by Bradford McIntyre
November 2004 - Individuals living with
HIV and AIDS may not only have to deal with the threat of illness
but the toll of illness. All that is required to stay healthy
and alive can leave an everlasting mark!
I'm referring to the loss of subcutaneous fat from the face, commonly
referred to as facial wasting or Lipoatrophy.
While individuals are often able to re-gain weight
and build up muscles on their arms, shoulders, and other areas,
they fail to be able to replace the loss of fat to their face.
Although fat loss in the face has been reported in individuals
who are not taking HIV/AIDS medications, large numbers (up to
80%) of people on antiretroviral combination therapies (Protease
inhibitors and nucleosides) are developing Lipoatrophy. Reportedly,
the longer a person is on HIV/AIDS medications the greater the likelihood of developing problems with
facial wasting. Along with surviving, many show in their face the telltale signs of living
At one time or another, most of us infected have
feared the onset of facial wasting. The longer we are on medications
the more we become concerned. Facial wasting causes great anxiety
due to the stigma and discrimination that often accompanies it!
These circumstances affect self esteem and may cause individuals
to become socially withdrawn and cut off their ties with family
and friends. They may go so far as to stop working. Individuals
report that people treat them badly. Often, they are treated like
they are drug addicts or homeless street people because their
faces are so caved in from Lipoatrophy; when the truth of the
matter is the treatments that enable them to live have brought
The fact that I was able to go without HIV medications
for some 13 years (the exception being 9 months on AZT in 1990)
meant that I personally did not experience the devastating effects
of Lipoatrophy I witnessed in others. But, in the last 7 years
taking medications, I have watched the fullness in my face slipping
away. Then last summer (2004) my face started to rapidly sink
in; caused by the fact I've been living with HIV for over 20 years,
along with the side effects from HIV medications necessary in
these later years. There was only sadness for a situation for
which I thought there was no lasting treatment. I knew only of
people who sought out some temporary fixes that fell short of
what was necessary for repairing the deep scarring of Lipoatrophy.
I was not aware of the long term or permanent treatments available.
In November, 2004, John McCahill, President of Pur
Medical Corporation in Toronto contacted me through my website.
John informed me of a product being brought to Canada that will
help to restore the natural appearance in the face for people
living with HIV antiretroviral drug induced Lipoatrophy. The product,
called Bio-Alcamid or polyalkylimide made by Polymekon, an Italian
company, is a synthetic gel made up of 96% water and 4% synthetic
reticulate polymer. It is injected below the skin to restore volume
and natural contours of the face. Bio-Alcamid is one of the only
products that can be used in large volumes necessary to correct
this problem with results that are permanent.
"We have implanted this substance in 73 patients
with up to three years' follow-up. The aesthetic results were
deemed excellent by both physicians and patients. No implant dislocation,
implant migration, granuloma, allergic reaction or intolerance
Department of Plastic Surgery, University of Parma,
Parma, Italy (2003)
John McCahill organized Pur Medical Corporation's
first treatment training session for facial restoration in Toronto,
Canada on November 26, 2004, where Drs. Beninger, Kasrai, Weiglein
and Rice treated 8 volunteer patients with Bio-Alcamid. The following
day, 3 others and I participated in a training session here in
Vancouver for some of Western Canada's top cosmetic practitioners.
This included Drs. Alastair and Jean Carruthers, Robert Thompson
and Calgary's Wayne Perron. Dr. Peter Velthuis from the Netherlands,
one of the highest volume users of Bio-Alcamid in the world, flew
in to direct the physicians in the subtleties of the technique.
These 12 volunteer patients were the Canadian debuts of a product
that has been used in Europe and other countries for 5 years.
Dr. Alastair Carruthers, cosmetic dermsurgeon, Clinical
Professor at the University of British Columbia (UBC) and Vice-President
of the American Society for Dermatologic Surgery, performed my
procedure. Forty minutes later, my sunken face was restored! Over
a period of two months, my body creates collagen and a film will
form to encapsulate the Bio-Alcamid and make my face appear natural
and feel soft under the skin. Swelling lasted several days and
each day since, my face has become smoother and softer to the
I am very thankful for this opportunity to participate
and receive Bio-Alcamid for my facial Lipoatrophy. I would recommend
this product and procedure to people living with Lipoatrophy concerns;
Bio-Alcamid has rejuvenated my face and having the treatment has
increased my self esteem.
Until now, Canadians have traveled to Mexico, South
America and Europe to have Bio-Alcamid treatments performed at
an expense, which is out of reach of most people in need. Currently
Bio-Alcamid is available in Canada under provisions of the Special
Access Program, which involves application on a patient by patient
Many individuals living with HIV and AIDS have often
overcome bouts of illness but the side effects of the medications
have resulted in deep facial scars, which affect their self-image
physically and mentally. This will contribute to their hardship
and ill health! We need government to recognize the severity of
the problem and treat Lipoatrophy like that of the restoration
treatments patients with cancer receive. Lipoatrophy is a direct
result of the medications to treat HIV infection. To remedy the
problem, the procedure needs to be covered under Health Care.
I believe we can All work together, recognizing
that there is a need; helping to create change and providing better
copyright © Bradford McIntyre
Bio-Alcamid - Updates
BIO-ALCAMID TREATMENT MATERIALS, INSTRUCTIONS FOR USE, AND PATIENT INFORMATION
Facial Lipoatrophy Research Literature Review
by Maple Leaf Medical Clinic/
Canadian Immunodefiency Research Collaborative.
Prepared January 4, 2006 by Dr. Mona Loutfy and Jennifer Major
Bio-Alcamid received Health Canada approval
The CBC Reports on Facial Lipoatrophy
Polyalkylimide gel safe and effective for treatment of facial lipoatrophy
Bio-Alcamid Highlighted as Most Viable Permanent Treatment for Facial Lipoatrophy
Best face forward:
Four people share their experiences with the psychosocial effects of facial lipoatrophy and reconstructive treatment
Bio-Alcamid: Letter to Dentists
Polyacrylamide Gel Injection for Facial Lipoatrophy Safe at 4 Years
Four-Year Safety with Polyacrylamide Hydrogel to Correct Antiretroviral-Related Facial Lipoatrophy
Bio-Alcamid associated with unacceptable complication risk: no longer recommended as a treatment for facial lipoatrophy
"Although 90% of the patients who have had
Bio-Alcamid treatments have NOT had problems; due to the number of patients who have developed infections or other problems, I do not recommend treatment with
Bio-Alcamid for HIV/AIDS related
Bio-Alcamid is no longer available in Canada.