Post to Forum
anyone had problems with artefill moving or shifting?
First to Last
a dermsurgeon friend asked her colleagues, and one suggested checking with Dr. Sheldon (http://www.derma-surgery.ca/meetdr.asp). She also forwarded me an article called "Soft-Tissue Filler Complications: The Important Role of Biofilms" that is worth looking up.
The authors provide this information:
Biofilms and Their
Relationship to Soft-Tissue Fillers:
The cause of foreign-body granuloma after
soft-tissue filler injection has been hypothesized to
be attributable to implantation in one session of
volumes that are too large, impurities in the agent,
or irregularities of the filler surface, but the impact
of biofilms has yet to be established. Reports of
delayed complications temporally related to systemic infections support the infectious cause.
All fillers, especially longer lasting products, have
the potential for biofilm complications....
Complications should be approached in an
algorithmic manner with early recognition (Fig.
2). If possible, one should make every attempt to
determine what was injected into the site. If the
wound is fluctuant, it should be needle-drained
and cultured. Cultures should be sent to the laboratory immediately for appropriate handling.
They also should be monitored for up to 21 days
for routine culture and atypical infections. The
initial antibiotic regimen should consist of at least
two-drug therapy, such as a quinolone and a third generation macrolide, to prevent further biofilm deposition. Macrolides have been shown to be
uniquely effective, which appears to be related to
improved accumulation in the subcutaneous fat
(where the filler material typically resides) and
may also block quorum sensing.
After a trial of antibiotics, intralesional highdose steroids should be considered. If hyaluronic acid was used, hyaluronidase should also be
Excision should be the last step. This
algorithm is exemplified in Figure 3. This patient
presented with nonfluctuant inflammation following hyaluronic acid to the lips. She was successfully treated sequentially with an antibiotic regimen,
hyaluronidase, intralesional steroids, and eventual
I also have had a terrible problem with an artecoll injection I had done 13 years ago. Unfortunately it is getting worse as my skin ages. I am interested to know if anyone has had any luck removing artecoll and the scar tissue from smile lines?
my phone at the office Megan is (310) 736-2818
Before & afters from doctors (33)
Sign up for our newsletter to receive the latest stories, photos, and