How Can I Get Rid Of My Facial Wasting Due To HIV?

Q: Dr. Eppley, I would like to get rid of my facial wasting due to HIV. I am interested in cheek implants and fat fillers for lipodystrophy. I have attached a picture of my face for your evaluation.

A: In looking at the one picture you sent, your greatest area of lipoatrophy is in the temples and secondarily in the submalar regions. Compared to many patients that I see, your degree of facial lipoatrophy is fortunately more moderate in severity. Given that you have existing lipoatrophy, and I assume you are on antiviral medication, this makes the use of injectable fat survival precarious at best. For this reason, I make an effort to use permanent synthetic implants when possible for its treatment. These would be applicable to the temporal, submalar and even the nasolabial fold areas. But facial implants do not cover all facial lipoatrophy areas and are at best thought of as building blocks from which to fill around with fat injections as needed. Even though fat injection survival is unpredictable, it is the best filler to use for broader facial areas. And since it is not the only method of treatment that is being done, any survival that is achieved is a bonus to the underlying implants.

Dr. Barry Eppley