Artefill is an injectable dermal filler, made of synthetic microspheres and bovine (cow) collagen. It is a permanent facial filler used primarily to treat nasolabial creases, lines, and folds in the face, which is created from the degradation of the body’s collagen.
Artefill is an improved version of the facial treatment Artecoll. Artefill was approved for use in the United States by the Food and Drug Administration in 2006, and is used by many plastic surgeons all over the world for facial cosmetic treatment.
Artefill Components, How It Works
Artefill contains polymethylmethacrylate (PMMA), or synthetic microspheres, along with cow collagen and lidocaine, a local anesthetic. These synthetic polymer beads are suspended in cow collagen which will be absorbed by the body. The microspheres however, are not absorbed, and remain permanently in the skin. When the bovine collagen degrades, it is replaced with new collagen, which encapsulates the PMMA microspheres, keeping them in place.
Artefill is distributed by Suneva Medical, to only those physicians and plastic surgeons who have undergone sufficient training using Artefill procedures of injection, because injection depth is the key element to its success. Artefill is injected under the wrinkles, just above the fat layer of the skin, using a tunnel or threading technique, unique to this permanent dermal filler, and to Radiesse, Restylane, and Juvederm. Because bovine collagen is used to suspend the polymer microspheres for injection, an allergy pre-test for the skin is necessary, and must be done one month prior to any Artefill injections.
Am I a Good Candidate?
- Any women or men over the age of 18
- Patients who want permanent results, and who have tried other types of dermal fillers first, to know what the results may look like aesthetically
- Patients without any allergies to bovine collagen, lidocaine or without previous history of severe allergies
- Patients with no chronic or existing skin infections, rashes, or acne
- Patients who are not taking aspirin or non-steroidal anti-inflammatory (NSAID) drugs, as these will promote bleeding and bruising
- Patients who are not currently under immunosuppressive therapy
- Patients who are not pregnant or breast feeding
Benefits, Risks and Comparisons
Artefill is a permanent dermal filler which promotes collagen production in facial skin tissue. It may last 5-7 years or longer, and is very convenient, because it involves only two initial treatments. Artefill costs approximately $1,000 per syringe, and if a patient is comfortable with a permanent injection, will cost less than injections of Restylane, Juvederm (hyaluronic acid based fillers), or other collagen fillers such as Cosmoderm, Evolence, or Zyplast, because Artefill is injected in two treatments, as opposed to every 3-4 months.
Artefill’s synthetic microspheres are not absorbed by the body, therefore the results are permanent, and cannot be reversed with hyaluronidase enzymes as with Restylane or Juvederm. Allergy pre-tests are mandatory, and Artefill is not recommended for use in the area around the eyes or lips. If the desired results are not achieved, Artefill can only be removed surgically, so it is wise to have experimented with temporary, or semi-permanent injectables before committing to Artefill.
Artefill’s microsphere behavior cannot be totally predicted. It is influenced greatly by the depth, technique, amount, and area of injection. If injected too superficially, granulomas or bumps may develop. Artefill may also develop a new look as your body’s tissue changes around it, which may cause further bumps to appear. Even though it is a permanent filler, its aesthetic appearance is somewhat unpredictable, due to changes in the body. There is also a slight chance of rejection by your body’s tissue, which may also cause granulomas.
The Artefill Procedure, How it is done
The procedure begins with finding a doctor who is trained, experienced and qualified to administer Artefill injections. Artefill and MetaCrill are both PMMA injectables which have been used for a long time in the medical field by orthopaedic surgeons, for joint replacement, or skull bone defects, however cosmetic facial injections use a special technique in order to achieve desired results. Consultation with a board-certified plastic surgeon, who has been trained to inject Artefill, is a key to a successful outcome. Your medical history should be discussed, and alternatives to Artefill, such as other non-permanent fillers should also be discussed as options.
A pre-test for skin allergies is required before injections. After the skin test, the patient will wait one month for results, to return for injections. The skin is cleansed, and locations for injections are marked. Artefill contains lidocaine, a local anesthetic, so that it is less painful. After injections, there is little to no downtime, and most severe side effects are rare, due to the pre-test for bovine collagen allergies.
Injection treatments normally take 15-20 minutes. Most patients will require two treatments which are scheduled 3-6 weeks apart, for maximum results. The results are immediate, yet full results are gradual with formation of the skin’s collagen production. Because Artefill is permanent, changes may occur within the skin tissue with time, causing changes in appearance, and further visits may be scheduled as necessary with the injector, in order to monitor results.
Side Effects and Complications
Common side effects experienced are:
- initial lumpiness/firmness
- tenderness around the injection site.
Artefill lasts longer than any other dermal filler, yet can only be removed surgically. It costs less in the long run, but could cost more, if injections are not administered properly. An allergy pre-test is required, because bovine collagen is used to suspend the PMMA microspheres, and it is not recommended for off-label uses such as around the eyes, or for lip enhancement.
Reviewers have stated that the unpredictable nature of Artefill causes new bumps every so often, and have expressed displeasure in use for “crows feet” around the eyes. Tear trough injections are not recommended, due to the bulging effect and irritation, along with discomfort. It is critical to have a well-trained injector, and to discuss other alternatives before trying Artefill, because it is there to stay.
Artefill does work, and has worked in reconstructive orthopaedic surgeries for a long time. Cosmetic surgery is a different use however, and the patient and doctor should both be comfortable discussing possible outcomes, or alternatives. Proper placement, injection depth and technique, are all factors of achieving desired results. Other aesthetic changes that may happen in the soft tissue around the injection site, only time will tell.