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Injectable Silicone for Facial Lipoatrophy
Nov 14, 2002

Dr. Bob, I realize that answering the many questions presented to you certainly must take up an inordinate amount of your time. However you are a special type of person. Not only do you have the medical training to allow you to be of service to those of us who are inflicted with HIV, but you have also fight the same battle we do, and do so with humor and insight that at the very least is remarkable. I have asked this question before, and although it does not fall squarely under Fatiague and Anemia I feel it is a growing concern for many of us with HIV. Please consider answering it. Several weeks ago you shared with us that you had opted for New Fill treatment for your lipoatrophy. I now reside in Palm Springs and am considering seeking some kind of teatment for this problem. I have seen a local dermitologist who advocates the use of of injectable silicone for the treatment of facial lipoatrophy and further have researched it on the internet, and know that there are several doctors in the Los Angeles area who favor it, especially with the recent FDA approval which it has received in certain areas. Since you recently made the decision to go with New Fill I am hoping that will share with us why you opted for it over the silicone treament. There is no question that facial wasting has become the scarlet letter of HIV, and I wish I had the courage that you have displayed in your handeling it. However this is not the case with me, and I wish to take whatever action that is available to me to insure that I look as normal as possible. I heard just the other day that some insurance is covering the silicone injections, and we all know that if insurance will pay for it that it has to be considered a medical necessity by some of those in power. Thanks for being there for us, and teaching us how imortant hunmor is in handeling even the most devistating of situations.

Response from Dr. Frascino

Hello,

Palm Springs? I love Palm Springs, and try to escape there every chance I can. You can usually find me poolside at Inn Exile.

Yes, I too have heard about the doctors in LA using injectable silicon. By report, the short-term results sound encouraging. My only concern is that silicon can produce some fairly weird immunoglic reactions. New-Fill is inert, which means it supposedly cannot induce an immunological reaction. Both of these procedures are relatively new (especially in this country) and so we are all learning as we go. Long-term side effects will take a "long term" to show up. I chose New-Fill because the results from France were very encouraging out to several years, and the fact there is hypothetically less chance for an immunological reaction. It would be bad for the immunologist to have a bad immunological reaction, don't you think? Although on the humorous side of things, it would be rather ironic!

I'll try to keep the forum posted on results, as they come in. In the meantime, see you at Hunters.

Stay well.

Dr. Bob


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