University of Foggia, Italy
Raffaele Rauso obtained his medical degree at 24 years, after that he performed a 5 years training in Cranio- Maxillo- Facial Surgery at the Second University of Naples (Italy), during that period he also performed 2 fellowships in Plastic Reconstructive and Cranio-Maxillo-Facial Surgery; one at the University of Basel (Switzerland), and another at the G.S.R. Insitute in Hyderabad (India). Once he became consultant in Cranio-Maxillo-Facial Surgery, he obtained a Master's degree in Aesthetic Surgery at the University of Milan. He has published several papers in the most reputed journals in Cranio-Facial and Plastic Reconstructive Aesthetic Surgery; He is reviewer for several scientific medical journals, and is full member of E.A.F.P.S. (European Academy of Facial Plastic Surgery), and E.A.C.M.F.S. (European Association for Cranio-Maxillo-Facial Surgeons). Nowadays is Associate Professor in Cranio-Facial deformities at the University of Foggia (Italy).
Nowadays facial wasting is considered a stigma of HIV-infection; well-known are the devastant effects on facial features of the drugs used for the highly active anti-retroviral therapy. Years after years, several techniques and filling devices have been proposed to restore facial features of these patients. Several authors stated that when facial wasting is associated with trunk lipohypertrophy (another side effect related to the drugs intake), structural fat graft is the best option achievable, because at the same time, removing the lipohypertrophied fat of the body, and using it to fill the face, let to reach a great improvement both at the face and the body. However, often and often, the injected fat can be resorbed in a very high percentage, so the use of dermal filler is quite frequent to help the physicians in treating these patients in removing facial wasting's stigma. Several fillers have been proposed for this purpose, however, HIV-infected patients presenting facial wasting are not like cosmetic patients seeking a little improvement, these patients need a treatment more reconstructive than cosmetic; this is why long lasting or permanent fillers are often used, and in these cases the physician need different skills. Furthermore, it is very important how these fillers act once injected, and if late side effects can be seen; so, only long follow-up let a physician, involved in this tretament, to really understand what works and what doesn't. The author presents what he learned by its own experince, in using fillers for facial wasting rehabilitation.