Facial Wasting

This condition commonly accompanies patients on antiviral drugs for HIV. It is also known as lipodystrophy. Features are typically sunken cheeks, very prominent cheekbones not concealed by the usual fat layer, hollowness, and sunken temples. There are several techniques to address this issue including but not limited to custom implants, fat grafting, facial fillers, and face-lifting. In most patients with facial wasting, cheek implants are the best or first solution, later coupled with injectables to “fill in the edges.” Dr. Romano has expertise in cheek implants specifically for facial wasting, and he has performed many of these operations with very natural results.

The options Dr. Romano offers patient in the spectrum of facial wasting treatments are:

• Facial Implants: This is the gold standard of treatment described above. Implants that are specifically designed, carved, and placed can beautifully fill out the midface concavities and provide a tremendous and natural result.
• Filler Materials and Injectables: Dr. Romano uses these to fill in around the edges of where the implant is placed.
• Facelift: Sometimes there is skin laxity that, once tightened, very much improves the look.

Separately or together, these options enable Dr. Romano to create results that are consistently attractive, quick to heal, and exceptionally natural. He uses minimal incisions, especially in the face.

There is a condition of facial wasting that I would like to dedicate this section to. It occurs in patients on antiviral medications and can be very dramatic.

I see many of these patients and am very sympathetic to their extreme distress and desire to have the fullness of youth restored to the face. I can help you with this issue.

Features are typically sunken cheeks, very prominent cheekbones not concealed by the usual fat layer, hollowness, and sunken temples. This condition commonly accompanies patients on antiviral drugs for HIV. It is also known as lipodystrophy. The anatomy is basically loss of the subcutaneous fat layer that lies directly below the skin and above the muscles. It can also relate to the degree of looseness of the skin and your underlying bony foundations, so that there are many different anatomic features which must be analyzed and addressed prior to your surgery. I will coordinate the features of your anatomy with your expectations, formulate a plan with you, and guide you through this process. There are several techniques to address this condition including but not limited to custom implants, fat grafting, facial fillers, and face-lifting. I will explain and illustrate all of these techniques to you.

In most patients with facial wasting, cheek implants are the best or first solution, later coupled with injectables to “fill in the edges.” I have expertise in cheek implants specifically for facial wasting, and I have performed many of these operations with very natural results. Surgery involves a light general anesthetic and is performed where I do surgery, which is in a hospital setting. There is a small 1.5″ incision inside the mouth through which the implant is inserted. The surgery is safe and predictable. There is a mild to moderate degree of swelling after surgery. All of the stitches are small and removed in four to seven days, and you can return to work in as little as five to seven days and to some physical exercise in the second week. I spend a great deal of time discussing your anatomy, listening to your expectations, and interpreting for you what your anatomy and tissues will safely and predictably allow me to do in a safe and predictable way. In addition I consider your body as a whole, and I build a system into every facial surgery that, initially, allows you to recover much more quickly and, secondly, preserves your surgical results.

To learn more you can also review the articles on periorbital rejuvenation and fat grafting FAQs in the Educational Articles section of the website.