Soft tissue augmentation with artecoll: 10-year history, indications, techniques, and complications.
Most of the biologic filler materials that increase the thickness of the corium in a wrinkle line are phagocytosed within a certain time. Therefore, a lasting effect can only be achieved with nonresorbable synthetic substances. Artefill consists of 20 volume percent microspheres of polymethyl-methacrylate and 80 volume percent of bovine collagen. Beneath the crease, the microspheres with their exceptional surface smoothness stimulate fibroblasts to encapsulate each individual one of the 6-million microspheres contained in 1 mL of Artefill. Collagen is merely a carrier substance that prevents the microspheres from agglomerating during tissue ingrowth. The 20 volume percent of microspheres in Artefill provides the scaffold for the 80% volume of connective tissue deposition, a complete replacement of the injected collagen. The filler material beneath a crease acts like a splint and prevents the possibility of its further folding, thereby allowing the diminished thickness of the corium in a crease to recover. This recovery process is well known even in older patients with facial paralysis or after a stroke, whose facial wrinkles and furrows on the paralyzed side disappear over time.
Lemperle
Gottfried
G
Division of Plastic Surgery, University of California, San Diego, USA. glemperle@aol.com
Romano
James J
JJ
Busso
Mariano
M
D001672:Biocompatible Materials / Q000008:administration & dosage; D002921:Cicatrix / Q000628:therapy*; D003094:Collagen / Q000008:administration & dosage*; D003357:Cosmetic Techniques; D005145:Face; D006801:Humans; D007271:Injections, Intradermal; D008863:Microspheres; D018579:Patient Selection; D019904:Polymethyl Methacrylate / Q000008:administration & dosage* / Q000031:analogs & derivatives*; D019651:Plastic Surgery Procedures / Q000379:methods; D015595:Skin Aging / Q000187:drug effects*
C445359:Artecoll; D001672:Biocompatible Materials; D003094:Collagen; D019904:Polymethyl Methacrylate