Hi there and thanks all for your great job you do for us all!I have been HIV+ sin ce 1985 and been thru almost all combos..the latest one is Rescriptor,Ziagen,Kaletra,tenofovir..CD4 at 500 AND V.L. at 2000copies.The combo is quite ok but am worried about lipodistrophie on in particular both breasts and I think of a liposuction.Would be greateful if you could tell me if a lyposuction in that area is safe and will the result be final or does it all come back due to the fact that I don't change my combo?Also I am very very tired in the morning and have to sleep up to 10-11 a.m. every day to be able to work in the afternoon.Could you tell me which one of my meds cause this immense fatigue every morning? Looking forward to your reply as I will probably go for the lyposuction soon and would like to have your opinion first.Thanks again for your tremendous effort you do for us. Sincerely yours. Erick

Liposuction can provide some benefit but the problem can recur. The use of growth hormone and some diabetic drugs are being looked at in the setting of fat accumulation. ou might want to check your prolactin and testosterone levels (total/free). KH