title: Comparison between lipofilling and a nonabsorbable filler for facial wasting rehabilitation in HIV-positive patients.
abstract: BACKGROUND
  Several treatments have been described for facial wasting rehabilitation in HIV-positive patients. In this article, we compare lipofilling and a nonabsorbable filler for facial wasting rehabilitation induced by antiretroviral therapy in HIV-positive patients.
  
  
  METHODS
  This study was conducted as a clinical prospective study. Twenty-three HIV-positive patients affected by facial wasting were treated for facial rehabilitation, between January 2007 and December 2008, at the Head and Neck Department of the II University of Naples. They were divided into 2 groups; the first group was treated with lipofilling (group A), and the second one with the injection of a nonabsorbable filler, Aquamid reconstruction (Contura International A/S, Soeborg, Denmark) (group B).All the patients were HIV-positive, they had been receiving antiretroviral therapy for several years (1.8-6.7 years, 3.2 years on average) and showed clinical signs of facial lipoatrophy. Group A was composed of 14 patients (9 men, 5 women; mean age, 43.7 years), all presenting facial wasting and lipohypertrophied areas of the body. Group B was composed of 9 male patients, 7 presenting only facial wasting, and 2 presenting lipohypertrophied areas of the body (mean age, 44.8 years). Clinical efficacy was assessed independently by the investigator and the patient, 3 months, 6 months, and 1 year after baseline. The main assessment was made by the investigator using the Global Aesthetic Improvement Scale (GAIS) 1 year after baseline; secondary assessment using the GAIS was made by the investigator and the patient 6 months after baseline.
  
  
  RESULTS
  There were no major complications. No infections or other complications were observed. According to GAIS ratings, group A (lipofilling) obtained significantly higher ratings than did group B (nonabsorbable filler) after baseline (P < 0.05).
  
  
  CONCLUSIONS
  We can treat HIV-related lipodistrophy more extensively with lipofilling because, after harvesting the fat graft, other body contouring procedures also can be performed; there is a better aesthetic outcome in facial rehabilitation performed with lipofilling, probably due to the possibility to fill deeper than with nonabsorbable fillers.
authors.affiliation: Unit of Maxillo-Facial Surgery, Head and Neck Department, II University of Naples, Naples, Italy. raffaelerauso@virgilio.it
authors.forename: Raffaele
authors.initials: R
authors.lastname: Rauso
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Curinga
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Santillo
authors.forename: Giovanni
authors.initials: G
authors.lastname: Corvo
authors.forename: Gianpaolo
authors.initials: G
authors.lastname: Tartaro
mesh_terms: D000180:Acrylic Resins / Q000627:therapeutic use*; D000273:Adipose Tissue / Q000637:transplantation*; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D001672:Biocompatible Materials / Q000627:therapeutic use*; D003357:Cosmetic Techniques; D004954:Esthetics; D005145:Face; D005260:Female; D015658:HIV Infections / Q000188:drug therapy; D039682:HIV-Associated Lipodystrophy Syndrome / Q000628:therapy*; D006801:Humans; D020100:Hydrogels / Q000627:therapeutic use*; D007267:Injections; D008297:Male; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D000180:Acrylic Resins; C486838:Aquamid; D001672:Biocompatible Materials; D020100:Hydrogels