Preliminary Experiences with Bio-Alcamid in HIV Facial Lipoatrophy

Abstract

Background: Highly active antiretroviral therapy for HIV-infected patients causes metabolic changes known as the lipodystrophy syndrome. Autologous fat injections, dermal fat grafts, malar implants and injected fillers have been reported as treatment options. Objective: To evaluate the results of HIV-infected patients treated with Bio-Alcamid for facial lipoatrophy. Methods and Materials: Over a 3-year period, 13 HIV-infected patients with facial lipoatrophy had Bio-Alcamid injections for aesthetic purposes. The procedure was done under local anesthesia, and the amount of the injected material varied from 5 to 13 ml. Results were independently evaluated by patients and physicians. Results: Most of the patients felt they had good to excellent results. Touch-ups were necessary for 2 patients; the added volume was 2–3 ml for each. No major complications were recorded. A small hematoma was noted in 1 patient. Overcorrection was attained in 2 cases, and some of the filler was removed at the patient’s request. Conclusion: One of the greatest advantages of this filler is that, although permanent, it can be removed easily. We consider Bio-Alcamid to be a safe and useful correcting tool for patients suffering from drug-induced facial lipoatrophy.

Adverse reactions to injectable soft tissue fillers

“…It has been used to increase volume in the cheeks in HIV patients with facial lipoatrophy related to antiretroviral therapy and for gluteal augmentation, correction of irregularities after liposculpture, scar depressions, and posttraumatic subcutaneous atrophy and filling of pectus excavatum or other malformations of the skeleton. [270][271][272][273][274][275][276][277][278] Complications secondary to the injections of Bio-Alcamid include edema (Fig 30), bruising, and nodules and, in particular, infections. [279][280][281][282][283][284][285][286] To our knowledge, no granulomas secondary to Bio-Alcamid have been described.…”

Complications of Penis or Scrotum Enlargement Due to Injections with Permanent Filling Substances

“…Although penis girth enlargement with permanent fillers may in general be able to yield good results in the short term, the possible severe complications in the longer term, such as migration, granulation, and infection, cannot be ignored. The fillers referred to above and other permanent fillers are also used elsewhere in the body for cosmetic purposes and for medical indications (e.g., lipoatrophy based on highly active antiretroviral therapy or atrophic facial defor- mities as a result of Romberg's disease), 4,7,19,20 and unfortunately with the same type of complications. [21][22][23][24] Injections of permanent fillers into the penis introduce additional risks that are inherent to the anatomy of the penis.…”

Complication of a Polyalkylimide Implant in a Patient with Facial Trauma

“…Multiple studies have reported the use of polyalkylimide for the correction of lipoatrophy produced by drugs mainly in HIV-positive patients with no reports of adverse effects. [12][13][14] However, the behavior of the implants in these patients can be different because of alterations in their cellular immune response.…”