Basics and Prevention

• I am experiencing fat loss and veins in my lower legs. I'm on Kaltera and Truvada. Is there a better drug regiment for me?
  Response from David Wohl, M.D. (May 7, 2007)

• Can I change my meds to reduce fat loss? I'm taking Combivir (AZT/3TC) + Viread (tenofovir) + Sustiva (efavirenz, Stocrin), and I've begun to notice a lot of fat loss under my cheekbones. What meds can I switch to in order to decrease or stop this fat loss?
  Response from Keith Henry, M.D. (September 20, 2006)

• Is stomach bloating a side effect or symptom of lipodystrophy?
  Response from Keith Henry, M.D. (September 17, 2006)

• Is my testosterone gel contributing to my lipoatrophy? I have been using testosterone gel for over three years, and my new doc tells me that it could be contributing to my lipoatrophy -- Is this true?
  Response from Brian Conway, M.D. (August 14, 2006)

• What is lipodystrophy? Is it a side effect of HAART or is it directly related to HIV disease progression?
  Response from Keith Henry, M.D. (May 22, 2006)

• Will my fat come back? Will our bodies recoup the lost/transferred fat deposits once a viable treatment for lipodystrophy has been found? Or are these fat deposits lost/relocated forever?
  Response from Keith Henry, M.D. (June 6, 2006)

• I am currently on a regimen of Zerit, Kaletra, Viread and T-20 and have experienced some facial wasting. If I cut out the Zerit from my regimen, would my facial wasting reverse?
  Response from Brian Conway, M.D. (September 12, 2005)

• What non-surgical procedures can I do to stop facial wasting?
  Response from Keith Henry, M.D. (July 28, 2005)

• Lipodystrophy scares me. Does it occur in all people with HIV or as a side effect of HIV medications? I'm no Brad Pitt, but I like the way I look! How do I keep my physical appearance the same so I don't have to walk down the street with my head down?
  Response from Gerald Pierone, M.D. (July 2, 2005)

• My doctor switched me to Lexiva/Norvir with Truvada once a day. I am tolerating the regimen well, but am scared of facial wasting. Do you know if this regimen causes it?
  Response from Robert J. Frascino, M.D. (February 21, 2005)

• Do HIV medications effectively prevent facial wasting?
  Response from Benjamin Young, M.D., Ph.D. (February 9, 2005)

• I have been on a regimen of Sustiva and Combivir for the past two years. My doctor, however, has suggested reducing the AZT content primarily because both she and I have noticed some facial wasting. This will mean changing from Combivir to two 100-mg tablets of AZT and one 150-mg tablet of Epivir twice a day. How common is this practice?
  Response from Gerald Pierone, M.D. (February 6, 2005)

• I've been on meds for six years, five years with efavirenz and Combivir (AZT + 3TC). My CD4 count is 1100 and my viral load blips up and down over the detection limit. I really would like to stop taking my drugs to slow down the steady path towards greater facial wasting. What do you think?
  Response from Graeme Moyle, M.D. (June 8, 2003)

• I've been on 3TC and d4T for seven years and am just beginning to see signs of facial wasting. Should I consider switching the 3TC for tenofovir (Viread) to stop the wasting, even though my current regimen has worked extremely well against HIV?
  Response from Graeme Moyle, M.D. (June 8, 2003)

• Can anabolic steroids make facial wasting worse?
  Response from Nelson Vergel, BSChE, M.B.A. (May 23, 2003)

• Is facial wasting more common in people who take d4T (Zerit)?
  Response from Graeme Moyle, M.D. (May 19, 2003)

• Are there any vitamins, supplements or foods I can take that would help prevent or reverse facial wasting?
  Response from Nelson Vergel, BSChE, M.B.A. (May 18, 2003)

• Is it possible to have facial wasting without ever being on HIV meds?
  Response from Cade Fields-Gardner, M.S., R.D. (October 10, 2002)

Treatment

• If I have surgery to get rid of my excess fat, will it return because of my meds? I have been on meds for many years, and my only problems have been with lipoatrophy and lipohypertrophy. I want to have surgery to get rid of the excess fat, but I'm worried my meds will just bring it back. What do you suggest?
  Response from Brian Conway, M.D. (August 13, 2006)

