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Facial Lipoatrophy

Irene A Kim, Gregory Keller, Michael J Groth, Vishad Nabili
Three-dimensional facial volume restoration using fat has become widely accepted as an essential component of facial rejuvenation. Transplanted fat has benefits due to its inherently nonallergenic nature. The versatility of fat grafts allows for their use in all types of facial enhancement-improving the appearance of nasolabial folds, mesolabial grooves, flattened cheeks and upper lips, glabellar furrows, lipoatrophy, acne scars, and temporal hollowing. Yet despite its virtues as the ideal filler, autologous fat has its shortcomings with risks of complications...
October 2016: Facial Plastic Surgery: FPS
Douglas C Wu, Mitchel P Goldman
BACKGROUND: The risk of nodule formation following poly-L-lactic acid (PLLA) injections for facial volume loss is well known. Traditionally, post-treatment massage according to the 5-5-5 rule (5 times per day for 5 minutes for 5 days) has been applied to mitigate this risk. However, such a regimen may be onerous for patient compliance. Using currently accepted injection technique and product dilution, the efficacy of massage for nodule prevention has never been formally evaluated. OBJECTIVE: To evaluate the efficacy of massage in reducing the incidence of nodule formation post-PLLA injection...
September 9, 2016: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
Derek Ho, Jared Jagdeo
BACKGROUND: Human immunodeficiency virus (HIV) facial lipoatrophy (FLA) is associated with the use of highly active antiretroviral therapy (HAART) and HIV disease. HIV FLA is primarily characterized by midface (cheeks and temples) volume loss, resulting in a "sunken" and aged appearance. Filler agents for treatment of HIV FLA can provide midface volumization and improve quality-of-life (QOL). A 20 mg/ml hyaluronic acid (HA) filler (Juvéderm Voluma® XC, Allergan plc, Irvine, CA) may provide an immediate, natural appearing facial enhancement outcome in one treatment...
September 1, 2016: Journal of Drugs in Dermatology: JDD
Christina N Kraus, Lance W Chapman, Dorota Z Korta, Christopher B Zachary
Facial lipoatrophy (FLA), characterized by a decrease in facial volume, has a high prevalence in patients with human immunodeficiency virus (HIV) infection treated with long-term highly active antiretroviral therapy (HAART). The social stigmatization that results from such changes in facial appearance has led some HIV patients to discontinue HAART. The use of fillers is one method of restoring facial volume. A critical outcome of treatment concerns the patient's quality of life (QoL). Although many studies have assessed patient satisfaction, as well as the social and psychological outcomes associated with the correction of HIV FLA, fewer studies have assessed QoL...
August 6, 2016: International Journal of Dermatology
Johnson C Lee, Z Paul Lorenc
Soft tissue filler procedures have increased dramatically in popularity in the United States. Synthetic fillers such as calcium hydroxyapatite (CaHA), polymethyl methacrylate (PMMA), and poly-l-lactic acid (PLLA), and silicone provide initial volume replacement but have an additional biostimulatory effect to supplement facial volumization. Indications include human immunodeficiency virus lipoatrophy and nasolabial folds for CaHA and PLLA and atrophic acne scars for PMMA. Most clinical use of these synthetic fillers is in an off-label fashion...
July 2016: Clinics in Plastic Surgery
Albert W Wu, Tanyaporn Wansom, I-Chan Huang, Joseph CoFrancesco, Marcus A Conant, David B Sarwer
BACKGROUND: Facial lipoatrophy is common in people on antiretroviral (ARV) regimens for HIV/AIDS and can impair health-related quality of life. OBJECTIVES: We developed the Facial Appearance Inventory (FAI) to measure the impact of ARV-associated facial lipoatrophy. METHODS: Qualitative methods were used to identify key concerns of people with facial lipoatrophy. The major concerns were used to identify 24 items for the FAI. The FAI was administered to a cross-sectional sample of 96 people with HIV and facial lipoatrophy and compared to the established Assessment of Body Change Distress (ABCD) and MOS-HIV questionnaires...
July 2016: Aesthetic Surgery Journal
Derek Ho, Jared Jagdeo
BACKGROUND: Dermal fillers are important for facial aesthetic enhancement as patients are favoring non-surgical procedures with minimal recovery time. Voluma is a volumizing hyaluronic acid filler, 20 mg/ml HA dermal filler, which was FDA-approved in 2013 as the first dermal filler for treatment of age-related volume loss in the midface. OBJECTIVE: We sought to systematically review clinical studies and expert opinions of this 20 mg/ml HA dermal filler and to provide evidence-based recommendations and expert opinions...
