Barraquer Simons Syndrome: Case Series and Review of Surgical Treatments for Facial Lipodystrophy

Abstract

Background: Barraquer Simons Syndrome (BSS) is a subtype of idiopathic acquired lipodystrophy, wherein patients—mostly female—lose subcutaneous fat in the upper half of the body starting in childhood or puberty. A disproportionate fat allocation can be seen in the trochanteric region and thighs. Methods: Along with three cases of lipoatrophy treated at our hospital, we conducted a comprehensive review and presented the treatments in the literature for improving bilateral facial lipodystrophy. Results: Flaps and autologous fat grafting procedures were favored across the literature, and regardless of the intervention of choice, patients reported satisfaction and improved life prospects. Conclusion: The loss of facial fat is especially afflicting for patients as the bilateral lipoatrophy imparts an aged, cachexic look which negatively affects not only their self-image but their social status as well. Alternatives to approach lipoatrophy vary in their invasiveness, permanency, and feasibility, thus, treatments must be thoroughly tailored to each patient’s needs and expectations. Barraquer Simons Syndrome is a rare subtype of lipodystrophy primarily affecting females, leading to fat loss in mainly the upper body. The negative social impact of the syndrome necessitates intervention, and patients receiving appropriate treatment reported improved psychosocial parameters. Treatment plans should consider each patient's specific needs and expectations, balancing invasiveness, permanency, and feasibility of the procedures. Level of Evidence IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. © 2025 Elsevier B.V., All rights reserved.