Navegando por Palavras-chave "Preenchimento facial"

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    Avaliação do uso do ácido poli-l-láctico no tratamento da lipoatrofia facial associada à terapia antirretroviral em pacientes soropositivos para o vírus da imunodeficiência humana
    (Universidade Federal de São Paulo (UNIFESP), 2009-06-24) Yoshioka, Marcia Cristina Naomi [UNIFESP]; Tomimori, Jane [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Background: Lipodystrophy was first described in 1998, after the beginning of HAART era, in context of improvement of morbidity and mortality of HIV patients. Changes in physical aspects interfere with social relationships, depression and adherence to treatment. Lipoatrophy is by far, the most bothersome of these alterations. Treatment of facial lipoatrophy is, therefore, associated with improvement in quality of life. Objectives: To assess the usefulness of treatment with poly-l-lactic acid, a temporary filler indicated for the correction of HIV lipoatrophy and to analyze the features related to the response to the treatment. To assess the use of the adapted index of facial lipoatrophy and measurement of malar skinfold. Material and methods: We studied 61 patients, classified as moderate (n=24), severe (n= 22) and very severe lipoatrophy (n= 15). The criteria of severity and improvement were based on adapted index of facial lipoatrophy and skinfold measurement. Patients received poly-l-lactic acid injections once a month, according to clinical improvement and were followed until the need of a new treatment. Results: Mean number of poly-l-lactic acid vials used was 7.9 vials. Adapted index of facial lipoatrophy improved from 11.9 at the beginning to 4.2 at the end of treatment. Skinfold measurement improved 105%. Maximum follow-up period was 58 months and the mean duration was 33.4 months. Patients did not present papules or nodules, the most reported adverse event related to the treatment with poly-l-lactic acid. Discussion: Patients that discontinued HAART or had higher CD4+ cell count at the beginning of treatment with poly-l-lactic acid presented better responses. Patients with worse scores of lipoatrophy severity and those with thinner skin presented lower response. Adapted index of facial lipoatrophy is useful for comparison between pre and post-treatment severity grades and different patients. Skinfold measurement can be used for pre and post-treatment comparison in the same patient. Comparison of skinfold between different patients is not accurate because of individual variation in skin thickness. Conclusion: Poly-l-lactic acid is an alternative for treatment of HIV facial lipoatrophy. Adapted index of facial lipoatrophy can be used to assess facial lipoatrophy. Measurement of skinfold can be used for pre and post-treatment comparison, but additional studies are necessary for comparison between different patients.