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

Permanent Facial Fillers

• PMMA (Artefill, Precise, Metacrill): 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. 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): 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. The procedure costs approximately $2,000 per cheek.
• Bioalcamid: This product is not approved in the US. It is available in Europe, Mexico, and Canada, where it is used for cosmetic and reconstructive purposes. It is an injectable gel, around which the body then forms collagen. Bioalcamid usually requires one or two sessions. There have been reports of infections and of the Bio-Alcamid moving downward in the face. Total costs are approximately $4,500, including travel.
• 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. The cost depends on the amount of silicone oil needed and the fee associated with the injections.

Taking Care of Yourself

Some body shape changes and metabolic problems have been linked with heart disease and strokes in HIV+ people. To lower your risk of heart disease and/or stroke:

• Get checked and, if needed, treated for high blood pressure
• Have regular lab tests to check your lipid and glucose levels
• Eat a healthy diet; see a dietician or nutritionist if you need help with this
• Get regular exercise
• Stay at a healthy weight
• Stop smoking or cut down on how much you smoke
• For more information, see our info sheet on Caring for Your Heart

It may also be a good idea to get a BIA (Bioelectrical Impedance Analysis). A BIA is an easy and painless test that gives information about fat and lean body mass. Having BIAs done over time can be helpful in monitoring body shape changes.

If you are experiencing lipodystrophy it is especially important to take care of yourself. Keep all of your medical appointments, get regular lab tests, and tell your health care provider about any changes in the way you feel or in your body shape. Do not make any changes to your medication regimen without your health care provider's guidance.