El-Khatib Hamdy A
Plastic Surgery Department, Al-Khor Hospital, Doha, Qatar.
Ann Plast Surg. 2008 Jul;61(1):2-8. doi: 10.1097/SAP.0b013e318156debe.
Unusual fat distribution of the lower part of the body is clinically characterized by massive symmetric and diffuse fat deposition in the trochanters, groins, buttocks, hips, and lower extremities, which contrasts sharply with the normal upper part of the body. The massive lipomatoses of the lower part of the body can be classified into 3 types: type 1, the familial symmetrical lipomatosis that affects the groins, trochanters, hips, buttocks, and thighs; type 2, the bilateral peritrochanteric familial lipomatoses; and type 3, the unilateral peritrochanteric lipomatosis. This unusual adiposity runs in families and predominantly exists in the Mediterranean region, and seems, however, to be common in North Africa. It is rarely reported in the literature. In this regard, a differential diagnosis is presented regarding the lipomatosis and lipodystrophies-described syndromes to familiarize plastic surgeons with these unique deformities. Between 2000 and 2006, 50 women with abnormal diffuse fat deposits in the lower part of the body were investigated and treated with conventional liposuction; patients' ages ranged between 20 to 46 years. Laboratory examination includes the serum concentrations of lipoprotein, cholesterol, triglycerides, uric acid, fasting glucose, and other routine laboratory tests. Endocrinologic tests include serum estradiol and testosterone levels, and thyroid function tests. Histologic examination of the lipoaspirate was performed. All cases were treated with liposuction. For type 1 cases liposuction was performed in stages; the maximum amount of lipoaspirate per setting was 3,000 to 4,000 mL, and for type 2 and type 3 a single stage liposuction was undertaken. Laboratory examination showed normal values and routine parameters were within normal limits. Endocrinologic investigations revealed no abnormalities and histologic examination of lipoaspirate showed normal subcutaneous fatty tissue. The esthetic outcome of all individuals was satisfactory. Abnormal swelling of the lower half of the female body caused by deposition of subcutaneous fat is determined by heredity and seems to be common in North Africa. It is often accompanied by a psychological reaction due to the disturbed body image. A clinical classification is reported in the current study. The traditional liposuction is the treatment of choice for these esthetic deformities.
身体下部异常脂肪分布的临床特征是转子区、腹股沟、臀部、髋部和下肢出现大量对称性弥漫性脂肪沉积，这与身体正常的上半部分形成鲜明对比。身体下部的大量脂肪瘤可分为3种类型：1型，家族性对称性脂肪瘤病，累及腹股沟、转子区、髋部、臀部和大腿；2型，双侧转子周围家族性脂肪瘤病；3型，单侧转子周围脂肪瘤病。这种异常肥胖具有家族遗传性，主要存在于地中海地区，不过在北非似乎也很常见。文献中对此报道较少。在这方面，本文对脂肪瘤病和脂肪营养不良相关综合征进行了鉴别诊断，以使整形外科医生熟悉这些独特的畸形。2000年至2006年期间，对50例身体下部有异常弥漫性脂肪沉积的女性进行了调查，并采用传统抽脂术进行治疗；患者年龄在20至46岁之间。实验室检查包括血清脂蛋白、胆固醇、甘油三酯、尿酸、空腹血糖浓度以及其他常规实验室检查。内分泌检查包括血清雌二醇和睾酮水平以及甲状腺功能检查。对抽脂物进行了组织学检查。所有病例均采用抽脂术治疗。对于1型病例，抽脂术分阶段进行；每次抽脂的最大量为3000至4000毫升，对于2型和3型病例则采用单阶段抽脂术。实验室检查显示各项数值正常，常规参数均在正常范围内。内分泌检查未发现异常，抽脂物的组织学检查显示皮下脂肪组织正常。所有患者的美学效果均令人满意。女性身体下半部因皮下脂肪沉积引起的异常肿胀由遗传决定，在北非似乎很常见。由于身体形象受到干扰，常伴有心理反应。本研究报告了一种临床分类方法。传统抽脂术是治疗这些美学畸形的首选方法。
