Treatment of Steroid Induced Lipoatrophy with Structural Fat Grafting

Background: Systemic corticosteroid injections are used to treat a variety of medical conditions. Inaccurate placement of intramuscular injections of corticosteroid can result in local lipoatrophy, and a resultant cosmetic deformity. Objective: Describe the condition, and a simple, reproducible method of correcting the volume deficiency and skin changes associated with steroid induced lipoatrophy. Methods: A retrospective chart review was undertaken of all patients treated by the author for steroid induced lipoatrophy between June of 2005 and March of 2011. Results: Structural fat grafting was used to treat 11 patients with steroid induced lipoatrophy during this time period. 10 patients were female and one was male. 9 of the patients had atrophy of the buttock or hip, and 2 had atrophy of the upper extremity. All patients had satisfactory correction of their deformities, and only one of the patients required a second grafting session to achieve an adequate volume for complete correction. Conclusions: Structural fat grafting can eliminate the volume deficiency and skin changes associated with steroid induced lipoatrophy. It is a straightforward, well tolerated method for correcting a problem which can be quite cosmetically deforming.