Soft Tissue Augmentation with ArteFill

Abstract

ArteFill is a novel, third-generation polymethylmethacrylate (PMMA) injectable filler with unique properties. When compared with predecessor materials, ArteFill demonstrates improved biocompatibility as a result of more uniform PMMA microsphere size and shape. This translates into less adverse events after placement. ArteFill can provide a permanent volume enhancement by stimulation of fibroblasts that encapsulate nonabsorbable microspheres with collagen deposition. Currently, ArteFill is FDA approved for permanent augmentation of moderately deep nasolabial folds. It is also commonly used offlabel for augmentation of other skin creases and regional areas of volume deficiency, such as the tear trough-malar and marionette line-prejowl sulcus regions. The key to success with ArteFill is a conservative approach with avoidance of overcorrection. Proper technique includes deep dermal to subcutaneous placement with full correction achieved gradually over several treatments. Complications are mostly limited to nodule formation, which is easily managed in most cases with conservative intervention.

Introduction to Fillers

“…100 Nodules, beading, and scarring can occur, particularly after too-superficial injections. 100,112 100,112 …”

Non‐operative facial rejuvenation

“…After implantation, the carrier solution dissipates within 1-3 months, leaving behind the nonresorbable microspheres that induce fibroplasia and become encapsulated by collagen. [43][44][45][46][47][48] Although severe complications are not as common with third-generation product, 49 PMMA is associated with a steep learning curve in terms of patient selection and injection technique and schedule, and should not be attempted by the inexperienced clinician. PMMA is used to treat well-defined, deeper folds and rhytides, as well as facial wasting and cheek depressions.…”

Dermal fillers in aesthetics: an overview of adverse events and treatment approaches

“…The nonbiodegradable fillers provoke a foreign body reaction that stimulates a fibroblastic deposition of collagen around the nonabsorbable microspheres 9. Products in this category include polymethylmethacrylate (PMMA; Artecoll®; Rofil Medical International B.V., Breda, the Netherlands), the polyacrylamide hydrogel Aquamid® (Contura International, Soeborg, Denmark), and Silikon® 1000 (Alcon Laboratories, Inc., Fort Worth, TX, USA), a medical-grade pure form of silicone.…”