HIV-patients affected by lipodystrophy that are undergoing anti- retroviral therapy suffer from a whole complex of symptoms consisting of dysfunctions of the fat distribution and changes of the metabolism. It results in the peripheral loss of subcutaneous fat (face, arms, legs, posterior) and the development of central fat deposits (abdomen, neck, chest). Although we are successful with removing fat (by liposuction) and achieving good cosmetic results, efforts to correct the unwanted loss of fat by using filling materials out of the sector of plastic- and cosmetic surgery have not been very satisfactory up to now.
Facial lipoatrophy is a condition in which people lose fat in their faces, especially in their cheeks and around their eyes and temples. People with HIV who take anti-HIV drugs may develop lipoatrophy.HIV-associated facial lipoatrophy has become epidemic among the greater than 1 million HIV-infected individuals living in the United States. Those affected usually have well-controlled HIV disease, and are most often healthy and living productive lives. However, their facial appearance often suggests the opposite and frequently serves as a stigma and psychological burden. Facial lipoatrophy, or commonly known as facial wasting, is rapidly becoming an important issue in the lives of those living with HIV. The confidentiality of a person's HIV status is being compromised by their appearance.a virtual Scarlet Letter.
Lipoatrophy, often referred to as facial wasting, has become the "scarlet letter" of HIV, a public mark of HIV infection. Lipoatrophy, patients are forced to endure a constant visual reminder of the infection, essentially announcing to the world that they are HIV positive or have AIDS.
'Bio-Alcamid™: is a novel prosthetic polymer, does not interfere with morphological and functional characteristics on human skin fibroblasts.It can be considered a novelty in the aesthetic and reconstructive surgery; it is absolutely biocompatible, non toxic, non allergenic, easily injectable and quickly removable.It can be defined as a sort of endoprosthesis, perfectly suitable for soft tissue augmentation and for the correction of different tissue deficiencies, with a long-term safety and efficiency.These features make the polymer suitable for long-term reconstruction of tissue damage even when large amounts of the polymer are used.
A Bio-Alcamid procedure takes 30-45 minutes and is performed under local anaesthetic. Using tiny needles, the watery gel Bio-Alcamid is injected. The substance can be dosed highly accurately. After treatment, the presence of the substance can be felt for around 7 to 10 days, after which it acquires the same consistency as the skin tissue. It will remain in the skin permanently and will not be broken down. Neither will the substance 'travel' through the body. Usually you can return to work the same day. There may be some redness or swelling that can last a few days (ice packs can help) . Generally an antibiotic is given for a few days after the procedure.
New-Fill
This material, often used in the USA, achieves excellent cosmetic results, but it has to be reapplied so often, that the costs are beyond the financial possibilities of most patients. Recent reports state an increasing number of indurations (hardenings) of the injection sites.
Collagen and hyaluronic acid
Within cosmetic surgery, these 2 materials are the most commonly used at the moment. Hyaluronic acid (also called Hyaluronan) is a component of connective tissue whose function is to cushion and lubricate.Hyaluronic acid has been nicknamed by the press as the "key to the fountain of youth" because it has been noted that at least some people who ingest a lot of it in their diets tend to live to ripe old ages.
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