Plastic surgical approaches for HIV-associated lipoatrophy

Area of Science:

• HIV/AIDS Treatment
• Cosmetic Dermatology
• Facial Reconstructive Surgery

Background:

• Prolonged antiretroviral therapy (ART), especially thymidine analogue-based regimens, can cause generalized lipoatrophy.
• Facial lipoatrophy leads to stigmatizing changes, negatively impacting patients' quality of life and treatment adherence.
• While switching to thymidine-sparing ART may allow gradual fat recovery, it often fails to fully restore facial appearance over several years.

Purpose of the Study:

• To evaluate the efficacy of cosmetic treatments for facial changes associated with lipoatrophy.
• To identify rapid and effective solutions for restoring facial aesthetics in patients with HIV-associated lipoatrophy.
• To assess the psychological benefits of cosmetic interventions for facial lipoatrophy.

Main Methods:

• Review of cosmetic management strategies for facial lipoatrophy.
• Focus on the role of surgical fillers (permanent and biodegradable) as a primary treatment modality.
• Exploration of patient outcomes related to physical appearance and psychological well-being.

Main Results:

• Surgical fillers are the primary approach for cosmetic management of facial lipoatrophy.
• These interventions can significantly enhance facial appearance.
• Improvements in physical appearance correlate with reduced social anxiety and depression.

Conclusions:

• Cosmetic fillers provide a rapid and effective solution for facial lipoatrophy secondary to ART.
• Treatment enhances physical appearance and positively impacts psychological health.
• Addressing facial changes improves overall quality of life for patients on long-term HIV therapy.