Which Filler

[cityboy]

I have been taking Reyataz, Norvir and Truvada for about 8 months and would estimate was positive 1 year and a few months.

 How fast does wasting start? Does everyone who is positive get some form of wasting or lipo?

 I have some very mild indenting on my temples, one side a little more than the other. I have always had a thin face, so  I can't remember if I always had this or if this has recently happened.  I am looking at myself so much more carefully these days.

I would like to know what would be a good filler to use for this and any good places to go to have done.  I am in New York.  Willing to travel. 

[bobino]

Hi Cityboy,

I don't know that there are any definite answers to your questions.  Some people have been on meds for years and never gotten lipo.  Other people, like me, get it without even being on meds.  I've seen posts on here in which people have reported seeing lipo soon after starting meds, and others who only begin to see the signs years after being on a particular combo.

As I have said elsewhere in this forum, a leading lipo researcher at UCSF, Dr. Carl Grunfeld, says that he has documented fat changes in most positive people, even those not on meds.  So, that's one researcher's opinion, based on studies he's conducted.

Now for my two cents on your situation.  My guess is that if you think you're seeing changes, they are probably occurring.  Remember that you know your own body better than anyone.  So if it looks to you like you're losing fat, I'd say trust what your eyes are telling you.  You say that the indenting in your temples is more pronounced on one side.  The plastic surgeon who did my Sculptra says that lipo is always asymetrical.  He's worked with hundreds of HIV+ patients with lipo, so I think he probably knows what he's talking about.

As for fillers, I wouldn't recommend Sculptra.  I spent thousands of dollars on it, and although it certainly works, the effect isn't permanent, so you have to keep going back again and again for follow-up treatments.  I recently had permanent filler injections done at Clinic'Estetica in Tijuana, Mexico.  They use a PMMA-based product, which produces a permanent effect.  That's what I'd recommend.  Lots of members of this forum have been to Clinic'Estetica, and I'm sure they'll be happy to share their experiences with you.  If you want more details from me, just PM me.

Hope this helps.

John

[pozniceguy]

I have to agree with  John  Sculptra  woks and looks good for a while..I am part of study group sponsored by the manufacturer...I get free treatments for 5 years...just had my second year one...    I couldn't recommend this to anyone who has to pay..very expensive and fades in 2 yrs or less.....  I have had the equivalent of more than $25,000 worth and my last treatment was back to my condition of almost two yrs ago    ..got new stuff in for now but it will fade also I am sure.....after the study I will consider doing what John did..

  PS    .... my picture is after my first few treatments (15 vials as part of initial study)  looks good and then faded  to where I needed 3 more vials in second year

Nick

[denb45]

I have to agree with  John  Sculptra  woks and looks good for a while..I am part of study group sponsored by the manufacturer...I get free treatments for 5 years...just had my second year one...    I couldn't recommend this to anyone who has to pay..very expensive and fades in 2 yrs or less.....  I have had the equivalent of more than $25,000 worth and my last treatment was back to my condition of almost two yrs ago    ..got new stuff in for now but it will fade also I am sure.....after the study I will consider doing what John did..

  PS    .... my picture is after my first few treatments (15 vials as part of initial study)  looks good and then faded  to where I needed 3 more vials in second year

Nick

I wish that they would come out with something a lott more permanet lasting only 2 yrs  .............that's NOT very good, also where's the BANG for your buck?    just doesn't seem worth it to me 

[pozniceguy]

you are so correct  "no bang for the buck" here..the Derm Dr I started the study with had a session with the manufacturer about pricing  said he couldn't in good conscience charge people that much for the time it lasted...they agreed to part ways...Dr no longer offers Sculptra...and transferred my study to a Plastic surgeon  who apparently doesn't have a problem with the price....Nice guy with a beautiful office in the most expensive part of town  ,,,, figures!!!   my treatment is still free for 3 more yrs....

Nick

[cityboy]

Like I mentioned, the indenting is slight on one side mostly.  I do not know what the difference is between Sculptra, and PMMA.  Where is a good place for reference on all fillings for HIV positive folks?  My situation is more preventing this situation from becoming noticeable to others. So I don't think I would have to do anything as extreme as going to  Mexico yet to get a procedure like this done. Is PMMA only done outside the country and not approved by the FDA or is it just too expensive in the US.   

Hi Cityboy,

I don't know that there are any definite answers to your questions.  Some people have been on meds for years and never gotten lipo.  Other people, like me, get it without even being on meds.  I've seen posts on here in which people have reported seeing lipo soon after starting meds, and others who only begin to see the signs years after being on a particular combo.

As I have said elsewhere in this forum, a leading lipo researcher at UCSF, Dr. Carl Grunfeld, says that he has documented fat changes in most positive people, even those not on meds.  So, that's one researcher's opinion, based on studies he's conducted.

