The National Institute for Health and Clinical Excellence (NICE) issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on Deep dermal injection of non absorbable gel polymer for HIV-related facial lipoatrophy.

This document replaces previous guidance on deep dermal injection of non absorbable gel polymer for HIV-related facial lipoatrophy (NICE interventional procedure guidance 291, March 2009).


HIV-related lipoatrophy is a loss of fat from the skin, often the face, which can occur as a side effect of antiretroviral drug treatment for HIV. Non-absorbable gel polymers are water-based synthetic substances that are not broken down by the body. The gel polymer is injected under the skin to restore the shape and volume of the areas where fat has been lost.

Coding recommendations

S50.4 Injection of inert substance into subcutaneous tissue NEC

Z47.- Skin of face

Includes: Subcutaneous tissue of face

Your responsibility

This guidance represents the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, healthcare professionals are expected to take this guidance fully into account, and specifically any special arrangements relating to the introduction of new interventional procedures. The guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer. 

All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.

Commissioners and/or providers have a responsibility to implement the guidance, in their local context, in light of their duties to have due regard to the need to eliminate unlawful discrimination, advance equality of opportunity, and foster good relations. Nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties. Providers should ensure that governance structures are in place to review, authorise and monitor the introduction of new devices and procedures.

Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.

  • National Institute for Health and Care Excellence (NICE)