HIV Q and A: Facial Fillers

I’ve had HIV for 30 years and because of it I’ve had lipodystrophy. I want to have fillers injected in my face but my friends tell me I’m being overly obsessive about my sunken cheeks. What do you think?



This is a great question. The decision to get facial fillers is something I often talk about with clients. And it’s a big decision.


So let’s get started. Imagine, if you will, a kindly therapist sitting across from you, wearing a cardigan sweater (therapist uniform). That would be me. Addressing you in a gentle tone:


As I am sure your friends have said, you are much more than any imperfections you might have. And which we all have, in one way or the other, by the way. What about your strengths, your quirks that make you unique, your loyalty to the people in your life? That’s what your friends value you for.


So ask yourself about your expectations for how getting the fillers. Are you hoping that your life will change in some way? More friends? More dates? More success in some area of your life?


What I am encouraging you to do is to get clear with yourself on your expectations for what this procedure will mean for your life. And to consider whether your expectations are reasonable.   Making cosmetic improvements doesn’t necessarily lead to major life changes. Just ask the next person you see who has clearly had one too many cosmetic procedures. (Or on second thought, maybe you shouldn’t.) Don’t set yourself up for disappointment if the change isn’t life-changing.


Having said that…


You are the one who looks in the mirror every morning. And it sounds like you aren’t happy with what you see. It’s only human to want to look as present yourself in the best possible light. My clients with lipodystrophy tell me that their sunken cheeks are a reminder that they have HIV. And they express concerns that other people look at them and also see HIV. It’s their perception. But your perception is your reality.


If you feel that getting the fillers will make you happier with what you see in the mirror, then that is a reason to consider the procedure. If you think that looking better will give your self-confidence a little boost, then that’s a reason to consider. And not unreasonable.


It’s your face. Your bank account. Your life. And your choice. Be clear on your expectations. And then do what you feel is right for you.


I want to go on meds finally but I haven’t told anyone I’m HIV-positive. How do I keep the prescription bottles hidden? Should I tell them I have something else so they aren’t suspicious?



First, I want to congratulate you on the decision to get your treatment started. That’s taking good care of yourself. But it sounds like this decision has also brought up concerns about disclosing your HIV status.


Here’s how I begin this conversation with my clients: You are in control of whom you choose to tell and when you choose to tell them. It’s your decision.


If you are living with roommates or family members, and aren’t ready to disclose, then it is your choice to keep your medications in a place where they won’t be discovered. If you are living alone and you are concerned that someone might check out your medicine cabinet, this is another reason to keep your medications in a more private place. Do what is going to help you to feel comfortable. Again, take care of yourself.


But I also have to say that I am sensing a lot of shame in your question. That tells me you may be viewing your HIV status as something that others might judge you for. Something that you should keep a secret. And the “but” in your question – “but I haven’t told anyone – makes me wonder if you might be delaying your treatment for fear that others will find out.


You know the people in your life. And it sounds like you have given some thought to how they might react to learning your HIV status. And based on that, you may be feeling this is something you need to keep to yourself.


This raises a question for me: Are you talking to anyone about your HIV status?


Getting emotional support is an important part of your self-care. Having a safe place to talk about what’s going on in your life, your concerns, your fears. As well as the joys. And to give you encouragement when you need it. Do you have anyone in your life you can look to for support?


And I also have to ask: Is it possible that some of the people in your life might surprise you? I am wondering if you might be doing some mind reading, and assuming you might be rejected. Just a thought. You won’t know if you don’t give them a chance.


If you haven’t started taking the medication, I hope you will get your treatment on track right away. Designate yourself the decision-maker in terms of how you want to store your medication. You’re in charge.


You’re also in charge of when you disclose your status and who you disclose to. But get support. Think about the people in your life who you can trust to be part of your support network. You might also look into HIV support groups in your area. Or talking to a counselor. Get connected. Don’t go through this alone!