Multiple Symmetric Lipomatosis: Lipectomy for Madelung Collar

Abstract

Multiple symmetric lipomatosis (MSL) is a rare disease associated with metabolic disorders and alcoholism. In this report, we describe the clinical outcome and surgical protocol for eight men with Madelung collar who underwent treatment in a craniofacial and plastic surgery facility in Hanoi, Vietnam, between May 2018 and December 2020. We discuss the patients' clinical symptoms, subclinical signs, epidemiology, magnetic resonance imaging, computerized tomography, surgical protocol, complications, and postoperative indicators that we collected and evaluated. Each patient underwent surgery in two stages (i.e., in supine and prone positions). We injected a tumescent solution 10 min before the incision. Two surgeons performed each operation simultaneously. After surgery, we followed the patients for 6-27 months. All of the patients had a history of long-time alcohol abuse and had associated comorbidities that included liver disease, blood disorders, restricted neck movement, and orthopnea. We did not have to open the trachea or transfuse blood during any of the surgical procedures. Postoperatively, all patients were satisfied with their functional results and aesthetic appearance. One patient experienced a recurrence of his MSL. We believe our surgical protocol provides optimal results for patients with MSL and Madelung collar.