major steps in all of these techniques. Methods We conducted a retrospective study of 60 patients who underwent genital reassignment procedure for male-to-female GD at our department between November 2008 and August 2013 with a minimum follow-up of 1 year. Data were collected on surgical technique, postoperative dilations protocol, complications, and functional and aesthetic outcomes. We describe and critically evaluate the surgical technique used in our department. Results Follow-up ranged from 14 to 46 months. Two patients developed late neovaginal stricture, and two patients experienced rectovaginal fistulae (one required surgical revision with dermal porcine graft placement). Minor complications occurred in 13 patients and included urethral stenosis, partial wound dehiscence, and minor bleeding. Secondary aesthetic revision surgery was performed in 13 cases. Conclusions GRS can provide good functional and aesthetic outcomes in patients with male-to-female GD. However, despite a careful planning and meticulous surgical technique, secondary procedures are frequently required to improve the function and appearance of the neovagina.

'Buffalo hump' adipose tissue shows specific disturbances in gene expression with respect to subcutaneous fat from HIV-1-infected/HAART-treated patients. Mitochondrial alterations cannot explain the differential behavior of 'buffalo hump' with respect to adipose depots prone to lipoatrophy. The absence of a local inflammatory status in 'buffalo hump' may explain in part the differential behavior of this adipose tissue.

Using objective measurement, this study demonstrates that with one fat grafting procedure a durable result can be achieved, persisting for a minimum of 12 months without any trend towards reabsorption.

This study provides patients and surgeons with the confidence to keep using lipofilling reconstruction in women with breast cancer history when it is performed in a hospital setting by trained surgeons.

Autologous fat grafting is a good method for correction of retracted or sunken scars instead of the traditional scar surgical excision.

Therapeutic, II.

in nonlipodystrophic HIV-infected naive patients, viral infection is associated with adipose tissue mtDNA decrease and mitochondrial dysfunction independently of antiretroviral treatment.

A parallel effect of the use of protease inhibitors in human immunodeficiency virus-positive patients is the appearance of facial fat atrophy. To correct this, the authors propose lipoinjection of autologous fat into the areas of facial atrophy by a technique based on the atraumatic procurement of fat and posterior treatment with decantation, centrifugation, and cleaning of other material obtained by aspiration. The method of fat injection is also important and is performed by means of interlaced tunnels and the introduction of a small volume of fat into each tunnel as a graft. In 30 percent of the cases, reinjection of fat was required during the first postoperative months. The results obtained after the experience of 2 years were very satisfactory.