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HIV/AIDS and Lipodystrophy Treatments Part II: Treatments for Fat Loss

September 30, 2014

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Permanent Facial Fillers

  • PMMA (Artefill, Precise, Metacrill): PMMA stands for polymethyl-methacrylate. PMMA filler is an injectable substance that contains PMMA microspheres in collagen gel. The body absorbs the collagen over time, and the PMMA microspheres stimulate the body to produce its own collagen.

The FDA approved Artefill for the treatment of facial wrinkles, lines, and furrows, but not for HIV-related facial lipoatrophy. Precise and Metacrill have not been evaluated by the FDA. Most HIV+ people treated with either Precise or Metacrill go to Mexico or Brazil to receive treatment. The cost varies, depending on the brand, the amount of filler needed, and travel expenses for Precise or Metacrill.

  • ePTFE Implants (Gore-Tex, Gore S.A.M., SoftForm): ePTFE stands for expanded polytetrafluoroethylene, which is a mesh-like substance that does not degrade once implanted in the body. These solid implants require minor surgery to insert. Gore-Tex and SoftForm are FDA approved for filling out the face (although not for HIV-related facial lipoatrophy). There is a risk of infection and scarring.
  • Bio-Alcamid: This product is not approved in the US. It is available in Europe, Mexico, and the UK, where it is used for cosmetic and reconstructive purposes. It is an injectable gel, around which the body then forms collagen. Bio-Alcamid usually requires one or two sessions. There have been reports of infections and of the Bio-Alcamid moving downward in the face. In the UK, it costs about £200 per vial at private clinics.
  • Silicone Oil (Silikon 1000, VitreSil 1000): Silicone oil is not approved for lipoatrophy, but is commonly used for this purpose. Its safety and effectiveness are still being investigated for facial filling. The oil is injected in very small quantities which require anywhere from three to six sessions. Once injected, it cannot be removed. Silicone has been known to trigger inflammatory reactions in some recipients. Also, it sometimes forms nodules and leads to disfigurement over time.

When considering permanent facial fillers, it is important to remember that our faces age -- what looks good now may not be what helps us look good two, five, or ten years from now.

Taking Care of Yourself

Even though the physical changes of lipodystrophy can cause emotional distress, no researcher has suggested that people with lipodystrophy should stop taking their HIV drugs. If you are concerned about your appearance, talk to your health care provider about treatment options. There are many things that you can do to stay healthy and feel good about your body.

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Related Stories

Lipodystrophy Treatments Part I: Treatments for Fat Gain
Lipodystrophy Treatments Part III: Treatments for Metabolic Changes
An HIVer's Guide to Metabolic Complications's Lipoatrophy Resource Center
Ask a Question About Facial Wasting at The Body's "Ask the Experts" Forums
More on Lipoatrophy/Facial Wasting: Treatment

This article was provided by The Well Project. Visit The Well Project's Web site to learn more about their resources and initiatives for women living with HIV. The Well Project shares its content with to ensure all people have access to the highest quality treatment information available. The Well Project receives no advertising revenue from or the advertisers on this site. No advertiser on this site has any editorial input into The Well Project's content.

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