Hi Nelson, It's John Hutson , the guy that worked with Dr Michael Dullnig on Lobbying to get European Steroids into America. And I'm also a friend of Michael Mooney. I hate to say this but my face looks sunken and sharp. I want to get someone great to "plump it up". Who would you reccomend? Money is a concern. Do you know if Blue Cross will pay for any of this, I have a private policy. I live in DC but will fly anywhere to get it done right. Thanks Nelson, Love John Hutson(yet another Lazarus!)

Dear Jon:

How are you! Wow, I have not heard from you or seen you in a long time.! Yes, you were Dr X's best friend! I think he would be proud to see the work that we have done after his death, I hope.

Is your facial wasting mild, moderate, over-moderate or severe (4 grades).? For the two last grades, Bio-Alcamid (Anna Love www.clinicestetica.com)or Silikon 1000 ( Dr Derek Jones in Los Angeles, Dr Hal Brody in Atlanta, or Dr Orentreich in NYC) are the best bets, in my opinion. Bio-Alcamid can be injected in larger quantities, so you will need one to two sessions in most cases. Silikon 1000 is injected in microdroplets and it can take 4-6 sessions. Both seem to be permanent and I have heard equally good comments from patients in my lipodystrophy yahoo group of 730 members.

The cost for Bio-Alcamid is a flat fee of $4500 and they require half up front, no credit cards. The cost of Silikon 1000 is around 700 per session, depending on the doctor.

For the two first grades (mild to moderate), NewFill (Sculptra in the US) may be a good option. This procedure requires 4-6 sessions, and a touch up every 15-18 months. It is not premanent, but this may be a good thing if your fat slowly returns like the studies are starting to indicate after a switch of Zerit to Ziagen or Viread. This product may get approved soon and there will be a patient assistance program set up for people with low income and no insurnace/Medicare/Medicaid. Dermik, the company who owns the rights of Sculptra, is also working hard at getting reimbursement for this procedure. The total cost for 5-6 sessions of Sculptra will probably be around $5,500, but pricing has not been set. Currently, some doctors are using NewFill imported through DAAIR and charging $800 per session (product included). NewFill (Sculptra) is the option with more HIV related data. But keep in mind that we have no long term data of over 5 years with any of these products, so it is a risk we are taking when we decide to get our faces injected.

More information here: www.facialwasting.org

I hope to see you in the near future!

Nelson