HI, I have been positive for almost 4 years and my numbers are very good CD4 is almost 600 and HIV is undectible. I'll be 41 years old this year and have always been skinny its inherited. I've noticed that in the past year my face has gotten very gaunt looking, I honestly don't know if its wasting syndrom, my wasteline is a little thicker too but that could be age. My weight has not changed though, Im 5'9'', 142lbs. I am on epivir, zerit and sustiva. My question is,If I got facial surgery, like a face lift would that solve the gaunt look? Would it come back again? Any advise you can offer I would greatly appreciate. Thank you again for all your help. Sincerely, Concerned

Talking to a dietitian may be the best starting point. There are no realy good data to look at facelifts for facial wasting although facial fillers like Newfill sometime help. Cosmetic treatment are expensive and don't always achieve the desired results. It is possibility that you may be getting lipoatrophy. You should discuss this with your doctor and consider some possible modification of you HIV therapy best wishes Graeme