Summary
The advent of highly active antiretroviral therapy (HAART) has dramatically improved
the life expectancy of people infected with human immunodeficiency virus (HIV). Although
patients often have excellent disease control with these combinations of antiretrovirals,
they are at risk for the multiple toxicities associated with these drugs. Facial lipoatrophy
is a particularly distressing complication of some HAART regimes. This disfigurement
can lead to significant psychosocial stress, resulting in decreased treatment compliance.
Polylactic acid (PLA) facial implants provide a potential method of restoring a normal
appearance.
One hundred consecutive patients had a course of PLA facial implants. All patients
were assessed clinically and had photographs, facial surface laser scans and completed
psychological questionnaires throughout the course of treatment.
After a mean of 4.85 treatments per patient, there were improvements in all measures.
The mean clinical scores improved from a moderate–severe grade to none–mild grade
after treatment. Three-dimensional (3D) laser surface scans showed a volume increase
of 2.81 cc over the treated area of the cheek. There were significant improvements in all
of the psychological measures.
This study shows clear objective evidence of the psychological and physical benefit
of PLA implants in HIV-associated facial lipodystrophy.
Keywords
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Article info
Publication history
Published online: November 26, 2008
Accepted:
July 17,
2008
Received:
March 19,
2008
Identification
Copyright
© 2008 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
