HIV :: HIV/AIDS Lipoatrophy – Facial Wasting

Individuals living with HIV and AIDS may not only have to deal with the threat of illness but the toll of illness. All that is required to stay healthy and alive can leave an everlasting mark! I’m referring to the loss of subcutaneous fat from the face, commonly referred to as facial wasting or Lipoatrophy.

While individuals are often able to re-gain weight and build up muscles on their arms, shoulders, and other areas, they fail to be able to replace the loss of fat to their face. Although fat loss in the face has been reported in individuals who are not taking HIV/AIDS medications, large numbers (up to 80%) of people on antiretroviral combination therapies (Protease inhibitors and nucleosides) are developing Lipoatrophy. Reportedly, the longer a person is on HIV/AIDS medications the greater the likelihood of developing problems with facial wasting. Along with surviving, many show in their face the telltale signs of living with HIV!

At one time or another, most of us infected have feared the onset of facial wasting. The longer we are on medications the more we become concerned. Facial wasting causes great anxiety due to the stigma and discrimination that often accompanies it! These circumstances affect self esteem and may cause individuals to become socially withdrawn and cut off their ties with family and friends. They may go so far as to stop working. Individuals report that people treat them badly. Often, they are treated like they are drug addicts or homeless street people because their faces are so caved in from Lipoatrophy; when the truth of the matter is the treatments that enable them to live have brought this on!

The fact that I was able to go without HIV medications for some 13 years (the exception being 9 months on AZT in 1990) meant that I personally did not experience the devastating effects of Lipoatrophy I have witnessed in others. But, in the last 7 years taking medications, I have watched the fullness in my face slipping away. Then last summer (2004) my face started to rapidly sink in; caused by the fact I”ve been living with HIV for over 20 years, along with the side effects from HIV medications necessary in these later years. There was only sadness for a situation for which I thought there was no lasting treatment. I knew only of people who sought out some temporary fixes that fell short of what was necessary for repairing the deep scaring of Lipoatrophy. I was not aware of the long term or permanent treatments available.

In November 2004, John McCahill, President of Pur Medical Corporation in Toronto contacted me through my website. John informed me of a product being brought to Canada that will help to restore the natural appearance in the face for people living with HIV antiretroviral drug induced Lipoatrophy. The product, called Bio-Alcamid or polyalkylimide made by Polymekon, an Italian company, is a synthetic gel made up of 96% water and 4% synthetic reticulate polymer. It is injected below the skin to restore volume and natural contours of the face. Bio-Alcamid is one of the only products that can be used in large volumes necessary to correct this problem with results that are permanent.

“We have implanted this substance in 73 patients with up to three years” follow-up. The aesthetic results were deemed excellent by both physicians and patients. No implant dislocation, implant migration, granuloma, allergic reaction or intolerance was recorded”. Department of Plastic Surgery, University of Parma, Parma, Italy (2003)

John McCahill organized Pur Medical Corporation”s first treatment training session for facial restoration in Toronto, Canada on November 26, 2004, where Drs. Beninger, Kasrai, Weiglein and Rice treated 8 volunteer patients with Bio-Alcamid. The following day, 3 others and I participated in a training session here in Vancouver for some of Western Canada”s top cosmetic practitioners. This included Drs. Alastair and Jean Carruthers, Robert Thompson and Calgary”s Wayne Perron. Dr. Peter Velthuis from the Netherlands, one of the highest volume users of Bio-Alcamid in the world, flew in to direct the physicians in the subtleties of the technique. These 12 volunteer patients were the Canadian debuts of a product that has been used in Europe and other countries for 5 years.

Dr. Alastair Carruthers, cosmetic dermsurgeon, Clinical Professor at the University of British Columbia (UBC) and Vice-President of the American Society for Dermatologic Surgery, performed my procedure. Forty minutes later, my sunken face was restored! Over a period of two months, my body creates collagen and a film will form to encapsulate the Bio-Alcamid and make my face appear natural and feel soft under the skin. Swelling lasted several days and each day since, my face has become smoother and softer to the touch.

I am very thankful for this opportunity to participate and receive Bio-Alcamid for my facial Lipoatrophy. I would recommend this product and procedure to people living with Lipoatrophy concerns; Bio-Alcamid has rejuvenated my face and having the treatment has increased my self esteem.

Until now, Canadians have traveled to Mexico, South America and Europe to have Bio-Alcamid treatments performed at an expense, which is out of reach of most people in need. Currently Bio-Alcamid is available in Canada under provisions of the Special Access Program, which involves application on a patient by patient basis.

Many individuals living with HIV and AIDS have often overcome bouts of illness but the side effects of the medications have resulted in deep facial scars, which affect their self-image physically and mentally. This will contribute to their hardship and ill health! We need government to recognize the severity of the problem and treat Lipoatrophy like that of the restoration treatments patients with cancer receive. Lipoatrophy is a direct result of the medications to treat HIV infection. To remedy the problem, the procedure needs to be covered under Health Care.

I believe we can All work together, recognizing that there is a need; helping to create change and providing better care!

Bradford McIntyre, HIV+ 20 years

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