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First Person: Ford Warrick

First Person: Ford Warrick

January 2006

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How can you have no results if there's an injection of a fluid into your cheeks?

What happens is, with Sculptra, it's injected into your skin, and then your body reacts to the particles in Sculptra. It's suspended in a fluid, and the particles cause collagen to be generated. For some people, their body doesn't react to the particles as well as other people [do]. It's dependent on your body reacting to this substance being injected, because the Sculptra itself and the fluid eventually just get absorbed into your system and go away. They're counting on that collagen to be generated to create the filler.

There's no real way of predicting, is there, whether it has to do with your immune health, or anything like that? Or is it just an idiosyncratic thing?

According to the doctor who I spoke to, they can't really predict who it's going to work well for, and who it's not. He said that he's had people who have done well after a couple of treatments. He's had people who had multiple treatments and had no reaction. He's had people who have had a couple of treatments and then, all of a sudden, on the third treatment, it works. He said he didn't really have an idea of why, with some people, it works and [with] some people, it doesn't. I think, just like any medication, it reacts differently with certain people. So that was Sculptra. The other options were leaving the country and going to Canada, Mexico, Brazil or Italy to have a permanent filler done, such as Bio-Alcamid or PMMA. They are both permanent fillers, so you're not really as dependent on a reaction, the way you are with Sculptra. After talking with different people about their experiences with different physicians, I decided that PMMA was more of what I was interested in because, for one thing, it was more affordable. It was much less expensive than Bio-Alcamid.

How much are the comparative prices, approximately?

I contacted Clinica Estética, in Tijuana, Mexico, who has done Bio-Alcamid for years. They gave me a quote of $4,300 to do my face. I had contacted Dr. Márcio Serra, in Rio de Janeiro, who estimated it would be $600 to $700 to do my face.

With PMMA?

With PMMA. One of the differences between PMMA and Bio-Alcamid is that Bio-Alcamid apparently can be removed. PMMA cannot be removed. Once it's there, it's there. But PMMA has an advantage over Bio-Alcamid, in that it's a smaller filler. So, it tends to give a more smoother appearance than Bio-Alcamid. Since I started researching this, Clinica Estética in Tijuana has gone from using part Bio-Alcamid, part PMMA, to all PMMA in most situations.

What is PMMA made of?

PMMA is made of a plastic that has been used for years and years in joint replacements, and it's also what contact lenses are made out of. So it's been used in the body for many years and people don't have allergic reactions to it. I felt good that it's a substance that's been used in the body for numerous years. What they do is that they have it in different concentrations, depending on how much filling needs to be done. For example, I had PMMA done in my buttocks and my face. In my buttocks, [Dr. Serra] used a higher concentration of PMMA than in my face, particularly my temples. Because the skin is so thin there, he used a 10 percent solution, where[as], in my buttocks, he used a 30 percent solution. So that's what PMMA is, basically. Bio-Alcamid is a polymer, as I understand it, which is larger than PMMA. Therefore, for doing temples and things like that it's not quite as good, because it sticks out too much; it's too voluminous.

So you went to Rio de Janeiro?

Yes. I went to Rio de Janeiro. I actually went twice. I went in January and had an initial treatment of my face and my buttocks. When I went there for the first session, Dr. Serra told me that it would probably be two sessions for my face and possibly three sessions for my buttocks.

Was that a surprise?

No, it wasn't. Because I had read that what Dr. Serra had done typically is, especially with your face, he kind of under-fills it the first time. Because when you have these injections, he's injecting a fluid. The fluid gets absorbed into your body and so, what he does is, he does the initial one, and he kind of under-fills. Then, with the second treatment, that's more of a touch-up, where he can see where you need a little bit more. Because, like I say, you can't remove this filler. So he under-fills, initially, and then does a second treatment, where he touches up.

It sounds almost like -- well, it clearly takes a great deal of artistry on his part.

Right. That's one reason why I went to him, is because he's done hundreds of treatments with people. And there's technique to this. For example, he was telling me that through years of experience, he's learned kind of the pattern of injections that he has to do, based on the lines of your face, because as you age the filler will follow the contours of your face so that it looks natural, even if you have continued lipoatrophy. Also, experience is necessary, because if you don't do the injections to the proper depth in your skin, you could end up with granulomas, which are basically red lumps that can form on your skin where you've had an injection. So one thing that I have told people online who have asked me about my treatment is, whichever doctor you go to, make sure that they have experience with lipoatrophy, that they have experience doing this type of treatment, because it's not just sticking a needle in your face and shooting something in. There's artistry to it.

What's the actual process like? How long does it take? Is it painful? How many needles does it take? How many injections?

Well, we talked for quite some time about what my expectations were, what I wanted. He looked at my face. He looked at my buttocks. He took photographs. He explained what he was going to do. With my buttocks, he gave me localized injections for numbing. Then it took, he said, about 60 injections per cheek for my buttocks, for my first treatment. I felt almost nothing when he did my buttocks, because it was numbed and I just didn't feel it. I definitely noticed the results when it was done. It was a dramatic difference.

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