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What a poor situation I am in! please advise.
Jul 31, 2009

I'm HIV+ and have facial wasting caused of last Meds taking (3TC, D4T, AZT!!) Now, i'm living in Bangkok, Thailand. Looking for the appropriate treat my facial waste. But, I don't really know all of these you are taking about. Please advise what 's "Sculptra", "Bio-Alcamid" and "Radiesse". How's the difference? Which one is the working best? Where can I access them, in Dermatology clinic or hospital? I only know "Collagen" , "Botox", "Silicon" ? Appreciate your advice and it would be the great help for me. Everytime i look at a mirror I see i'm very ugly and older than age.

Response from Dr. Pierone

Hello, and thanks for posting.

The two fillers that are approved in the United States are Radiesse and Sculptra. Both are effective, but require multiple sessions to correct lipoatrophy. Sculptra lasts longer, but it also takes longer for the benefit to develop.

Bio-Alcamid is a permanent filler that is effective and still used in many parts of the world. However, there is a significant risk of late infections associated with this implant and better options are available.

Collagen lasts only a few months and has been supplanted by other fillers. Botox relaxes muscles and helps soften wrinkles, but does not address the issues with facial lipoatrophy.

Silicon is a permanent filler that can be used to treat facial lipoatrophy, but only by doctors with expertise using this agent with micro-droplet technique. PMMA is another permanent filler that is used in many countries and works well for facial lipoatrophy.

Unfortunately, I do not know how you find treatment in Thailand. Your HIV provider may be able to make a referral and point you in the right direction.

Good luck!



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