Facial lipoatrophy has been observed to occur in a variety of patient populations, with inherited or acquired disease, or even in aging patients as a natural progression of tissue change over time. There is currently no framework from which physicians of all medical specialties can communally discuss the manifestations, diagnoses, and management of facial lipoatrophy.
The aim of this assembly was to derive a definition of facial lipoatrophy capable of being applied to all patient populations and develop an accompanying grading system.
The final consensus of the Facial Lipoatrophy Panel encompasses both aging and disease states: “Loss of facial fat due to aging, trauma or disease, manifested by flattening or indentation of normally convex contours.” The proposed grading scale includes five gradations (Grades 1–5; 5 being the most severe), and the face is assessed according to three criteria: contour, bony prominence, and visibility of musculature.
Categorizing the presentation of facial lipoatrophy is subjective and qualitative, and will need to be validated with objective measures. Furthermore, during the assembly, several topics were exposed that warrant further research, including the physiology of volume loss, age and lipoatrophy, and human immunodeficiency virus and lipoatrophy.
*Clinique Iena, Paris, France
†Tribeca Plastic Surgery, New York, New York
‡Washington Institute of Dermatologic Laser Surgery, Washington, DC
§Chirurgia Plastica Pediatrica, Azienda Ospedaliera di Padova, Padova, Italy
∥Center for Dermatology and Dermatologic Surgery, Washington, DC
¶La Jolla Spa MD, La Jolla, California
**The Savin Center, New Haven, Connecticut
††Apex South Beach Laser and Medical Skin Care, Miami Beach, Florida
‡‡Institut d'Explorations Fonctionnelles des Glandes Salivaires, American Hospital of Paris, Paris, France
§§Nouvelle Clinique Vert Pré, Geneva, Switzerland
Address correspondence and reprint requests to: Benjamin Ascher, MD, Plastic Surgeon Board Certified, Lecturer and Clinical Assistant, Paris Academy, Clinique Iena, 11 rue Fresnel, 75116 Paris, France, or e-mail: firstname.lastname@example.org.
1Member of the Facial Lipoatrophy Panel.
Dr. Coleman received royalties from instruments sold by Bryon Medical. The authors received honorarium and travel expenses for the consensus meeting from which this study was generated.