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Surgical Techniques Improve HIV-Associated Facial Wasting

Researchers find that lipofilling or silicone implants produce satisfactory long-lasting results

WEDNESDAY, Nov. 29 (HealthDay News) -- HIV-associated facial lipoatrophy can be successfully treated with either lipofilling or submalar silicone implants, according to a study published in the November issue of the Journal of Plastic, Reconstructive & Aesthetic Surgery.

Giulia Lo Russo, M.D., of the University of Florence in Italy, and colleagues treated 12 HIV-positive patients, eight of whom underwent lipofilling following Coleman's technique and four who underwent bilateral malar silicone implantation after the correct positioning was determined with new computer software. All patients had been on highly active antiretroviral therapy for a median of seven years.

After a mean follow-up of two years, the researchers found that both techniques produced good to very good results in facial contour reshaping. They observed no complications and found that no patients were dissatisfied with their facial image.

"HIV-positive patients treated with antiretroviral therapy have a long life expectancy," the authors write. "Today no drugs or particular therapy regimens are able to stop lipodystrophy progression. Plastic surgery treatment is essential for them to ameliorate lipoatrophy facial stigmata, giving back fullness to their faces. We prefer using autologous tissue for facial enhancing when possible, strictly following Coleman's lipofilling technique. Otherwise, we opted for submalar silicone implants positioning for its technical simplicity and few drawbacks."

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