A systematic review of filler agents for aesthetic treatment of HIV facial lipoatrophy (FLA)

Jared Jagdeo, Derek Ho, Alex Lo, Alastair Carruthers

Research output: Contribution to journalArticlepeer-review

16 Scopus citations


HIV facial lipoatrophy (FLA) is characterized by facial volume loss. HIV FLA affects the facial contours of the cheeks, temples, and orbits, and is associated with social stigma. Although new highly active antiretroviral therapy medications are associated with less severe FLA, the prevalence of HIV FLA among treated individuals exceeds 50%. The goal of our systematic review is to examine published clinical studies involving the use of filler agents for aesthetic treatment of HIV FLA and to provide evidence-based recommendations based on published efficacy and safety data. A systematic review of the published literature was performed on July 1, 2015, on filler agents for aesthetic treatment of HIV FLA. Based on published studies, poly-L-lactic acid is the only filler agent with grade of recommendation: B. Other reviewed filler agents received grade of recommendation: C or D. Poly-L-lactic acid may be best for treatment over temples and cheeks, whereas calcium hydroxylapatite, with a Food and Drug Administration indication of subdermal implantation, may be best used deeply over bone for focal enhancement. Additional long-term randomized controlled trials are necessary to elucidate the advantages and disadvantages of fillers that have different biophysical properties, in conjunction with cost-effectiveness analysis, for treatment of HIV FLA.

Original languageEnglish (US)
Pages (from-to)1040-1054
Number of pages15
JournalJournal of the American Academy of Dermatology
Issue number6
StatePublished - Dec 1 2015


  • facial volume loss
  • filler agent
  • highly active antiretroviral therapy
  • HIV facial lipoatrophy
  • HIV lipodystrophy
  • quality of life

ASJC Scopus subject areas

  • Dermatology


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