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Facial WastingFacial Wasting
           
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Body Fat Transfer or facial fillers?
Jan 23, 2011

I am seriouly thinking about having facial implants but is undecided in what really works for a longer period of time. There are so many and very costly and i do not have the money. I was leaning toward body fat transfer into cheeks but hears it does not last long maybe one year. I read on Sculptra and Radiesse facial implants. What would you recommend where i will not waste my money for treatment that does not work. I am also looking for treatment cost with a monthly payment plan

Response from Dr. Pierone

Hello, and thanks for posting.

There are many choices for facial fillers and the good news is that the list of available products and procedure continue to expand. The bad news is that all of these fillers are very expensive.

In the United States, Radiesse and Sculptra are available to patients with HIV-related lipoatrophy through company sponsored patient assistance programs. Also, for those with Medicare benefits, there is coverage for the physician injection fee if there is depression related to facial lipoatrophy (although finding a willing provider is difficult). Both of these products are effective for treatment of HIV lipoatrophy. Sculptra has better durability and improvement may persist for 2-3 years.

Juvederm and Restylane are not approved for facial lipoatrophy, and their relatively short durability (6-12 months) makes their use impractical for treatment of lipoatrophy.

Artefill is a permanent filler that contains PMMA and bovine collagen. It is not approved for treatment of HIV lipoatrophy, but is effective. It is very expensive and cost prohibitive for most patients because of the volume that is usually necessary to treat lipoatrophy.

Fat transfer can work very well for years when it does work, but this procedure is disappointing in many cases because of suboptimal fat survival and contour irregularities in some patients. Newer fat transfer techniques are being developed and hopefully these challenges will be overcome.

Micro-droplet silicone injections may be performed for facial lipoatrophy, but this non-approved use of silicone is not widely available. It also requires many treatment courses over a prolonged period of time to correct the volume deficits that typically accompany lipoatrophy.

Depending on the country in which you reside, there may be other treatment choices as well. Other formulations of PMMA are available in Mexico and South America at a much lower price.

The one facial filler that has a high rate of late infections is Bioalcamid, and this is one filler that should be avoided like the plague.

Thanks for posting and good luck!



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