• Are Nucleomaxx and Oxandrin recommended for treating lipoatrophy? I've experienced severe lipoatrophy and have tried everything I can think of to correct or stop it. Now I'm thinking about taking Nucleomaxx or Oxandrin -- Do you think either of these could help me?
  Response from Keith Henry, M.D. (August 1, 2006)

• What are the risks involved in fat transfers? Can I get fat suctioned from my arms, back and waist at the same time as facial fat injections? I know that there is a risk of infection, but is doing both procedures together more dangerous than if I only did the fat suction?
  Response from Keith Henry, M.D. (July 7, 2006)

• What can I do for non-med-related lipodystrophy? I've never been on meds, but I do suffer from lipodystrophy. What are the possible treatments I can try?
  Response from Keith Henry, M.D. (June 28, 2006)

• Can stopping medications reverse fat loss? My son has been HIV positive for 10 years, and his face is starting to have a sunken look. I've heard that taking him off the medication will make his face fuller again -- Is this true?
  Response from Keith Henry, M.D. (April 2, 2006)

• I have extreme facial wasting and want to change meds or go off of them completely. I have heard about Sculptra to treat facial wasting, but my insurance won't pay for it. What do you suggest?
  Response from Benjamin Young, M.D., Ph.D. (October 23, 2005)

• What's the best treatment for facial wasting: Bio-Alcamid or Sculptra?
  Response from Brian Conway, M.D. (March 17, 2005)

• Where can one find out information about which doctors perform Sculptra treatments?
  Response from Brian Conway, M.D. (February 16, 2005)

• I had three treatments of New-Fill (Sculptra) before it was approved and have been satisfied. Still, I would like one more treatment, and my physician who administered it agrees. Unfortunately, since its approval, the cost of New-Fill has risen to $960 for one kit, double the cost from just two months ago. This does not include the cost of administering it. How can we facially challenged folks get this any cheaper?
  Response from Robert J. Frascino, M.D. (August 27, 2004)
• Where do I get New-Fill to help my facial wasting?
  Response from Robert J. Frascino, M.D. (June 16, 2003)

• I am experiencing facial wasting. What do you think of cheek implants?
  Response from Graeme Moyle, M.D. (June 8, 2003)

• Dr. Frascino: I read that you took New-Fill injections to combat facial wasting. How is that working out for you in the long run?
  Response from Robert J. Frascino, M.D. (June 3, 2003)

• Are there any vitamins, supplements or foods I can take that would help prevent or reverse facial wasting?
  Response from Nelson Vergel, BSChE, M.B.A. (May 18, 2003)

• What are the best, cheapest options for restoring some of the fat to my face?
  Response from Graeme Moyle, M.D. (May 9, 2003)

• Could a drug holiday restore some of the facial weight I've lost?
  Response from Cade Fields-Gardner, M.S., R.D. (April 1, 2003)

• Is Botox safe for HIV-positive people? Can it treat my facial wasting?
  Response from Cade Fields-Gardner, M.S., R.D. (March 13, 2003)

• Can anti-wrinkle creams help plump up sunken-looking eye sockets?
  Response from Cade Fields-Gardner, M.S., R.D. (December 13, 2002)

Personal Stories

• My dermatologist's suggestion made me look like me again. I want to relate my experience with injections of silicone micro-droplets to combat lipoatrophy. I had a mild case of lipo, but after treatment, I look exactly like I did before.
  Response from Keith Henry, M.D. (October 7, 2005)

• My fat transfer wasn't a permanent solution. A year ago, I had fat liposuctioned from my abdomen and injected into my face to correct my lipoatrophy. At first I was extremely pleased with the results, but now I'm back to the same old "lipo-face."
  Response from Keith Henry, M.D. (June 29, 2005)

• I came back from lipoatrophy feeling hotter than ever! I just wanted to share a few of the things that helped me overcome my lipoatrophy. Now I feel hotter than ever!
  Response from Keith Henry, M.D. (February 2, 2005)

• Just wanted to give some feedback about my experience with facial wasting and New-Fill. I experienced severe facial wasting at age 26, which was devastating.
  Response from Graeme Moyle, M.D. (June 11, 2003)

• HIV-positive physician Dr. Bob Frascino talks about his personal experience with facial wasting.
  Response from Robert J. Frascino, M.D. (October 3, 2002)