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15-01-2012 | Surgery | Article

Polyacrylamide hydrogel injection effective for treating HIV-related facial lipoatrophy


Free abstract

MedWire News: Treating human immunodeficiency virus (HIV)-related facial lipoatrophy by means of polyacrylamide gel injections is effective in the long-term, show study findings.

This was demonstrated by soft-tissue thickening, morphologic improvement, patient satisfaction, and a low incidence of adverse events.

Facial lipoatrophy, a wasting of the soft tissues of the cheeks that can produce a cachetic appearance, can compromise patients' quality of life, explain Marco Pignatti (Azienda Ospedaliero-Universitaria di Modena, Italy) and co-investigators in the journal Plastic and Reconstructive Surgery.

Injection of different materials in the cheeks can improve this condition, but there is concern in terms of potential long-term complications of nonbiodegradable fillers.

The team therefore investigated the long-term efficacy of polyacrylamide gel injections for the treatment of facial lipoatrophy in 314 HIV-infected patients.

Each patient was treated with an injection of one vial (1 ml) of polyacrylamide hydrogel in each cheek at outpatient appointments (approximately every 4 weeks) until a correction of the facial soft-tissue defect was obtained.

Every 6 to 12 months, ultrasound measurements of cheek soft-tissue thickness were performed, aesthetic improvement was evaluated, and satisfaction and psychologic consequences of treatment were self-evaluated (visual analog scale for the face, Assessment of Body Change and Distress questionnaire, and Beck Depression Inventory score). Adverse events were also assessed.

Thirty-eight of the patients were available for follow-up of more than 5 years. The mean number of treatment sessions was seven (range two to 13), performed over a mean period of 8.15 months.

Pignatti et al report significant improvements in cheek thickness and esthetic results 5 years after treatment. Patients also reported significant satisfaction and psychologic improvement. No serious adverse events occurred during the follow-up period.

"This, to our knowledge, is the longest published follow-up in such a population," write the researchers.

Our findings suggest that polyacrylamide gel injections "can be considered a suitable treatment for human immunodeficiency virus-related facial lipoatrophy," they conclude.

By Nikki Withers

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