For the first time in U.S. history, the FDA has approved a permanent cosmetic filler. Artefill was approved in late 2006 for the correction of naso-labial folds (smile lines.) Safety data shows no significant side effects and minor side effects equal that of placebo.

Artefill is a more purified version of Artecoll, which has been safely used in Canada for many years. But in order to received FDA approval in the U.S., Artes, the maker of Artefill, needed to make the PMMA microspheres (see below) more uniform in size. Artefill therefore is a safer, better product than its Canadian cousin Artecoll.

Although the studies on Artefill show continued improvement in patients five years after their injections, Artefill is expected to last permanently. Like the rest of the face, areas it is injected in will continue to age normally, therefore enhancements may be necessary as more facial volume is lost with aging.

Results are seen immediately after injection and 1-2 treatments are usually required. Other off-label uses that will probably be popular will be injecting the marionette lines (lines between the corners of the mouth and chin) and scar correction.

Artefill contains tiny PMMA (poly-methyl-methacrylate) microspheres in a purified bovine collagen gel with an anesthetic for comfort during injection. The collagen acts as a carrier for the PMMA and dissolves over several months, leaving the microspheres in your skin. These microspheres provide structure, like scaffolding, that skin will then build its own collagen around. PMMA is one of the most widely used synthetic implant materials in medicine.

Juvederm and Restylane are still the fillers of choice for lips and fine lines and Radiesse is often the best choice for sculpting and plumping cheeks. Artefill may be the new treatment of choice for smile lines (the lines between the nose and corners of the mouth) when permanent correction is desired. Artefill can also be used to plump up marrionette lines (the lines and depressions below the mouth), fill in scars and smooth out depressions and crooked contours on noses (the LunchTime Nose Job). Artefill is also often used in combination with Restylane, Juvederm, Radiesse, Botox and laser rejuvenation treatments, such as Fraxel, IPL and V-Beam for comprehensive, no downtime rejuvenation.

Treatments typically last 10-20 minutes and are usually painless. Depending on the areas treated, more than one syringe may be needed to create the desired results. Enhancements are recommended 1-3 months after the initial treatment to fine-tune results. These may require only the smaller 0.4 cc syringe.

Some preparation is necessary before an Artefill treatment. You must be skin tested 4 weeks prior to your treatment to screen for allergy to bovine collagen. Some physicians, including myself, recommend 2 skin tests, 2 weeks apart. It is also recommended to wait at least 6 months after you have had a temporary filler placed in the same area, to give it a chance to dissolve, leaving room for the new filler. To reduce the risk of bruising you should avoid aspirin, ibuprofen, vitamin E and similar medications for 1-2 weeks before your treatment. Taking Arnica Montana, a natural oral medication the day of your treatment and for several days after your treatment helps reduce bruising and swelling.

After injection, some common, temporary, injection-related reactions might occur: tenderness, redness, itching, bruising, bumps, pain or swelling. These typically resolve within a few days. Rare potential side effects of all dermal fillers may be lumps, abscesses and granulomas, which are usually treatable.

No special care is needed after treatment, however you should not massage the area on the day of your treatment, as this may displace the gel. Exaggerated facial expression during the first 24 hours may also displace the gel, so avoid prolonged laughing, playing musical instruments with your mouth and sleeping on your face. Cold packs for 10-15 minutes every 1-2 hours until bedtime on the day of your treatment helps to reduce swelling & bruising.

Since results with Artefill are probably permanent you should only have this treatment if you desire permanent results. Depending on who you go to, there is the possibility you could have a permanent bump or other undesirable result. Do your research and make sure you are treated by an experienced injector who is also artistic with her or his technique. Ask to see before and after photos of other patients and go to someone who is a specialist in aesthetic medicine (dermatologists, plastic surgeons and head and neck surgeons usually have the most experience with cosmetic injections.) If the treatment you do not desire a permanent implant, Juvederm, Radiesse or Restylane may be preferable. If you have never used a cosmetic filler, I recommend trying one of these temporary fillers first before having a permanent filler.  

For more information and for complete safety information visit www.artefill.com

Dr. Klein has won several awards and has published several articles in medical journals. She has lectured to other physicians at medical conferences and at numerous community and civic organizations. For more information about Artefill visit at WWW.SKIN1.COM