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facial wasting options - fat transplant or Sculptra
Dec 31, 2009

after taking videx, sustiva and ziagen for more that ten yrs I was finally switched to atripla this past June. Facial wasting is very noticable and I almost had a face lift for improvements but changed my mind. Now I've been asking what would be better and easy on the pocket,Sculptra or transplanting fat from my abdomen area to the face. What can you advise?

Response from Dr. Pierone

Hello and thanks for posting.

I don't think that fat transplant for HIV lipoatrophy is generally a good thing because of the variability of results, high cost, and eventual loss of the fat.

The two approved treatments for HIV lipoatrophy in the U.S. are Sculptra and Radiesse. Both products have a patient assistance program available for those with an annual income less than $80,000. For someone with moderate to severe lipoatrophy who has a higher income level, the cost to get a complete facial correction would likely be in the range of $5000 (with lots of variation in charges among providers). Since these are not permanent products, touch up treatments would be necessary in the future. Radiesse touchup treatments may need to be done yearly and Sculptra every 2 years. These are rough estimates only, since there is so much individual variability of response to fillers.

For those with an intrepid spirit and willingness to travel, Brazilian PMMA is available in Mexico and Brazil. This permanent filler has been used quite a bit for HIV lipoatrophy and the cost (not including travel) is in the range of $2000 to $3000. Luis Casavantes in Tijuana has much experience with this agent and is very talented.

Artefill is the U.S. version of PMMA. The cost for a complete facial correction for moderate to severe lipoatrophy would likely be in the range of $10,000 (with huge variation in charges among the relatively few providers).

I hope that this information helps and best of luck to you!



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