title: Polyacrylamide hydrogel injection in the management of human immunodeficiency virus-related facial lipoatrophy: a 2-year clinical experience.
abstract: BACKGROUND
  Facial lipoatrophy is defined as the reduction in buccal and orbital fat pads along with a more global loss of fat within the subcutaneous tissue. It is the most common and distressing sign of human immunodeficiency virus-associated lipodystrophy. Injectable polyacrylamide hydrogel (Aquamid) is a synthetic nonbiodegradable polymer consisting of a minor backbone of 2.5 percent cross-linked polyacrylamide and 97.5 percent nonpyrogenic water and is used for cosmetic facial contour correction. Favorable results with maximum aesthetic gains with the use of polyacrylamide hydrogel for reconstruction of facial lipoatrophy on the face in significantly immunocompromised individuals are being reported. These results are attributable to its use in limited volume injected at multiple sites and in multiple sittings.
  
  
  METHODS
  Aquamid has been used for the correction of severe nasolabial folds and mid and lower facial volume loss in patients affected by human immunodeficiency virus-associated lipodystrophy. Fifty patients were enrolled and treated, with a mean follow-up of 13.1 months. Results were evaluated clinically, by standardized ultrasonography, and by psychological tests (visual analogue scale, Beck Depression Inventory, and Assessment of Body Change and Distress questionnaire) to quantify patient satisfaction.
  
  
  RESULTS
  No significant side effects or issues such as swelling, infections, allergies, or nodule formation were noted over the follow-up period.
  
  
  CONCLUSIONS
  Aquamid has provided a minimally invasive, effective, long-lasting facial contour correction that significantly improves the quality of life in human immunodeficiency virus-infected patients.
authors.affiliation: Modena, Italy From the Department of Plastic and Reconstructive Surgery, University of Modena and Reggio Emilia.
authors.forename: Giorgio
authors.initials: G
authors.lastname: De Santis
authors.forename: Vinay
authors.initials: V
authors.lastname: Jacob
authors.forename: Alessio
authors.initials: A
authors.lastname: Baccarani
authors.forename: Antonio
authors.initials: A
authors.lastname: Pedone
authors.forename: Massimo
authors.initials: M
authors.lastname: Pinelli
authors.forename: Antonio
authors.initials: A
authors.lastname: Spaggiari
authors.forename: Giovanni
authors.initials: G
authors.lastname: Guaraldi
mesh_terms: D000180:Acrylic Resins / Q000008:administration & dosage*; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D005782:Gels; D015497:HIV-1; D039682:HIV-Associated Lipodystrophy Syndrome / Q000601:surgery* / Q000821:virology; D006801:Humans; D007279:Injections, Subcutaneous; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010781:Photography; D019919:Prosthesis Implantation / Q000941:ethics / Q000379:methods*; D013997:Time Factors
chemical_list: D000180:Acrylic Resins; D005782:Gels; C016680:polyacrylamide gels