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Bada Bing Soprano guy asks Dr. Bob
Feb 15, 2004

Dr. Bob,

Bada Bing, it's really called Satin Dolls here in Jersey if you want to come on by. I do have a question for you.

I have my eye on the safety concerns with facial fillers such as new-fill, bio-alcamid, and other alternatives that you may know. I heard that you have new-fill, how long exactly does this last and can it be used on the face other than for sunken cheeks? Do you feel this is safer than bio-alcamid why? Do you feel safer new alternatives are on the way? I love your personal stories that are not only so enjoyable but delightful to the the heart as well. Thank you.

See you at the Bing, on bi-sexual night if you're interested, if not I understand.

Thanks again,

Bada Bing Soprano Guy

Response from Dr. Frascino

Hello Badda Bing Soprano Guy,

Do any of the "Satin Dolls" look like Ken or are they all silicone-enhanced Barbies?

Reconstructive (a better term than "cosmetic") procedures for facial lipoatrophy are becoming more prevalent and include temporary, semi-permanent, and permanent fillers. We've had the most experience with fat grafting, hard silicone implants, silicone gel or oil, Teflon paste, radiance (bioform), arteoll (PMMA), New-Fill (PLA), and Bio-Alcamid (polyalkymade gel). Are newer products "on the way"? Yes, even though some of the products listed above, like New-Fill and Bio-Alcamid, are not widely available in the U.S., because they are not FDA-approved, there are already other products currently being developed. I'd love to write a detailed discussion of all these options, but if I did, I'd miss tonight's episode of "Real Time with Bill Mahrer." So, I'll limit my comments to the specific products you mention.

New-Fill promotes the formation of natural collagen, and has produced impressive results. A study presented at the HIV meetings in San Francisco this week (Conference on Retroviruses and Opportunistic Infections) from France indicated that effects were durable out to at least 12 months. I've seen good results out to 18 months; however, I've also read reports where touchups were needed after a year or so. The durability is variable form person to person. As for use in areas other than the cheeks, that's not a problem.

Bio-Alcamid (polyalkymade gel) has been used in Italy for at least six years and provides lasting results. It appears safe from what we have seen so far. If too much is injected, it can fairly easily be removed, which is a nice feature in case you leave your plastic surgeon's office looking like a chipmunk. Bio-Alcamid feels natural to the touch and does not seem to migrate out of position. It can be used not only on the face, but also in other areas as well the buttocks, for instance. No, I'm not kidding. It really can be used on your can. But don't expect it to elevate your butt all the way up to your shoulder blades. The product is a filler, not a miracle worker. Both New-Fill and Bio-Alcamid appear safe so far. But our experience with them is fairly limited, and there is no really "long-term" data yet.

Yes, I've had New-Fill injections, and I'm very pleased with the results, but that's only one man's experience.

I'm pleased you find my personal stories helpful. I'm at times reluctant to spend time in this format discussing my life with HIV, because I'm here to help others with their concerns. However, telling our stores all our stories with honesty and a lot of heart, helps destroy the silence that spreads those pernicious myths, such as HIV/AIDS is no longer a concern, stigma and discrimination are not still happening, etc., etc., etc.

O.K. Soprano Guy, I'll see you at Bi night at The Bing.

Stay well.

Dr. Bob


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