Several years ago, I told someone that I was HIV positive before I agreed to his invitation for a date. "Yeah, I know," he casually replied, and then he looked a little embarrassed, as if he shouldn't have said it. It was too late, of course; I knew exactly what he meant. He knew my HIV status because of the appearance of my face.
I was crestfallen and felt something close to shame - certainly embarrassment. Why is it that I can produce a blog, proudly march with HIV POSITIVE on my T-shirt in gay parades, and even write a book about coming of age during the dawn of AIDS - but I get upset if someone can tell I'm positive by how I look?
When I choose to disclose, privately or publicly, it's on my terms. I choose how and when to tell you. I want you to know. Facial wasting (known as lipodystrophy) takes that choice away. It's as if the disease is intruding, is taking the upper hand somehow, and worse, taking away my decision about when and to whom I disclose my status. And as much as I want to claim "Most Out Poz Guy Ever," I don't like wearing HIV across my face.
Most of us know "the look." It's the telltale gullies and sunken cheeks associated with longtime HIV infection or (more likely) medications (right). Many of my friends and colleagues in this struggle suffer from it, and they may either be comfortable with it, proud of it as a badge of honor, or simply resigned to it. I salute us all, whether our features tells our HIV story or not. But meanwhile, I'll do what I can to wipe that shit off my face.
A few years ago I visited Dr. Gerald Pierone in Vero Beach, Florida (regarded as the leading expert in fillers and one of the Ask the Experts team at TheBody.com), and I documented that first visit and my facial filler treatments in a video blog, Treating My Facial Wasting (right). In that video I focused on my own attitudes - Was I ashamed? Trying to look younger? Simply vain? - and on the procedure process itself. Nearly a year later I revisited Dr. Pierone and got another treatment and documented it in my video blog, A Facial Wasting Update.
In this video episode of My Fabulous Disease, I revisit Dr. Pierone for a new treatment with the facial filler products Sculptra and Radiesse. While I'm there, I learn enough about Artefill, the only FDA approved permanent facial filler, to make me strongly consider the product the next time my face needs fluffing.
This video also focuses on very specific information about the actual costs of facial filler treatment. Both Sculptra and Radiesse have patient assistance programs that significantly reduce the cost of the medication, but you still need to pay the physician to do the procedure, and that price can vary. TheBody.com has a great article that outlines all the facial filler choices and how much they cost.
Tip: Don't allow any street corner vendor (or gym or even doctor office) to inject stuff into your face. Do some research and above all, find a physician who has done this many, many times (over 500 would be a good start). Be a smart shopper and empowered patient and ask about their experience level first.
I hope you find the video helpful and that you aren't too afraid of needles!