Q. I am a 37-year-old man and have been HIV positive for about five years. I am doing well and have managed to stay in shape. I have noticed that since I have been on my “cocktail’’ of medications I have lost a lot of volume in my face. What can I do? I don’t want to have people look at me like I’m sick.
I’m happy you’re doing well. Your problem is not uncommon. Patients who are being treated with the various medications needed to successfully keep HIV at bay often develop facial fat atrophy (loss of fat) in the face and frequently don’t have fat deposits of any significance on their body.
While it would be great to fill your facial loss with your own fat, the fact that you have atrophy often does not lend itself to this procedure. There are other facial injections that work well though.
Any of these injectable implants work: Restylane, Perlane, Juvederm, Radiesse and Sculptra are the most frequently used. My favorite for your problem is Sculptra.
Sculptra was initially FDA-approved for patients with facial fat atrophy due to HIV. It has since been approved for cosmetic use, with great results. Sculptra functions as a “bio-active’’ implant by stimulating your body to create collagen, thus filling in the volume loss. It works remarkably well and can last up to two years when done properly.
Other facial injectables may be used with excellent results, so you should discuss all your options with your physician.
You must tell your doctor if you choose Sculptra once you’ve had your initial consultation , as it must be mixed at least a day in advance. Your doctor may apply an anesthetic cream to your face to mitigate your discomfort (it’s really not bad). Sculptra is then injected into various areas where you have had volume loss, including cheeks, temporal region, jaw line and eye area. You can use ice compresses to decrease swelling, which will be gone within a few days. In about three to five weeks you will start to grow collagen and your face will fill out. You will be asked to return to your physician to assess how you are doing.
If you have filled in well, you will need no more .Once you have gotten to the look you want, your results should last between one and two years, with an occasional need for a fill-in about once a year.Good luck.