Caring for HIV-positive and aging patients with associated facial lipoatrophy

Plast Surg Nurs. 2006 Jan-Mar;26(1):17-23. doi: 10.1097/00006527-200601000-00006.

Abstract

Facial lipoatrophy is characterized by fat loss and redistribution. It is a natural, biological phenomenon that occurs over time, presenting as mild-to-moderate volume depletion that gives the skin the appearance of sagging. More recently, highly active antiretroviral therapy, introduced for the management of human immunodeficiency virus, has been associated with moderate-to-severe facial lipoatrophy, and is characterized by sunken cheeks, accentuated nasolabial folds, and protruding musculature and bones. Furthermore, the consequences of facial lipoatrophy have been found to substantially impact patient quality of life. Nurses play an integral role in the treatment of facial lipoatrophy by educating the patients on available therapies and assisting them in making informed treatment decisions. It is important that treating nurses conduct a well-organized interview to understand patient treatment goals. This article will discuss several treatment options available to correct facial lipoatrophy-associated volume deficits, including collagen, hyaluronic acid, calcium hydroxylapatite, poly-L-lactic acid, and permanent implants and injectables.

Publication types

  • Review

MeSH terms

  • Biocompatible Materials / therapeutic use
  • Body Image
  • Collagen / therapeutic use
  • Cosmetic Techniques* / nursing
  • Durapatite / therapeutic use
  • Face*
  • HIV-Associated Lipodystrophy Syndrome / pathology
  • HIV-Associated Lipodystrophy Syndrome / psychology
  • HIV-Associated Lipodystrophy Syndrome / therapy*
  • Humans
  • Hyaluronic Acid / therapeutic use
  • Informed Consent
  • Lactic Acid / therapeutic use
  • Nurse's Role
  • Nursing Assessment
  • Patient Education as Topic
  • Polyesters
  • Polymers / therapeutic use
  • Polytetrafluoroethylene / therapeutic use
  • Quality of Life
  • Severity of Illness Index
  • Skin Aging / drug effects*
  • Skin Aging / pathology

Substances

  • Biocompatible Materials
  • Polyesters
  • Polymers
  • Lactic Acid
  • poly(lactide)
  • Polytetrafluoroethylene
  • Hyaluronic Acid
  • Collagen
  • Durapatite