Complications Following Non-Surgical Aesthetic Treatments in HIV+ Patients Receiving Antiretroviral Therapy: A 12-Years Experience

Since the advent of HIV antiretroviral therapies at the end of the 20th century, the morbidity and mortality rates associated with HIV infection have decreased dramatically. Unfortunately, these benefits are associated with substantial morphologic changes in the body, such as abnormal fat distribution with peripheral lipohypertrophy and facial lipoatrophy. Facial wasting is considered the major stigma for HIV–infected people and may result in reduced antiretroviral adherence. Patients suffering from the stigmata of HIV infection can benefit from non-surgical aesthetic treatments performed with fillers or lipolytic agents that provide a quick and reliable service for facial rejuvenation, with high patient satisfaction and a low risk of complications. In the present paper, a retrospective analysis of complications following non-surgical aesthetic treatments (calcium hydroxyapatite-based filler, hyaluronic acid filler, polyacrylamide hydrogel filler and dehoxycholic acid injections), in a cohort of 116 consecutive HIV+ patients, treated over a period of 12 years, was performed. With the exception of the tardive swelling reported after calcium hydroxyapatite injections, complications were recorded just after polyacrylamide hydrogel treatment as small, palpable, nonvisible nodules or aseptic abscess. Our experience is consistent with those already published in the literature and the complication rate seems to be comparable to non-infected patients.

Idiopathic facial lipoatrophy in a healthy middle-aged woman: a case report

Background Facial lipoatrophy is a rare condition described by the disappearance of facial subcutaneous fat. The etiology of lipoatrophy can be congenital, or acquired including traumatic, iatrogenic or idiopathic. Idiopathic facial lipoatrophy has only been previously identified in three case reports, among which, the patient demographics vary considerably. Two of these case reports have identified a role for autologous fat transfer as a means of treatment. This case differs from those in the literature in patient demographics and severity of the facial lipoatrophy. The aim of the current report is to present a rare case of idiopathic facial lipoatrophy, and to assess the use of autologous fat transfer as a treatment modality. Case presentation We present a case of a 40-year old woman from Nova Scotia, Canada who presented with asymptomatic idiopathic facial lipoatrophy. The patient was otherwise healthy, taking no medications with no trauma or surgery in the region affected. Investigations, including a full autoimmune workup, were unremarkable. The facial lipoatrophy was considerably disfiguring and was assessed as a Grade 4 on the facial lipoatrophy scale. The patient was treated over the course of 2 years with two autologous fat transfers. Conclusions Achieving resolution of idiopathic lipoatrophy is important to patients because it can manifest in a disfiguring form and have negative effects on quality of life. The current study reports a treatment of idiopathic lipoatrophy that achieved results acceptable to the patient.