September 2015: Journal of Drugs in Dermatology: JDD
Aneta Szczerkowska-Dobosz, Barbara Olszewska, Małgorzata Lemańska, Dorota Purzycka-Bohdan, Roman Nowicki
Facial lipoatrophy refers to the loss of subcutaneous fat tissue presenting by flattening or indentation of convex contour of the face. Facial lipoatrophy is a feature of the normal ageing process. It may be also a manifestation of chronic diseases, most frequently it affects HIV-infected individuals treated with highly active antiretroviral therapy (HAART) and may constitute a complication of connective tissue diseases, like lupus erythematosus profundus or morphea. Early recognition and treatment of the active stage of connective tissue diseases is of essential significance in prevention of subsequent scarring and atrophy lesions...
April 2015: Postȩpy Dermatologii i Alergologii
Raffaele Rauso
BACKGROUND: Lipoatrophy of the face negatively impacts the quality of life and body image of individuals on antiretroviral therapy. Facial fillers can minimize the stigma associated with the human immonodeficiency virus (HIV). OBJECTIVES: In this 5-year follow-up study, the author assessed the safety and efficacy of a permanent, non-biodegradable, polyacrylamide hydrogel for facial volume restoration, and compared the results with those of a previous 18-month follow-up study...
November 2015: Aesthetic Surgery Journal
Francesco P Bernardini, Alessandro Gennai, Luigi Izzo, Alessandra Zambelli, Erica Repaci, Ilaria Baldelli, G Fraternali-Orcioni, Morris E Hartstein, Pier Luigi Santi, Rodolfo Quarto
BACKGROUND: Although recent research on micro fat has shown the potential advantages of superficial implantation and high stem cell content, clinical applications thus far have been limited. OBJECTIVES: The authors report their experience with superficial enhanced fluid fat injection (SEFFI) for the correction of volume loss and skin aging of the face in general and in the periocular region. METHODS: The finer SEFFI preparation (0.5 mL) was injected into the orbicularis in the periorbital and perioral areas, and the 0...
July 2015: Aesthetic Surgery Journal
Minerva Becker, Nicolas Balagué, Xavier Montet, Alexandra Calmy, Denis Salomon, Laurence Toutous-Trellu
OBJECTIVE: This prospective observational study evaluated magnetic resonance imaging (MRI) findings of hyaluronic acid (HA) injections used for the correction of HIV-associated facial lipoatrophy. METHODS: Ten consecutive males underwent subdermal HA injection (mean 1.3 ± 0.6 ml per side) and MRI examinations prior to and then 1, 6 and 12 months after injection. Two radiologists blinded to the clinical data assessed morphologic and quantitative changes. RESULTS: MRI revealed HA deposition in the subdermal and deep fat compartments...
2015: Dermatology: International Journal for Clinical and Investigative Dermatology
Eugenia Negredo, Jordi Puig, Arelly Ornelas, Patricia Echeverría, Anna Bonjoch, Carla Estany, Carmen Higueras, Vicente Gonzalez-Mestre, Bonaventura Clotet
Long-term results (>5 years) for synthetic substances used to repair facial lipoatrophy have not been published. We performed a cross-sectional study to evaluate the 10-year safety of polyacrylamide hydrogel (Aquamid) among the 751 patients from our unit who received facial infiltrations at least 10 years ago. Epidemiological and clinical data such as complications and patient satisfaction were collected. We also identified those patients who presented a facial infection at any time after infiltration. A total of 104 patients had received Aquamid at least 10 years ago...
August 2015: AIDS Research and Human Retroviruses
David J Gerth
Traditional views on facial aging and associated therapies focused on soft tissue descent and skin texture changes. Recently, revolumization for age-related lipoatrophy has become increasingly popular. Researchers are now reporting objective studies examining processes of structural and volumetric changes with age in increasing frequency as well. To better understand and treat facial aging, the surgeon should review all available data. Presented here are current evidence-based studies regarding age-related changes in the facial skeleton and soft tissue envelope...
February 2015: Facial Plastic Surgery: FPS
David Teplica, Marlon Bohorquez, Francis J Podbielski
BACKGROUND: A novel surgical technique to reconstruct facial wasting was developed for patients with severe human immunodeficiency virus lipoatrophy and no source of subcutaneous fat for donor material. Fourteen patients underwent endoscopic harvest of omentum, extracorporeal morcellation, and autologous transfer to the face. METHODS: Omental fat was harvested using a standard 3-port laparoscopic technique. A mechanical tissue processor created morsels suitable for transfer...
