HIV-associated facial lipoatrophy treated with injectable silicone oil: A pilot study

Background Facial lipoatrophy (FLA) is associated with HIV infection and is part of the lipodystrophy syndrome. Temporary filler treatments do not meet the need of the patient, as there is a lack of permanence, and excessive cost. Objective We sought to evaluate the safety and efficacy of a highly p...

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Bibliographic Details
Published in:Journal of the American Academy of Dermatology 2013-09, Vol.69 (3), p.431-437
Main Authors: Chen, Fionn, MS, Carruthers, Alastair, MD, Humphrey, Shannon, MD, Carruthers, Jean, MD
Format: Article
Language:English
Subjects:
Adipose Tissue - pathology
Adult
Atrophy - drug therapy
Atrophy - virology
Dermatology
Face
facial lipoatrophy
Female
HIV Infections - complications
HIV-associated lipoatrophy
Humans
Injections, Subcutaneous
liquid injectable silicone
Male
Middle Aged
Patient Satisfaction
permanent soft tissue filler
Pilot Projects
Quality of Life
Severity of Illness Index
silicone oil
Silicone Oils - administration & dosage
Silicone Oils - adverse effects
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Summary:Background Facial lipoatrophy (FLA) is associated with HIV infection and is part of the lipodystrophy syndrome. Temporary filler treatments do not meet the need of the patient, as there is a lack of permanence, and excessive cost. Objective We sought to evaluate the safety and efficacy of a highly purified medical-grade 1000-cst liquid injectable silicone in the treatment of HIV-associated FLA using the serial microdroplet injection technique. Methods Twenty patients with HIV-associated lipoatrophy were treated with liquid injectable silicone with a maximum of 6 treatment sessions (2.0 mL each session maximum). Patients were evaluated at 9-, 12-, and 18-month follow-up sessions. Safety, efficacy, injection volumes, and patient satisfaction were evaluated. Results No persistent adverse effects were reported throughout the study. Most of the patients achieved complete correction of their HIV-associated FLA after 6 treatments and maintained this correction to the 18-month follow-up. Limitations This is a noncomparative, nonblinded study. Study patient population size is small. Conclusion Given our small sample size of 20 patients, our results suggest that, if administered correctly, liquid injectable silicone is potentially a safe, effective, and natural-feeling treatment option for HIV-associated FLA. Larger studies may be needed to confirm safety, efficacy, and permanence.
ISSN:0190-9622
1097-6787
DOI:10.1016/j.jaad.2013.03.025