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Sculptra for Facial Lipoatrophy: New face sculpting changes lives for HIV patients  
  Updated: 4/9/2006 5:55 AM
By: Ivanhoe Newswire
(BALTIMORE) - Facial wasting is often the term used to describe the sunken look that many people with HIV develop. It's not reserved for them alone, though. As people age, many lose the volume in their face, and there hasn't been much anyone could do about it until now.
Last year, George Sakellaris had a tough time going out in public. "Because I'm HIV-positive and the type of medication that I was taking, what was happening was what they call wasting," he said. "It was hard to look in the mirror and see that that was happening, and there was nothing I could do."
Sakellaris had lipoatrophy, fat loss that causes a sunken look in the face.


But dermatologist Ciro Martins, M.D., could do something -- with a new filler called Sculptra. "It stimulates your body to produce collagen to actually increase the thickness of the skin," he said.
Sculptra is polylactic acid tissue filler. Doctors inject it in up to 60 spots on the face.
"It's an unbelievable reaction. It's an unbelievable effect that you have on people's lives," said Dr. Martins, of Johns Hopkins Medicine in Baltimore.


Sculptra can also fight one of the most common signs of aging by restoring fat that's been lost over time. Dr. Martins said it works very well for loss of tissue as it occurs with aging, but he's most excited about its effect on HIV patients.
"It's a dramatic change in quality of life," he said. "People who are affected by lipoatrophy really feel like they have a red flag stamped all over the face saying that they're HIV-positive."
Before and after pictures show just how dramatic the change can be. "I look in the mirror, and I look healthy," Sakellaris said. "It was so dramatic, I couldn't stop crying actually." Now, he's ready to live life with his best face forward.
Up to half of all HIV patients on anti-retroviral drugs have lipoatrophy. The Sculptra injections last for about two years. After than, touch-ups may be needed. Insurance does not cover the cost.
BACKGROUND: More than 1 million people are living with HIV in the United States and more than half a million have died after developing AIDS. Facial wasting is an important issue affecting the lives of people living with HIV. Facial wasting is one symptom of a syndrome called lipoatrophy. Lipoatrophy describes the loss of the soft layer of fat that sits just beneath the skin's surface.
Many times, people affected by the condition have well-controlled HIV disease, and are living healthy, productive lives. Yet, the appearance that comes with facial wasting often suggests the opposite and serves as a stigma.
ONE MAN'S ACCOUNT: George Sakellaris, who is HIV-positive, explains his own experience with facial wasting:
"It was pretty traumatic because what was happening is it just looked like I was constantly losing weight and sort of having that gaunt look. Even though I was working out and the rest of my body was proportioned, my face wasn't. It just became sunken. It was hard to look in the mirror and see that was happening and there was nothing I could do about it. I would have done anything to have my face look the way it did you know, four years ago."
FDA-APPROVED HOPE: There is now new hope for people living with lipoatrophy. Doctors are now using a product called Sculptra, which is poly-L-lactic acid, to fill out the face and restore a healthy appearance. Sculptra is a safe material that is injected below the surface of the skin in the area of fat loss. It provides a gradual and significant increase in skin thickness, improving the appearance of folds and sunken areas. A patient will generally receive four to five treatment sessions, where doctors inject Sculptra into the face. Up to 60 shots may be needed for the first session, but doctors say the number of shots decrease as the sessions continue. Ciro Martins, M.D., from Johns Hopkins University in Baltimore, says, "[Sculptra] gets deposited and then it stimulates your body to produce collagen to actually increase the thickness of the skin." A numbing cream is rubbed on the face to reduce the discomfort of the needle sticks. Thanks to that cream, many patients say they can barely feel the needles at all. Sculptra has been used in other countries since 1999. It is the first FDA-approved product of its kind for this condition.
COSMETIC USES? Sculptra may benefit more people than those living with HIV. As people age, many times they will develop facial fat loss. Dr. Martins says: "Lipoatrophy is very common. It's part of the aging process." Some dermatologists are now offering Sculptra as a way to fill in the face of older adults. However, Dr. Martins warns, "Most commonly for people who are looking for cosmetic correction of aging skin, they're going to have to have a combination of different things done to the skin to correct the different problems that are going on." In other words, Sculptra will only help people restore volume in the face associated with fat loss. It will not help sagging skin or wrinkles.
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