Use of the Temporal Muscle Flap in Barraquer-Simonʼs Progressive Lipodystrophy

Serra, J. M.; Ballesteros, A.; Mesa, Felipe; Bazán, Antonio; Paloma, Vincente; Sanz, Julian

doi:10.1097/00000637-199302000-00016

Cited by 9 publications

(7 citation statements)

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“…Management of subcutaneous fat loss is challenging and often frustrating for physicians and surgeons. Numerous cosmetic procedures have been attempted to correct cosmetic disfigurement, including paraffin injections 38 , acrylic prosthesis 75 , silicon implants 34,98,131,132 (Patient 29), facial injection of aspirated fat from thighs 48 (Patient 29), fascial and fat grafts from thighs 11 (Patient 24), free dermal fat grafts 85,191 , free anterolateral thigh flaps 70 , scapular grafts (Patient 18), temporalis muscle flaps 151,172 , and bilateral facial reconstruction with transverse rectus abdominis myocutaneous grafts 41,67 . Although improvement of facial appearance has been reported 41,85,191 , failure may occur.…”

Section: Cosmetic Proceduresmentioning

confidence: 99%

Clinical Features and Metabolic and Autoimmune Derangements in Acquired Partial Lipodystrophy

Misra

Peethambaram

Garg³

2004

Medicine

249

252

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We describe clinical features, body fat distribution, and prevalence of metabolic abnormalities in 35 patients with acquired partial lipodystrophy (APL) seen by us over 8 years, and also review 220 cases of APL described in the literature. Based on the review and our experience, we propose that the essential diagnostic criterion for APL is the gradual onset of bilaterally symmetrical loss of subcutaneous fat from the face, neck, upper extremities, thorax, and abdomen, in the "cephalocaudal" sequence, sparing the lower extremities. Analysis of the pooled data revealed that female patients were affected approximately 4 times more often than males. The median age of the onset of lipodystrophy was 7 years. Several autoimmune diseases, in particular systemic lupus erythematosus and dermatomyositis, were associated with APL. The prevalence rates of diabetes mellitus and impaired glucose tolerance were 6.7% and 8.9%, respectively. Approximately 83% of APL patients had low complement (C) 3 levels and the presence of polyclonal immunoglobulin C3 nephritic factor. Twenty-two percent of patients developed membranoproliferative glomerulonephritis (MPGN) after a median of approximately 8 years following the onset of lipodystrophy. Compared with patients without renal disease, those with MPGN had earlier age of onset of lipodystrophy (12.6 +/- 10.3 yr vs 7.7 +/- 4.4 yr, respectively; p < 0.001) and a higher prevalence of C3 hypocomplementemia (78% vs 95%, respectively; p = 0.02). The pathogenesis of fat loss and MPGN in patients with APL remains unclear, but activation of an alternate complement pathway has been implicated. Treating the cosmetic disfigurement by surgical procedures has yielded inconsistent results. The use of thiazolidinediones to treat fat loss in patients with APL remains anecdotal. Prognosis is mainly determined by renal insufficiency due to MPGN.

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Section: Cosmetic Proceduresmentioning

confidence: 99%

Clinical Features and Metabolic and Autoimmune Derangements in Acquired Partial Lipodystrophy

Misra

Peethambaram

Garg³

2004

Medicine

249

252

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“…7 Several methods of pedicled transfer have been described. 8,9 However, the mobility and sculpturing possibilities of pedicled flaps are limited. Since the advent of microvascular surgery, the scope of reconstructive methods has increased.…”

Section: Discussionmentioning

confidence: 99%

Facial contour restoration in Barraquer‐Simons syndrome using two free tram flaps: Presentation of two case reports and long‐term follow‐up

Goossens

Coessens

2002

Microsurgery

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Barraquer-Simons syndrome, a disorder of unknown etiology, is characterized by a cephalothoracic lipodystrophy. We present 2 patients treated with a bilateral free transverse rectus abdominis myocutaneous (TRAM) flap to restore facial contour. Our technique of using a muscle component to fill the cheek defect was based on our experience with free muscle transfer in facial reanimation. In comparison with adipose tissue, muscle tissue does not show a tendency for ptosis because of its consistency and firm attachment of the muscle surface to the surrounding tissues. These cases demonstrate the possibility for the use of simultaneous dissection of the face and flaps, and the reliability of the vascular pedicle. The stability of the abdominal wall was secured by closure of the rectus sheath over Teflon mesh, which has been proven to prevent hernia. Our long-term follow-up demonstrates a stable symmetrical facial appearance.

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“…Areas of concern include posttraumatic tissue damage, 218,219 such as that seen in extensive deep burns, avulsions, tumor resections, or postsurgical deformity, as well as congenital or acquired diseases of the subcutaneous fat, including lipodystrophy. [220][221][222] Local and free flaps, autologous adipose tissue grafts, and natural and synthetic fillers, are widely used for tissue contouring in these clinical settings. [220][221][222][223] Many of these treatment modalities, however, have limitations and disadvantages.…”

Section: Mesenchymal Stem Cells Ecm Proteins and Cosmetic Dermatologymentioning

confidence: 99%

“…[220][221][222] Local and free flaps, autologous adipose tissue grafts, and natural and synthetic fillers, are widely used for tissue contouring in these clinical settings. [220][221][222][223] Many of these treatment modalities, however, have limitations and disadvantages. Autologous adipose tissue grafts are desirable because they are derived from ubiquitous and accessible sources of fat and because they avoid use of materials that elicit foreign-body type reactions.…”

Section: Mesenchymal Stem Cells Ecm Proteins and Cosmetic Dermatologymentioning

confidence: 99%

Subcutaneous fat in normal and diseased states

Avram

James

2007

Journal of the American Academy of Dermatology

183

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Use of the Temporal Muscle Flap in Barraquer-Simonʼs Progressive Lipodystrophy

Cited by 9 publications

References 0 publications

Clinical Features and Metabolic and Autoimmune Derangements in Acquired Partial Lipodystrophy

Clinical Features and Metabolic and Autoimmune Derangements in Acquired Partial Lipodystrophy

Facial contour restoration in Barraquer‐Simons syndrome using two free tram flaps: Presentation of two case reports and long‐term follow‐up

Subcutaneous fat in normal and diseased states

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