In the 1980s one of the most noticeable scarlet letters that gay male survivors of HIV had to bear was volume loss in their faces. The afflicted looked visibly sick and gaunt.
Many within the gay community were "given lack of meaningful treatment options" for even their primary health-care needs let alone supplemental, cosmetic treatment needs, according to the U.S. Health Resources and Services Administration (HRSA).
In 2004, Sculptra was approved for HIV plus patients. "The filler, called Sculptra, is the first such treatment approved for a condition known as lipoatrophy… the FDA expedited review of the product because of its importance to people with HIV/AIDS," the FDA said at the time.
It is estimated that about 1 million people in the U.S. were HIV plus in 2004, although about one third were undiagnosed. Some 50 percent developed lipoatrophy. An estimated 150,000-350,000 patients benefited from Sculptra as a cosmetic treatment.
Dr. Albert Canas, a South Florida native and current medical practitioner in Miami Beach, was selected as the only research site in Miami-Dade County for a special study connected with the FDA approval of Sculptra. Canas initially agreed to be interviewed for this story but was unresponsive to phone calls and email.
Dr. Steven Santiago, chief medical officer for Care Resource, a nonprofit and health center for uninsured and under-insured LGBT patients in Miami-Dade and Broward counties, said over the years, he has referred about 400 HIV plus patients to Canas.
Santiago said Canas was trained by Dr. Peter Engelhart, an HIV specialist who died in the 1990s and was one of the first researchers of Sculptra. Miami-based Drs. Joseph Piperato, Tory Sullivan and Richard Feinstein are also trained in this injectable cosmetic treatment, he said.
Former Fort Lauderdale resident Mark King, who is gay and suffered from facial volume loss as a result of HIV, used Sculptra from 2008-2012. He was injected by Dr. Gerald Pierone in Vero Beach.
"I am really grateful that this solution exists… It's hard to describe how self-conscious and even debilitating it can be to walk around with the physical effects of wasting," said King, who now lives in Baltimore. “I would recommend Sculptra for HIV plus patients… because of the patient assistance available."
Newer HIV medicines are less likely to cause the condition than HIV medicines developed in the past. Many people with HIV now never develop lipoatrophy, according to the National Institutes of Health (NIH).
Broader Appeal & Use for Sculptra
Sculptra is now being used more broadly as a cosmetic anti-aging treatment to address facial volume loss for gays and straights alike.
Dr. Neda Vanden Bosch, primary cosmetic physician of Medical Specialists of the Palm Beaches, has several lesbian and gay non-HIV patients, in addition to hundreds of heterosexual patients, whom she treats for facial volume loss with Sculptra.
“Today’s patients are looking for long lasting and natural results delivered with minimal to no downtime,” Vanden Bosch said. “In clinical trials, over 85 percent of patients were satisfied with their results 25 months after treatment.”
Boynton Beach resident Jamie Simmons, who is a lesbian, also had her first Sculptra treatment with Vanden Bosch recently to restore lost volume in her face and "return the appearance of younger, fuller skin with less wrinkles."
"From what I've read about Sculptra, and from what Dr. V explained, it provides a very long lasting volumnization, because it induces my own collagen production. It can also last a few years," said Simmons, who said once her treatment plan is completed, she expects a "natural, fuller, uplifted look."
Sculptra typically requires 2-3 injection sessions, Vanden Bosch said. There is a 6-8 waiting period between each session with two vials per session at $750 per viable, or $1,500 per session. However, the maker of Sculptra, Galderma, is offering $625 in instant rebates on a series of three sessions before Sept. 30.
Simmons said she would recommend Sculptra to others. There are temporary side effects associated with Sculptra, including possible nodules (rare), swelling and bruising, according to www.docshop.com.
There are other products similar to Sculptra, such as Juvederm, Restylane or Radiesse, but Vanden Bosch said when those products are used they don’t provide as much of a natural look as Sculptra does.
“Other fillers are implanted material that last 4-9 months, on average, depending on the person and product used,” Vanden Bosch said.
Mark King said this of Sculptra, “I would use my money more wisely on Bellafill, a semi-permanent filler. This filler was not available when I began being treated; and once it was approved, I began using it. After 2-3 sessions, I don't believe I will ever have to be treated again.”
Vanden Bosch acknowledged the more permanent effects of Bellafill (5-7 years), but she but warns of small, plastic beads, used in the cosmetic treatment. She said bacteria can form around the beads.
“The body will often try to encapsulate the involved area with scar tissue, resulting in an inflammatory lump that is often palpable below the skin surface,” Vanden Bosch said, adding results will eventually fade and become “lumpy” as the aging process continues around the filler.
In addition to Vanden Bosch, Drs. Albert Canas of Miami, and dermatologist Shino Bay Aguilera, who is based in Fort Lauderdale, also perform cosmetic facial filler injections for interested patients.