Can one session of Bio-Alcamid restore the parts other fillers can’t reach? Robert Fieldhouse investigates…
Photos Mike Kear
Over the past few months many people have shared very positive personal experiences
with me about their use of a facial filler called Bio-Alcamid. They all reported
the same reassuring result, that they only needed one or two sessions to fill
out depleted cheeks and temples. The extra benefits were that it was long-lasting
and pretty easy to implant.
What is it?
Bio-Alcamid, or polyalkymide, is a biopolymer, made mostly of water. It’s
stable, non-toxic and can be injected into the face, the bottom of the feet,
buttocks or anywhere else where fat is depleted. It forms a soft gel replacement
for lost fat and its manufacturer says it should not degrade or move.
At £975 per 5ml syringe, it costs more than its main competitor, New-Fill,
but it should require fewer sessions to achieve and maintain the desired effect,
and can be used in cases of the most extreme facial wasting.
Bio-Alcamid has been used in Europe for cosmetic and restorative procedures
for several years. Several studies in HIV negative people in reconstructive
and cosmetic surgery have been conducted in Europe showing positive and lasting
results.
An offer we couldn’t refuse
Recently, London-based Dr Séan Cummings agreed to carry out the procedure
free of charge for one of his patients with severe facial wasting to enable
Positive Nation readers to see how beneficial Bio-Alcamid can be. The patient,
Steve, rather bravely agreed to have the whole process recorded and reported
by us.
Steve is a long-term survivor. He was diagnosed in 1984 and started antiretroviral
therapy in 1993. He’s used all the nukes we now know are most implicated
in the development of body fat loss. He spent three years on AZT (zidovudine),
followed by treatment with d4T (stavudine) alongside protease inhibitors (PIs).
“I’ve been on treatment for 13 years but it’s only in the
last three or four that the facial wasting has become really noticeable,”
he says. “I’ve also lost fat all over my body, particularly on
my legs and buttocks.”
Steve now takes the PI lopinavir-ritonavir with tenofovir and abacavir.
No
access to a valid treatment
Steve discussed his wasted appearance with his HIV doctor in January this
year.
“They gave me a copy of a feature in Positive Nation on facial wasting
to read but couldn’t offer me access to any treatments. I live in one
of the wealthier parts of Berkshire, and I know patients treated at Ealing
Hospital who’ve had similar procedures.
“I tried to get funding from my local HIV clinic and my GP. But I got
a letter back from Berkshire PCT saying they
didn’t class it as a priority, they class it as cosmetic surgery. My
HIV doctor said
my facial wasting was simply the result of ageing.
“It’s not a nice feeling when you don’t feel you are being
taken seriously. The hospital said that I’m the only person who has
asked for it. I simply cannot believe that.”
Steve has never had any other facial fillers in the past, making him an ideal
candidate for treatment with Bio-Alcamid. His partner, Chris, said: “Although
Dr Cummings has been extremely kind to donate his professional services for
free on this occasion, we are still urging the PCT to recognise this as a
valid treatment and make this procedure available to people locally who don’t
have Dr Cummings to take care of them. I told Steve he must go back to his
HIV doctor and show him the results. This may help to change the view of the
PCT.”
Before the consultation with Dr Cummings, Chris showed me some holiday snaps
of Steve taken some years ago. The difference in Steve’s facial appearance
was staggering. His demeanour on the day of the consultation was of someone
wholly fed up with his lot. “I’m not happy with the way I look.
Sometimes I don’t want to go out.”
Dr Cummings said this was not uncommon: “When people first come and
see me they don’t smile much, but when it’s done they are really
smiley.”
Bio-Alcamid
vs New-Fill
Dr Cummings has a wealth of experience in general practice and, in more recent
years, private practice in the various procedures used for facial reconstruction
in HIV. His belief is that Bio-Alcamid is the product to beat.
“I’ve been using Bio-Alcamid for facial wasting since late 2003.
I’ve treated several hundred patients. The main competitor, New-Fill,
was designed as a cosmetic product to be applied to healthy tissue and not
fat-depleted skin; I don’t think it sits very easily in fat-depleted
skin. You also tend to develop lumps. However, my experience may be biased
as I tend to see lots of men coming in to have Bio-Alcamid because they are
dissatisfied with New-Fill.”
