Facial lipoatrophy is the loss of fat beneath the skin, which can result in sunken cheeks, indentations, and hollow eyes. About 50 percent of patients with HIV experience a condition known as lipodystrophy syndrome, which includes facial wasting and a characteristic gaunt appearance, after treatment with highly active antiretroviral therapy (HAART). HAART is the most effective therapy to treat HIV/AIDS known today and is used by many patients with HIV to prevent the onset of acquired immunodeficiency disease syndrome. Fortunately, the newer generation of medications appear to be associated with a lower incidence of lipoatrophy. Lipoatrophy may also occurs in certain individuals as part of the normal aging process.
The treatment of facial wasting and the loss of subcutaneous fat (fat under the skin) is aimed at replacing lost volume. Numerous injectable fillers as well as various surgical reconstructive options have been shown to be effective and can lead to a long term improvement in the appearance of the lipoatrophic areas.
Hyaluronic acid based fillers
Several hyaluronic acid based fillers are available (Restylane™, Restylane Fine-Lines™, Perlane™, Juvederm™) that, when injected into your skin, work with your body’s own hyaluronic acid to create the volume needed to fill soft tissue deficits. They can be used to correct frown lines, deep smile lines and to enhance the lips. Being a naturally occurring substance, hyaluronic acid is gradually broken down by the body over a period of several months. The treated areas remain slightly red and swollen for 24 hours. On rare occasions, patients have experienced temporary swelling, redness and tenderness at or near the injection site several weeks after treatment.
In certain patients, cheek implants can effectively reverse many of the visible effects of facial wasting. Implants are fashioned from a variety of materials with silastic being the most common.
Surgery is performed under twilight anesthesia in Dr. Denton’s fully accredited operating facility in Vancouver, British Columbia. Most individuals return to their normal routine in one to two weeks.