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Facial WastingFacial Wasting
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The best filler solution

Nov 13, 2008

Hi Dr. Thanks for you permanent help. What is, according to your knoledge and expertise (feedback) with other HIV people, the best filler solution that someone can look onto? One with the least complication, the smoothest with no side effects, in another word the best and the safest (putting the cost factor aside). Thank you once again

Response from Dr. Pierone

This is a difficult question to answer because all fillers have pros and cons. Perhaps more important than the particular filler, is the skill and experience of the injector.

Sculptra has an excellent track record for treatment of facial lipoatrophy and does appear to be durable at least past one year. Sometimes nodules may form, especially in the area under the eyes or in the temple region. It is not an immediate gratification agent, and requires multiple treatments and patience.

Radiesse is very safe and effective for HIV facial lipoatrophy and the results are immediate. The downside is that it appears not to last as long as Sculptra and retreatment will be necessary periodically.

PMMA - poly (methyl methacrylate) is a permanent filler that is available in many countries for use as a facial filler. In the U.S. the product is called Artefill and is PMMA combined with bovine collagen. PMMA works well for facial lipoatrophy, but because of the high cost of Artefill is not used much for this purpose in U.S. Also, permanent filler injections should only be performed by clinicians with experience and advanced skills in order to avoid poor aesthetic outcomes.

I hope this information helps and best of luck!

Wasting early in treatment
facial wasting from d4T (Zerit)

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