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 off-label 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.

KEYWORDS

ArteFill - polymethylmethacrylate (PMMA) microsphere - permanent injectable filler

REFERENCES

• 1 Lemperle G, Romano J J, Busso M. Soft tissue augmentation with Artecoll: 10-year history, indications, techniques, and complications.  Dermatol Surg. 2003;  29 573-580
• 2 Judet J. Protheses en resins acrylic.  Mem Acad Chir (Paris). 1947;  73 561
• 3 Laeschke K. Biocompatibility of microparticles into soft tissue fillers.  Semin Cutan Med Surg. 2004;  23 214-217
• 4 Klemm K W. Gemtamicin-PMMA chains (septopal chains) for local antibiotic treatment of chronic osteomyelitis.  Reconstr Surg Traumatol. 1988;  20 11–35
• 5 Lemperle G, Ott H, Charrier U et al.. PMMA microspheres for intradermal implantation: part I. animal research.  Ann Plast Surg. 1991;  26 57–63
• 6 McClelland M, Egbert B, Hanko V et al.. Evaluation of Artecoll polymethylmethacrylate implant for soft tissue augmentation: biocompatibility and chemical characterization.  Plast Reconstr Surg. 1997;  100 1466–1474
• 7 Cohen S R, Berner C F, Busso M et al.. ArteFill: a long-lasting injectable wrinkle filler material - summary of the U.S. Food and Drug Administration trials and a progress report on 4- to 5-year outcomes.  Plast Reconstr Surg. 2006;  118(3 Suppl) 64S-76S
• 8 Cohen S R, Berner C F, Busso M et al.. Five year safety and efficacy of a novel polymethylmethacrylate aesthetic soft tissue filler for the correction of nasolabial folds.  Dermatol Surg. 2007;  33(Suppl 2) S222-S230
• 9 Morhenn V B, Lemperle G, Gallo R L. Phagocytosis of different particulate dermal filler substances by human macrophages and skin cells.  Dermatol Surg. 2002;  28 484-490