Approaches to treatment of HIV facial lipoatrophy.

HIV-associated facial lipoatrophy has become epidemic among the greater than 1 million HIV-infected individuals living in the United States. Those affected usually have well-controlled HIV disease, and are most often healthy and living productive lives. However, their facial appearance often suggests the opposite and frequently serves as a stigma and psychological burden. Treatment approaches may be divided into three categories: 1) Surgically placed alloplastic, autologous, or synthetic implants; 2) Injection of temporary fillers; 3) Injection of permanent fillers, including liquid injectable silicone. Salient aspects of each treatment are reviewed, along with new techniques and pearls on the correct use of liquid injectable silicone.