Long-term efficacy and safety of polyacrylamide hydrogel injection in the treatment of human immunodeficiency virus-related facial lipoatrophy: A 5-year

Background: Facial lipoatrophy, a human immunodeficiency virus–related wasting of the facial soft tissues, can compromise patients’ quality of life. In- jection of different materials in the cheeks can improve this condition. Concern regarding potential long-term complications of nonbiodegradable fillers re- mains. The authors investigated the long-term efficacy and safety of polyacryl- amide gel injections. Methods: Human immunodeficiency virus–infected patients treated with poly- acrylamide gel for moderate to severe facial lipoatrophy with a minimum of 5 years’ follow-up were included. Aquamid (1 ml) was injected monthly into each cheek until adequate correction was obtained. Outcome measures were ultra- sound measurement of cheek soft-tissues thickness, evaluation of aesthetic im- provement, and self-evaluation of satisfaction and psychological consequences of treatment (visual analogue scale for the face, Assessment of Body Change and Distress questionnaire, and Beck Depression Inventory score). Adverse events were classified as acute ( 1 week), early (1 week to 1 month), midterm (1 month to 1 year), or late ( 1 year). Results: Onehundredforty-onepatientscompletedthetreatmentasofJuneof 2005; 38 (32 men; mean age, 42 years) were available for follow-up of more than 5 years (mean, 62 months). The mean number of treatment sessions was seven over a mean period of 8 months. Significant improvement of cheek thickness and aesthetic result and highly significant satisfaction and psychological im- provement were obtained. No serious adverse events occurred during the fol- low-up period. Conclusion: The long-term efficacy and safety of polyacrylamide gel injection for the treatment of human immunodeficiency virus–related facial lipoatrophy were shown over a period of 5 years. (Plast. Reconstr. Surg. 129: 101, 2012.)