For patients who desire fillers to replace volume in the face, or improve wrinkles and folds, a choice must be made at the start – permanent or temporary. Most often, patients will choose a temporary filler, like Restylane®, Juvederm®, Perlane®, Radiesse®, or collagen. The arguments in favor of temporary products are understandable, and include:
- objection to the placement of any permanent foreign body in the face;
- the potential for a foreign body reaction, like scar tissue formation; and
- fear that the result will be suboptimal but unchangeable.
The obvious shortcoming of temporary fillers is the need to replace them. Even the longest lasting permanent fillers will remain less than two years, so young patients will need to replace them many times as they age. This process is not only time-consuming, but also costly.
An excellent alternative to temporary fillers is ArteFill®, a safe and effective product with many uses in the facial aesthetic practice. The permanent component of this soft gel is polymethylmethacralate (PMMA), formed into smooth microscopic spheres. PMMA is a very inert material, and its manufacturing process emphasizes removing impurities, so the risk of excessive scarring (foreign body reaction) is extremely low. The PMMA microspheres are suspended in collagen, and because this collagen is derived from cows, a skin test is required before injection to minimize the risk of an allergic reaction. The injected collagen is absorbed during the months after injection, and the patient’s body deposits native collagen to replace it. So, the lasting effect should be very similar to the appearance immediately after injection.
ArteFill® can be used to correct many facial abnormalities, such as prominent nasolabial folds (“smile lines”), marionette lines (extending down from the corners of the mouth), lost cheek volume, acne scars, minor contour deformities, depressions of the inner lower eyelid, and many facial wrinkles. The injection process is very similar to other fillers, and is tolerated well by almost all patients. Potential risks are temporary, and include lumpiness at the injection site, swelling, redness, increased sensitivity, and rash or itching. Occasionally, two injection sessions are required to maximize the result.
Any filler must be applied carefully and conservatively, to avoid over-correction and ensure a good result. If used in this manner, ArteFill® creates impressive and permenent changes that any patient can appreciate. It is an excellent choice for augmentation of the face, and should be considered by anyone who desires a filler injection.
