PUTTING YOUR BEST FACE FORWARD

New treatments are giving people back the looks they’ve lost

by Scott Dagostino
photos by Tony Fong

Most of us have looked in the mirror and critiqued the reflection at some point, but 43-year-old Kevin Gaudet had bigger issues: “When I look in the mirror, that’s not my face.” Diagnosed with HIV nearly 10 years ago, Gaudet says that (aside from colds) “I’ve never been sick,” but a major side-effect of the drugs that have helped keep his HIV in check is lipoatrophy, a loss of fat from areas around the body. Gaudet’s face has been entirely altered.

“There’s the odd time I’ll notice people staring,” Gaudet says. “When people see my face like this, they think I’m sick, but I’m not!” This feeling of being stigmatized takes a toll: a British survey of patients with lipoatrophy concluded that they “have high levels of anxiety and depression, and quality of life and self-esteem is lower than in other reports of chronic illnesses.” Gaudet says, “I used to be a big person…If somebody started out thin, and then had the wasting on top of that, those are the people you really notice.”

Christie Chapman saw “a pretty grotesque example” at a medical conference two years ago. Having started her career in cosmetic enhancement, “I thought it was unfortunate that this person and many other people lived with this when there are so many fillers on the market in Canada that could treat it, could fill it up,” she says.

Chapman began an information website that eventually grew into the Face Forward Foundation, offering subsidized support to people with lipoatrophy. She learned from “great people” at the Maple Leaf Clinic on Carlton Street and began “putting out feelers” for cosmetic surgeons to help. It’s about “their comfort level,” she explains. “A lot of cosmetic doctors may not be comfortable having people who are living with HIV sitting in their waiting room next to the woman who’s there for a boob lift.”

“Not everybody in the medical community is interested or willing to work on HIV individuals,” admits Dr. Frank Beninger, mainly because purely cosmetic work is where the real money is. Beninger is one of the doctors who’ve “agreed to a set flat fee” for treating Face Forward clients, explains Chapman. “I’m a cosmetic surgeon —that’s how I make my money,” Beninger says, “but I’m doing this for the lipoatrophy community.”

Gaudet has come to the palatial Avenue Road clinic that Beninger shares with other doctors, in the hopes of having his face restored. “I’m excited to see what the results will be,” he says. “I don’t want to look like Brad Pitt—I just want to look like me.” The waiting room is decorated in a plush French style, with red and black zebrastriped carpets, thin curvy chairs and two-tone yellow and cream stripes on the walls—it’s oddly soothing and grandiose at once. The operating room, on the other hand, is a cool grey and white, with a large patient’s chair under an overhead lighting array. Dr. Beninger marks Gaudet’s cheeks with a pen and explains, “all that we’re treating is mainly this area in the front, which is actually one of the most common areas. It gives people that gaunt look, it makes them look prematurely aged. With natural aging, you lose the same fat so this is sort of an accelerated aging process.”

Gaudet has come for help at just the right time. “I’ve been approached by individuals with wasting—lipoatrophy—for years,” explains Dr. Beninger. “Three years ago, for most people, I had nothing to offer. Most treatments were very short-acting.” Now, however, there is a new permanent treatment. “I’m not exactly sure what they inject,” Gaudet laughs, “only what it does.”

The injectable Bio-Alcamid is a thick, clear gel comprised of 96% water and 4% synthetic reticulate polymer. It was created by Polymekon, an Italian research company, and its cheerful-if-slightlysinister slogan is “Don’t Stop the Beauty.” Beninger explains how the Bio-Alcamid gel “becomes encapsulated by the body’s own collagen, which acts as a sac to contain it. It takes about three weeks to become solid enough that you’re not going to move it.” Even within that time, however, “it takes a lot of force to move it.” This is a great relief to the patient. “I was thinking, ‘How am I going to sleep?” Gaudet says—envisioning himself waking up with half his face smushed upwards. Beninger assures him that the injections to freeze his face beforehand are “the worst part of the treatment.”

Chapman explains that this procedure is not covered under OHIP —“It’s considered cosmetic as opposed to reconstructive”—so the Bio-Alcamid distributor is supplying the gel to the Face Forward program at cost. Chapman feels “excited and honoured by the support that the BioAlcamid people have provided us...recognizing that there are people who can’t afford the treatment.”

“It’s amazing how easy it is for individuals to get assistance,” says Beninger. Gaudet had applied in November and is being treated three months later. “The physical cost [of the Bio-Alcamid gel] is about $190 a CC…this is a $2000 cost procedure,” he says, not even counting the overhead of the clinic or his salary. Gaudet, however, will be paying a fraction of that, if at all. Thanks to the foundation, he says, “if you make under a certain amount of money each year, they’ll help you to pay for the procedure.”

After injecting the gel, Dr. Beninger explains that “no two treatments are ever the same. It’s not like Botox…I’ve got control, to some degree, of shaping it.” He puts a thumb in Gaudet’s mouth and begins squeezing and kneading each cheek. “I wasn’t expecting that!” Gaudet laughs but says, “once the freezing took over, I didn’t feel a thing.” The procedure is remarkably quick, everything done in about half an hour.

Gaudet is thrilled with the results: “What a difference!” he exclaims. “This is how I probably would’ve looked had I not had anything.” He pokes at his face, saying, “It’s amazing—I can’t get over it.” Dr. Beninger tells him, “for the first few weeks, it’ll feel a bit stiff…but ultimately, it feels very natural.” As for Gaudet’s next work day, “there’ll be a bit of puffiness…just say you went to the dentist,” the doctor laughs. “Blame the dentist—that’s why they hate us!”

For more info: Face Forward Foundation—www.faceforward.ca
Dr. Francis Beninger —www.drbeninger.com

Scott Dagostino is fab’s Deputy Editor. He could use a little Botox