Plastic surgical approaches for HIV-associated lipoatrophy.

Prolonged antiretroviral therapy, particularly with thymidine analogue-based regimens, may lead to generalized lipoatrophy. The facial changes associated with lipoatrophy are highly stigmatizing, affecting quality of life and decisions around therapy. Changes in antiretrovirals to thymindine-sparing regimens may lead to gradual fat recovery but, even over several years, may not result in impressive restoration of appearance. The need for a rapid and effective panacea for facial changes has led to investigation of a range of cosmetic treatments to enhance facial appearance. Surgical fillers, which may be either permanent or biodegradable, are the mainstay of cosmetic management. These treatments not only lead to improved physical appearance but also may reduce social anxiety and depression.