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William J. Binder, MD; David C. Bloom, MD

Arch Facial Plast Surg. 2004;6:394-397.

Facial wasting syndrome is part of a lipodystrophy that occurs as a complication of highly active antiretroviral therapy. The loss of subcutaneous fat in the cheeks and temples results in a hollow-eyed, bony, emaciated appearance that is characteristic of the results of treatment of human immunodeficiency virus. Cessation of therapy results in a rebound in viral load and subsequent morbidity. The appearance of facial wasting syndrome is optimally treated with custom-designed implants that are made using high-resolution computed tomography combined with surgeon input and computer-aided design and manufacturing technology. Twenty-two patients with facial wasting syndrome were treated using either submalar implants (in more moderate cases) or custom-designed implants (in more severe cases). In each patient, the appearance of volumetric soft tissue restoration was successfully achieved, returning a permanent and more healthful appearance to the face.

Author Affiliations: Department of Head and Neck Surgery, UCLA David Geffen School of Medicine, University of California, Los Angeles (Dr Binder); and Department of Otolaryngology–Head and Neck Surgery, University of Washington, Seattle (Dr Bloom).

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