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Facial Wasting and Tummy Tuck

Oct 10, 2011

I've had hiv for 11 years and hepb for 5 years. My hepb viral load is zero and my hiv viral is under 10k while my cd4 is 640.

I use to be a weight lifter but had to stop some years ago. I still do daily walking, some yoga, some form of exercise and I strive to eat healthy, ie., no fast food joints, fruits and steam veggies, etc. My cholesterol is 149 and I am not on statins.

I know I need the facial filler, as I'm seeing it even more now, the loss in my cheeks and around my eyes. In pictures, I look, hallow.

As for my stomach, I cannot get it flat and that was before hiv. Even as a child, my siblings had flat stomachs and I did not. I was the thin one without a flat gut. Nowadays, I'm a tall big man. Still muscular and people notice, but I can gather the skin/fat up around my gut and pull it in a ball or squeeze it together outward where I am skin from underneath and from the top, touching with a fold of skin/fat sticking out. I want so much to get rid of it. I've saved up 3k so far. I know this is not, deep fat. So, what can be done and are there doctors who would work with me? Thanks

Response from Dr. Pierone

The facial filler part is straight-forward, Sculptra and Radiesse are approved in the U.S. for facial lipoatrophy. Both are effective, but have different performance characteristics. Radiesse works right away and lasts about a year. Sculptra takes a few months for the full effect, but lasts for about 2-3 years.

With regard to your abdomen it sounds like you have some extra fat and extra skin. The traditional treatment would be liposuction if there is not too much extra skin. A "tummy tuck" surgical procedure would usually be offered if the laxity and fat were beyond the effective range of liposuction.

A newer technology that does improve abdominal laxity is radiofrequency treatment (Exilis, Pelleve, Endymed, and others). This is a non-surgical modality and produces variable results. This technology holds promise for the future as it evolves and therapy schedules are better understood.

Good luck!

Just curious: do you think a treatment for body lipoatrophy will become available in the US?
Fat loss on arms and legs from Combivir?

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