HIV :: Silicon Reverses Facial Wasting in AIDS Patients

AIDS patients with a disfiguring skin complication caused by HIV infection can be treated safely and successfully with applications of an inexpensive silicone oil preparation, according to research reported in Dermatologic Surgery, the medical journal of the American Society for Dermatologic Surgery (ASDS).

“This is an important step for the many people diagnosed with HIV who suffer from facial wasting,” said ASDS President Rhoda S. Narins, MD, a New York dermasurgeon. “It will help bring more fullness, shape and contour to their faces and instill the confidence that is often lost with this disfiguring ailment.” Facial wasting – or lipoatrophy – is the loss of fat beneath the skin, which can result in sunken cheeks, indentations and hollow eyes.

“Facial lipoatrophy has become epidemic among HIV-infected patients,” said lead author Derek Jones, MD, a dermasurgeon affiliated with UCLA Medical Center. “Those affected usually are stigmatized and depressed, and this often causes patients to become discouraged and may hamper their compliance with medication regimens.”

Jones also noted that other treatments for this disorder are expensive, last only 18 to 24 months a shorter period and can leave an unnatural looking facial appearance and a bothersome feeling underneath the skin.

During his research, Dr. Jones and his research team followed 77 AIDS patients with lipoatrophy who were treated successfully with monthly facial injections of 1000 centistoke silicone oil, administered as small droplets (microdroplets) to areas of fat loss. . He They found that all patients showed a complete correction of lipoatrophy, even in those whose faces wereseverely affected. No adverse events were reported. The volume of silicone oil administered, number of treatments and time required to achieve full correction were directly related to the severity of the lipoatrophy, Jones reported.

Facial injections of silicone oil induce an inflammatory response that triggers production of collagen. The 1000 centistoke silicone oil preparation used in the study is less viscous (thick) than other silicone oils and can be injected with a specialized needle. Regardless of the amount given, silicone doesn?t break down and stays unchanged in the body. The immune response to the foreign substance produces layers of collagen that surround the silicone. Eventually, permanent facial augmentation is achieved as collagen stimulates formation of new facial tissuedue to the new tissue produced by the material.

“This pilot trial offers encouragement to AIDS patients coping with the stigmatizing and embarrassing affects of facial lipoatrophy,” said Jones. “The study showed that 1000 silicone oil was safe and effective, but further trials are needed to establish the long-term safety of this treatment.”

Studies like these and other research investigations by leading dermasurgeons provide further evidence of the significant clinical contributions made by the specialty. It also underscores the importance of choosing a qualified dermasurgeon for cosmetic skin rejuvenation.

“Patient safety and clinical effectiveness are our chief concerns,” says Dr. Narins. “There is a tendency for doctors with no cosmetic training and even non-physicians to jump on the bandwagon. However, patients should be aware that aesthetic results with soft tissue fillers are skill-dependent and dermasurgeons have the training, technical know-how and artistic finesse to ensure consistent, outstanding results.”

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