Loss of fat from my face

[Ali Yimer]

I tested Pos in 2001. I started ART in 2007. The anti-HIV medicines I took per day were Lamivudine, Stavudine, and Efavirenz until 2010. At the end of 2010 my face became sunken due to loss of fat, which give me an ugly appearance. Since 2011 I have been taking Atripla, but my face fat does not come back. How can I get back my face fat?  Somebody told me I can regain it by means of plastic surgery, which I can’t afford. Would you advise me please how can I get it back with or without surgery?

[Miss Philicia]

Stavudine is definitely known to do this. Unfortunately it's believed to cause a mitochondrial cellular level issue and isn't reversible or if so only marginally. You wouldn't get plastic surgery per se, but injections of something like Sculptra or Radiesse. These only last a couple of years and need to be redone regularly. There are some permanent solutions in terms of other things being injected but they aren't available in the US -- I assume you're in neither the EU or US as Stavudine isn't much used in either place. I forget the name of the more permanent material that can be injected but know people who have travelled to either Mexico or Brazil to obtain it.