title: Long-term efficacy and safety of polyacrylamide hydrogel injection in the treatment of human immunodeficiency virus-related facial lipoatrophy:  a 5-year follow-up.
abstract: BACKGROUND
  Facial lipoatrophy, a human immunodeficiency virus-related wasting of the facial soft tissues, can compromise patients' quality of life. Injection of different materials in the cheeks can improve this condition. Concern regarding potential long-term complications of nonbiodegradable fillers remains. The authors investigated the long-term efficacy and safety of polyacrylamide gel injections.
  
  
  METHODS
  Human immunodeficiency virus-infected patients treated with polyacrylamide gel for moderate to severe facial lipoatrophy with a minimum of 5 years' follow-up were included. Aquamid (1 ml) was injected monthly into each cheek until adequate correction was obtained. Outcome measures were ultrasound measurement of cheek soft-tissues thickness, evaluation of aesthetic improvement, and self-evaluation of satisfaction and psychological consequences of treatment (visual analogue scale for the face, Assessment of Body Change and Distress questionnaire, and Beck Depression Inventory score). Adverse events were classified as acute (<1 week), early (1 week to 1 month), midterm (1 month to 1 year), or late (>1 year).
  
  
  RESULTS
  One hundred forty-one patients completed the treatment as of June of 2005; 38 (32 men; mean age, 42 years) were available for follow-up of more than 5 years (mean, 62 months). The mean number of treatment sessions was seven over a mean period of 8 months. Significant improvement of cheek thickness and aesthetic result and highly significant satisfaction and psychological improvement were obtained. No serious adverse events occurred during the follow-up period.
  
  
  CONCLUSIONS
  The long-term efficacy and safety of polyacrylamide gel injection for the treatment of human immunodeficiency virus-related facial lipoatrophy were shown over a period of 5 years.
  
  
  METHODS
  : Therapeutic, IV.
authors.affiliation: Modena, Italy From the Department of Plastic and Reconstructive Surgery and the HIV Metabolic Clinic, Department of Infectious and Tropical Diseases, Azienda Ospedaliero-Universitaria di Modena, University of Modena and Reggio Emilia.
authors.forename: Giorgio
authors.initials: G
authors.lastname: De Santis
authors.forename: Marco
authors.initials: M
authors.lastname: Pignatti
authors.forename: Alessio
authors.initials: A
authors.lastname: Baccarani
authors.forename: Antonio
authors.initials: A
authors.lastname: Pedone
authors.forename: Antonio
authors.initials: A
authors.lastname: Spaggiari
authors.forename: Gabriella
authors.initials: G
authors.lastname: Orlando
authors.forename: Giovanni
authors.initials: G
authors.lastname: Guaraldi
mesh_terms: D000180:Acrylic Resins / Q000008:administration & dosage*; D000328:Adult; D005145:Face; D005260:Female; D039682:HIV-Associated Lipodystrophy Syndrome / Q000523:psychology / Q000628:therapy*; D006801:Humans; D020100:Hydrogels / Q000008:administration & dosage*; D007267:Injections; D008297:Male; D008875:Middle Aged; D019736:Prostheses and Implants; D016896:Treatment Outcome
chemical_list: D000180:Acrylic Resins; C486838:Aquamid; D020100:Hydrogels