HIV-Associated Facial Lipoatrophy
Restoring facial volume lost to HIV and its treatment, with the two fillers FDA-approved for the condition, in West Hollywood.
Facial lipoatrophy, the loss of fat in the cheeks, temples and around the eyes and mouth, affects many people living with HIV, particularly those treated with older antiretroviral regimens. The sunken appearance can make a healthy person look ill and can feel like a disclosure of status that was never chosen. It is also very treatable. Skinpeccable's West Hollywood office, in the heart of the community, has restored facial volume for HIV patients for many years, and Dr. Darvish treats the condition with the two fillers specifically FDA-approved for it.
Why lipoatrophy happens
Older nucleoside reverse transcriptase inhibitors, especially stavudine (d4T) and zidovudine (AZT), damaged fat cells and their mitochondria, causing fat to waste away from the face and limbs. HIV itself and chronic inflammation contribute. Modern regimens rarely cause new lipoatrophy, but fat that was lost does not return on its own, even after switching medications and even with excellent viral control.
Treatment options
Sculptra (poly-L-lactic acid)
Sculptra was the first product FDA-approved for HIV-associated facial lipoatrophy, in 2004, and remains the mainstay. Rather than filling directly, it stimulates the skin to produce its own collagen over several months, gradually rebuilding the thickness of the cheeks and temples. It is given as a series of two to four sessions, four to six weeks apart, and results typically last two years or longer. The gradual, natural result suits lipoatrophy particularly well.
Radiesse (calcium hydroxylapatite)
Radiesse was FDA-approved for HIV lipoatrophy in 2006. It provides immediate volume and also stimulates collagen, lasting about a year or more. Dr. Darvish often uses it for patients who want a visible change at the first visit, or in combination with Sculptra.
Hyaluronic acid fillers
Firm hyaluronic acid fillers such as Voluma or RHA 4 can be added for precise contouring of the cheekbone and temple once the base volume is restored. They are reversible, which some patients value.
What to expect
Consultation. A private consultation at either office. Dr. Darvish maps the areas of loss, discusses your medical history and current regimen, and lays out a plan with the total number of sessions and cost.
Treatment. Topical numbing, then injections of about 20 to 30 minutes. Sculptra requires firm massage of the area for five days afterward. Mild swelling and possible bruising for a few days.
Results. Radiesse and hyaluronic acid fillers show immediately. Sculptra builds over the series and for several months after, with results that last two years or more and can be maintained with a single session.
Coverage and assistance
Because Sculptra and Radiesse are FDA-approved for HIV lipoatrophy as a medical condition, treatment is sometimes covered by insurance or supported by manufacturer patient assistance programs. Our office can help you understand the options; call 310-979-SKIN.
Why Skinpeccable
Dr. Darvish has treated facial lipoatrophy since the early years of Sculptra and has placed thousands of filler treatments over twenty years. Our West Hollywood office at 8264 Santa Monica Blvd. has served the community since 2005 with the discretion and respect this condition deserves. Consultations are complimentary and private.
Frequently asked questions
Which fillers are FDA-approved for HIV lipoatrophy?
Sculptra (poly-L-lactic acid, approved 2004) and Radiesse (calcium hydroxylapatite, approved 2006). Dr. Darvish uses both.
How many treatments will I need?
Usually two to four Sculptra sessions, four to six weeks apart. Radiesse may be a single session with a touch-up.
How long do results last?
Sculptra results typically last two years or longer. Radiesse about a year or more. Maintenance is a single session.
Will it look natural?
Yes. Sculptra rebuilds your own collagen gradually, so the change looks like recovery rather than filler.
Is treatment covered by insurance?
Sometimes, because the products are FDA-approved for HIV lipoatrophy as a medical condition. Manufacturer patient assistance programs may also help. Our office can guide you.
Does my HIV medication matter?
Current regimens rarely cause new fat loss, and treatment is appropriate regardless of regimen. Dr. Darvish reviews your history at the consultation.
Is the consultation private?
Yes. Consultations are complimentary and conducted privately at the West Hollywood or Brentwood office.
Can lipoatrophy of the temples and under the eyes be treated?
Yes. Sculptra restores the temples; thin hyaluronic acid fillers are used carefully under the eyes once the cheek is rebuilt.