HIV associated Lipodystrophy is a syndrome which occurs in individuals infected with HIV who are being treated with antiretroviral medications. For most male patients, this results in a loss of fat from the face. It most commonly occurs in males of white ancestry. Other risk factors are a lower weight before treatment, longer duration of HIV infection, longer treatment of retroviral treatment, a lower CD4 count, and increased aging. Therapy with thymidine analogues such as zidovudine is also thought to be a risk factor in Lipodystrophy.
The main issue with Lipodystrophy is that it can make an otherwise healthy individual with HIV, noticeable to others and make the individual feel self conscious. The nest treatment for Lipodystrophy is the use of facial fillers. One such facial filler is Radiesse, which is made up of calcium hydroxylapatite microspheres and is FDA approved for the treatment of Lipodystrophy in HIV patients. Radiesse has a fairly predictable use as a facial filler and has been used for cosmetic applications as well. Sculptra is another option for patients with Lipodystrophy and is made up of poly-l-lactic acid.
The differences between the two fillers is that Sculptra takes a series of injections to see the result, while Radiesse will have an immediate impact. Other options for HIV Lipodystrophy include fat transfer, hyaluronic acid such as Perlane or Juvederm Ultra Plus, or the use of facial implants. Fat transfer tends to be less successful in patients with Lipodystrophy as the fat tends to have less “take” than when used for facial rejuvenation as part of the facial aging paradigm. Hyaluronic acid fillers are also not ideal fillers for facial atrophy in patients with HIV due to the amount of filler needed and the depth of location of the filler needed. Facial implants can add a tremendous amount of volume but have the main drawback of creating an artificial appearance in patients with Lipodystrophy.
At his Chicago office, Dr. Shah’s preference for treatment for Lipodystrophy is the use of Radiesse facial filler. He uses it as in multiple facial layers to add facial volume in a natural way with immediate impact. Radiesse tends to have excellent take in patients with Lipodystrophy and offers an excellent safety profile.
Dr. Shah is a leading facial plastic surgeon located in Chicago Midwest who is known for recreating a natural contour in HIV Lipodystrophy patients in Chicago, Illinois.