Now for my two cents on your situation.  My guess is that if you think you're seeing changes, they are probably occurring.  Remember that you know your own body better than anyone.  So if it looks to you like you're losing fat, I'd say trust what your eyes are telling you.  You say that the indenting in your temples is more pronounced on one side.  The plastic surgeon who did my Sculptra says that lipo is always asymetrical.  He's worked with hundreds of HIV+ patients with lipo, so I think he probably knows what he's talking about.

As for fillers, I wouldn't recommend Sculptra.  I spent thousands of dollars on it, and although it certainly works, the effect isn't permanent, so you have to keep going back again and again for follow-up treatments.  I recently had permanent filler injections done at Clinic'Estetica in Tijuana, Mexico.  They use a PMMA-based product, which produces a permanent effect.  That's what I'd recommend.  Lots of members of this forum have been to Clinic'Estetica, and I'm sure they'll be happy to share their experiences with you.  If you want more details from me, just PM me.

Hope this helps.

John

[bobino]

Cityboy,

The FDA has approved a PMMA-based product here in the U.S.  The brand name is Artefill.  You can read more about it and other fillers in the "Lessons" part of this site:

http://www.aidsmeds.com/articles/Lipoatrophy_4798.shtml

My understanding is that Artefill is even more expensive than Sculptra.  Because it's new, at this point not that many doctors have experience dealing with it.  It is a permanent filler, though, so if you can afford it, you might want to consider it.  Since your problem isn't that severe, it might be financially feasible.  In any event, pay attention to the problem of allergic reactions to the bovine collagen in the product.

And by the way, going to Mexico isn't that bad.  The clinic makes it very easy.  You fly to San Diego and they pick you up and take you to your appointment.  It's something to consider, particularly if your problem gets significantly worse.

John

[milguy]

John,

Which Clinic in Mexico are you referring to?  I would be very interested in reading about your experience if you went to a clinic in Mexico or what you have heard from others.  I'm thinking of going to Mexico this summer.  After almost 21 years of being HIV+ and being on so many different drugs for the same amount of years my face is showing the effects in fat loss.  I looking in to going to Dr. Casavantes or the clinic he use to be associated with Clinic'estetica.  Have your heard any thing good, bad or indifferent about either or both of these clinics?

Thanks,

Tom

[bobino]

Tom,

I went to Clinic'Estetica in Tijuana.  I was there at the end of March, and as I write this, my face is very slowly filling in.  I can certainly recommend the clinic.  It is very clean and professionally run, and the staff is extremely helpful.  They really try to make the experience as easy as possible.  You fly to San Diego, and they send a van to pick you up and take you across the border.  They'll also book you a hotel in Tijuana if you need to stay overnight.  Their web site is here:

http://www.clinicestetica.com/

My understanding is that Dr. Casavantes started at CE but then went out on his own.  Dr. Morales, who performs the treatment at CE, trained under Dr. Casavantes.  Note that only CE has the right to use the particular product (brand name "Precise") with which I was treated.  CE has a patent application pending for it here in the U.S.

Mind you, the treatment is not painless, depending on what areas you have treated.  In my experience, the face was the easiest.  The hard part was my hands and buttocks.  The clinic warned me that my hands would swell a lot, and they certainly did.  After the treatment, my hands looked like latex gloves that had been filled with water.  They have taken almost a month to return completely to normal.  That said, I went back to work one week after the treatment, and no one noticed anything.  The buttocks treatment requires an overnight stay, and you can't sit down for two days afterwards.  Not exactly painful, but extremely awkward. 

I can provide more details if you want, just PM me.  I'm also willing to talk by phone if you like.  Many members here have been to CE, so I'm sure others will have comments.  I also investigated Dr. Serra's clinic in Rio, and while he has a deservedly stellar reputation, he was just too far away.  I live in California, so CE just made a lot more sense. 

In one respect, you've been more fortunate than I've been.  It's taken you 21 years to show signs of lipo.  I've been infected for about four years and have never taken meds, and I've got a pretty bad case.  If it's taken you that long to develop lipo, perhaps you won't need repeated filler treatments.

Hope this helps.

John

[milguy]

John,

Thanks for the very informative reply.  Very helpful.  I would like to PM you but can't figure out how to do it on this site.  Any ideas?

Tom
   

[milguy]

John & Mitch

I received both of your PM's in my yahoo mail but I still can not figure out how to PM you guys from here.  I've gone to your profiles and neither one seems to have a link to PM, additionally, I can't find any link to my PM inbox (lucky that the content of your PMs are sent on to my yahoo account).  I'm going to try to find a link to an administrator for this site and try to see if he/she can help me out.

Thanks for the info.

Tom