Brand names: Artecoll (in Canada), Artefill (in the United States), Dermalive/Dermatech
Major risk: Artecoll has the same potential for allergic reactions as collagen injections because of the bovine vehicle substance. Dermalive/Dermatech has minimal risk of allergic reaction because it is suspended in hyaluronic acid, a non-sensitizing vehicle.
Stability: Benefits range from five to seven years but are most likely permanent, though this is still under investigation.
Artecoll and Dermalive are combination injectables; they are made up of a synthetic substance called polymethylmethacrylate (PMMA) and collagen (similar to Zyderm and Zyplast, described above) for Artecoll, and hyaluronic acid for Dermalive. The FDA has only recently (2006) accepted Artefill as a filler.
Artecoll has been around for the past 50 years as a bone substitute and it is approved in Canada and Europe as an injectable filler for wrinkles; it’s referred to as Dermalive in Europe. Results of a debate in the dermatologic community about the adverse events for both have yet to settle out; some research says it is no greater risk than other injectables, while other research has shown different outcomes. What needs to be considered, as is true with any permanent filler, is that when a problem such as lumping or migration does take place it doesn’t go away, as would be the case for a nonpermanent filler.
Artecoll is injected in the same manner as collagen, and has the same initial results; Dermalive avoids this risk. With Artecoll, however, after the collagen is absorbed or broken down by the body, the synthetic material PMMA remains, stimulating the formation of new collagen and connective tissue in the area surrounding the PMMA, and this is true for Dermalive as well. One or two injections are enough to obtain good results. The results are thought to be permanent, but are definitely long lasting, with some research showing effectiveness for at least five to seven years, with ongoing improvement as the new collagen matrix is being formed.
(Sources: Clinics in Plastic Surgery, October 2006, pages 551-565; Plastic and Reconstructive Surgery, September 2006, pages S64 and S76; Expert Review of Medical Devices, May 2006, pages 281-289; and Dermatologic Surgery, June 2003, pages 573-587.)