The
procedure
Dr Cummings carefully explained in detail each step and reassured Steve he
was going to look terrific.
“We start with the cheeks and later do the temples. Sometimes there
is a little bit of asymmetry.”
He began by applying iodine to the face and then injected the anaesthetic
inside Steve’s mouth and into Steve’s face. It soon numbed his
face.
Dr Cummings carefully felt the hollows of Steve’s face that required
treatment with Bio-Alcamid. The needle was large: 16 gauge, “like a
nail really”. He pinched the skin and injected the liquid very slowly.
After a few injections and about 30-40 minutes, one side of the face was done.
Dr Cummings pressed and molded the injected fluid to the form of Steve’s
face. He then massaged the area to reduce swelling from injection site reactions.
In total, the doctor injected about 4.5ml of Bio-Alcamid into one side of
Steve’s face.
With half the face done, Steve sat up in the chair. The results were astounding:
the hollow on the right side of his face was most definitely filled, but Steve
was too apprehensive to look at this early stage. The doctor continued to
restore the appearance of the other side of the face using the same procedure:
iodine, anaesthetic, Bio-Alcamid injection and then sculpting. Afterwards,
Steve was given a day’s worth of antibiotics and acyclovir to prevent
an outbreak of both bacterial and herpes infection.
What
a difference a week makes
I met up with Steve and Chris a week later at Dr Cummings’ consulting
rooms. This time Steve did not stop smiling. He told me the swelling had subsided
within a couple of days and the only bruising was a slight yellowing of the
skin at the injection site.
Chris said: “It’s been quite a week; people have been asking Steve
what’s happened. He just told them he’d shaved off his goatee
beard. People said he looked 10-15 years younger. Most people were perplexed.
Some of the women at work asked for his doctor’s number.”
“I’ve noticed a great improvement in his confidence. He even answers
the telephone differently. This whole scenario has been a source of anxiety
for months and months.”
Dr Cummings was happy with the results too: “We have some bits to finish
off; usually I wait for one or two months and then complete the temples and
under the cheekbone, but I’ve hidden the bullet marks.”
A
Big Lottery bid
Dr Cummings plans to apply to the National Lottery’s Big Lottery Fund
to try and get funding to provide Bio-Alcamid to more people.
“I’m arguing that this procedure should be regarded as a social
and community project. Last year we tried to put an advert for Bio-Alcamid
in the London Lesbian and Gay Film Festival brochure and they wouldn’t
carry it. They said it was inappropriate for their audience. I wrote to the
British Film Institute’s director but did not initially receive a reply.
I then wrote to the Chair of the Board of Governors, Anthony Minghella, and
received no response from him either. Eventually I received a limp excuse
from the director and a ticket voucher. I’m rarely shocked but I really
was shocked at that.”
Final
thoughts
While an increasing proportion of people with HIV are benefiting from Bio-Alcamid
and other procedures for fat loss, the fact remains these products will only
be available for the privileged few who have the cash or those who are lucky
enough to get onto a clinical trial.
Dr Cummings feels strongly about this: “No one would have the nerve
to say to a woman who had her breast removed that she could not have a restorative
procedure. Why should it be different with HIV? It’s a very good treatment
and the PCT should be funding it. I do not regard it as a cosmetic procedure.
The problem at the moment is that many hospitals are broke. I’m considering
the merits of a Judicial Review of some PCTs’ decision to limit the
funding on the basis that the decisions are irrational.”
Current treatment guidelines from the British HIV Association mention Bio-Alcamid,
stating: “Long-term safety data are important, but this should not be
used as an obstacle to treatment for patients requiring treatment now. A comparative
study between these two agents (New-Fill and Bio-Alcamid) is needed.”
One thing is sure, such a study would be recruited before it was even designed.
Meanwhile Bio-Alcamid raises the standard for lasting results in restoring
fat loss that will lead to a better quality of life.
• Dr Séan Cummings, Freedomhealth, 0845 2601 999, info@freedomhealth.co.uk
Bio-Alcamid
reader offer
Over the coming year Freedomhealth would like to offer ten people living with
HIV who could benefit from an individual Bio-Alcamid treatment the opportunity
free of charge. If you feel you could benefit, discuss your case with your
HIV consultant and ask him/her to contact Dr Cummings.
