Facial fat loss – measuring and treatment
Simon Collins, HIV i-Base
Numerous studies reported ways of measuring, monitoring and classifying stages of facial lipoatrophy, much of which is particularly frustrating for patients who clearly have symptoms but no access to treatment.
The most recommended approach in an overview of available treatment provided by Dr Heinz Bull in the final session was using injections of polylactic acid (PLA, New-Fill). This treatment was first reported at the 2nd Lipodystrophy workshop and every year thereafter, and usually is included in other major HIV conferences.
More severe lipoatrophy requires more treatment than mild lipoatrophy, but patient satisfaction is generally high and was reported as improving appearance in 27/30 patients who received New-Fill at St Mary’s Hospital in London and who had reported a high level of previous distress from these symptoms. 
One poster reported that 4/53 patients, who had undergone autologous fat transfer to treat facial lipoatrophy, had subsequently experienced hypertrophy in their cheeks at the same time as a relapse of their original buffalo hump or central hyperatrophy. Fat was sourced from a buffalo hump in 21/53 cases. Three of these four cases of severely swollen cheeks had involved injected fat removed from a buffalo hump, and one from abdominally collected fat. The study concluded that people undergoing fat transfer should harvest fat for this process from abdomen or groin areas. 
This article is part of a longer report from the 5th International Workshop on Adverse Drug Reactions and Lipodystrophy, 8-11 July 2003, Paris. Part nine of this report.
Unless otherwise stated, all abstracts refer to the programme and abstracts from the 5th International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV, 8-11 July 2003, Paris and are published in Antiviral Therapy Volume 8 issue 4.
- Frize G, Hughes A, Scullard G et al – Attitudes and perceptions of patients with facial lipoatrophy before and after intervention using polylactic acid. Abstract 110.
- Guaraldi G, De Fazio D, Orlando G et al – Fat accumulation of the cheeks after autologous fat transfer for treating facial wasting in HIV-related lipodystrophy. Abstract 81.