November 2013: Plastic and Reconstructive Surgery. Global Open
Martin Duracinsky, Pascale Leclercq, Susan Herrmann, Marie-Odile Christen, Marc Dolivo, Cécile Goujard, Olivier Chassany
BACKGROUND: Facial lipoatrophy is a frequently reported condition associated with use of antiretroviral (ARV) drugs. Poly-L-lactic acid (PLLA) acid has been used to correct facial lipoatrophy in people with HIV since 2004 both in Europe and the United States. The objective of this study was to establish, in real life conditions and in a large sample, the safety of PLLA (New Fill®, Valeant US, Sinclair Pharma Paris, France) to correct facial lipoatrophy among HIV-positive patients. METHODS: A longitudinal study was conducted between 2005 and 2008 in France...
2014: BMC Infectious Diseases
Jesus Claudio Gabana-Silveira, Laura Davison Mangilli, Fernanda C Sassi, Arnaldo Feitosa Braga, Claudia Regina Furquim Andrade
OBJECTIVES: This study evaluated the effects of facial stimulation over the superficial muscles of the face in individuals with facial lipoatrophy associated with human immunodeficiency virus (HIV) and with no indication for treatment with polymethyl methacrylate. METHOD: The study sample comprised four adolescents of both genders ranging from 13 to 17 years in age. To participate in the study, the participants had to score six or less points on the Facial Lipoatrophy Index...
August 2014: Clinics
Caterina Pelosini, Silvia Martinelli, Giovanni Ceccarini, Silvia Magno, Ilaria Barone, Alessio Basolo, Paola Fierabracci, Paolo Vitti, Margherita Maffei, Ferruccio Santini
OBJECTIVE: Progressive lipodystrophy is one of the major features of the rare MDPL syndrome. Until now, 9 patients affected by this syndrome have been described and a recent study identified in 4 of them an in-frame deletion (Ser605del) of a single codon in the POLD1 gene. Sequence alterations of the POLD1 gene at different sites have been previously reported in human colorectal and endometrial carcinomas. MATERIALS/METHODS: A 48-year-old woman was admitted to our department for the assessment of a previously diagnosed lipodystrophy...
November 2014: Metabolism: Clinical and Experimental
Joan Fontdevila, Eva Guisantes, Esteban Martínez, Eduard Prades, Juan Berenguer
BACKGROUND: This work evaluates the effect of adding platelet-derived growth factor to autologous adipose tissue grafts in the treatment of human immunodeficiency virus facial lipoatrophy by means of objective measurements. METHODS: This is a randomized clinical trial conducted at the Hospital Clinic of Barcelona. Patients with facial human immunodeficiency virus atrophy were randomized into two groups, one treated with autologous fat injection (group A), and another treated with autologous fat injection with plasma rich in growth factors (group B)...
August 2014: Plastic and Reconstructive Surgery
S M Balaji
INTRODUCTION: Parry-Romberg syndrome (PRS) is a progressive, irreversible disorder characterized by facial lipoatrophy. The patients' physical and psychological well-being is highly affected. The choice of graft for correction of PRS is dictated by numerous factors. This qualitative study aims to present the patients choice of graft for PRS. MATERIALS AND METHODS: Reports of experience of patients surgically treated for PRS in the period of 2000-2011 are presented...
January 2014: Annals of Maxillofacial Surgery
Danny Vleggaar, Rebecca Fitzgerald, Z Paul Lorenc, J Todd Andrews, Kimberly Butterwick, Jody Comstock, C William Hanke, T Gerald O'Daniel, Melanie D Palm, Wendy E Roberts, Neil Sadick, Craig F Teller
Poly-L-lactic acid (PLLA) was approved for use in Europe in 1999. In the United States, it was approved by the Food and Drug Administration in 2004 for the treatment of facial lipoatrophy associated with human immunodeficiency virus, and in 2009 for cosmetic indications in immune-competent patients. The need for consistent, effective PLLA usage recommendations is heightened by an increased consumer demand for soft tissue augmentation and a shift toward a younger demographic. Over the past 14 years, considerable experience has been gained with this agent, and we have come to better understand the clinical, technical, and mechanistic aspects of PLLA use that need to be considered to optimize patient outcomes...
April 2014: Journal of Drugs in Dermatology: JDD
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