ArteFill®
ArteFill® is a non-resorbable injectable dermal filler indicated for the correction of wrinkles known as “smile lines” or nasolabial folds. The unique microspheres in ArteFill are not absorbed by the body and therefore provide the permanent support for long lasting wrinkle correction in one or two treatments.
ArteFill® (Artecol in Europe) is an injectable filler made up of millions of microscopic beads of polymethylmethacrylate (a plexiglass like polymer) carried in hyaluronic acid or collagen. The product has been in use for many years in Europe and offers the “benefit” of permanent soft tissue augmentation. There is a relatively low reaction rate with Artecol and its use in small volumes for acne scars or small soft tissue defects, such as after rhinoplasty have shown a good risk to benefit ratio.
ArteFill® and other permanent injectable soft tissue fillers such as silicone, have substantial downsides to them. These downsides mainly involve the inability to remove the product without wide local tissue excision.
Why would one want the product removed?
Historically, we know that some percentage of patients will have a soft tissue filler placed in not exactly the right position. In the case of hyaluronic acid (HA) fillers such as Juvederm, Restylane, Perlane or collagen fillers such as cosmoderm & cosmoplast, or the newer Evolence, the products will gradually be biodegraded into their natural sugar or protein building blocks. In the case of the HA fillers, they can rapidly be removed with the injection of a hyaluronidase such as Wydase or Vitrease.
A certain number of patients may experience local (and long term) inflammatory conditions (i.e. reactions to the implant which are know as granulomatous reactions). In my experience these can be extremely difficult to get under control even with the use of local injections of corticosteriods. Our experience in treating patients manifesting chronic granulomatous reactions to injectable synthetic fillers is unfavorable. The reactions can last for years and in some cases are quite painful.
In addition, if the product is placed even slightly off from the desired placement as is seen in fairly commonly with injectable fillers, there is no way to remove or adjust the implant. It requires local tissue excision.
ArteFill® is a proprietary formulation comprised of polymethylmethacrylate, or PMMA, microspheres and bovine collagen, therefore, a skin test is required before initial treatment.
This is not to say ArteFill® has any higher rate of such reactions than other injectable synthetic fillers...it really in our opinion, is not worth the small risk of such reactions given their potential severity. Many physicians have had good experiences with these fillers and promote their use. At The Maas Clinic we do not.