What Are Artefill Injection Risks?

Artifill uses PMMA (plastic) beads, materials which are non-biologic and have no natural defenses against infection. If bacteria form around the beads, the body has no defense against them (i.e. no blood vessels of its own to carry white blood cells or antibiotics) as the bacteria multiply on the foreign object. The body will often try to encapsulate the involved area with scar tissue, calcium deposits and inflammatory tissue as white blood cells degranulate, or discharge their acid sack contents in an attempt to kill the bacteria. This creates an inflammatory lump that is often palpable below the skin surface. Occasionally the lump becomes infected and red. This process can take months to years to occur. The beads and inflammatory reaction can move over time as the dynamic process of the inflammatory response of the body acts on the bead complex.
We have found in our practice the best way to treat the problem is to surgically remove the lumps, usually with small incisions hidden if possible in natural creases or anatomic borders.
Autologous tissue from the patient's own tissues such as LiveFill (fascial fat grafts), all alive when they are placed, are a more permanent, more durable method of augmenting soft tissue in the face. LiveFill grafts have the disadvantage of not being universally available and of being more expensive than injected fillers, and requiring an outpatient surgical procedure to place.
If patients are interested in temporary fillers, current hyaluronic acid (HA) fillers last approximately 6 months (Juvederm, Restylane), and are therefore less durable than Artefill. However HA fillers offer much greater biocompatability, and tend to go away over time. If the results are undesireable, they eventually go away. This is not the case with Artecoll, Artefill or silicone, where bad effects of the injection are often permanent.
There are many patients who have had Artecoll and Artefill injections with no problems and have appreciated the long lasting results. However I have difficulty balancing the risks or a permanent or semipermanent filler with the benefits of longer duration of action. I would agree with the statement that they are risky, for the reasons above.

Unfortunately most of the answers listed to this question come from physicians who answered more than 5 years ago.  The product has undergone dramatic improvements since that time. The  artefill particle has been improved to markedly reduce any of the previous generation risks.It now has less or equal  risk than many of the other fillers like Sculptra, Juvederm, Radiesse or Restylane.  Facial filler satisfaction ratings with  Artefill show high rates of satisfaction for over  one year. Artefill is a dual action filler that visibly corrects wrinkles but also has microspheres that support the skin.  So many people rent their fillers paying thousands of dollars annually to restart from ground zero each time  with Artefill you own the filler ,it is economically  and aesthetically the best choice in my opinion.

I do not advise patients to undergo augmentation with permanent fillers. Complications are difficult (but sometimes possible) to treat. Raffy Karamanoukian Los Angeles

I have been injecting Artefill® for many years now in practically every part of the face and body, including the hands, lower eyelids, acne scars, nose, vermillion border. I have only seen two small granulomas in well over 800 patients which were easily and rapidly treated.

As with all permanent fillers, only small amounts should be injected at a time and in multiple planes. An expert injector of any filler (whether it be temporary such as hyaluronic acid [Restylane®, Juvederm®, Belotero®], Radiesse™ or permanent such as Artefill®, Aquamid™ or fat) should have a light touch and avoid injecting "lakes" of filler which are far more problematic. Since the center of these "lakes" have no blood supply to receive antibiotics or the body's own antibodies, they can become more easily infected. The same holds true with any permanent filler, whether it be Aquamid® or natural fat transfer for that matter.

My patients and I have been extremely satisfied with Artefill®, and have seen less untoward effects than with many of the hyaluronic acid fillers (which produce a swollen, bluish tinge around the eyes on a number of occasions).

I have been using artefill or artecoll its previous product name for over a decade in Canada.  Its biggest risk is palpable lumps.  These are generally small and often palpable but not visible.  True granulomas are rare and I have never seen one  in the hundreds of cases ive done.  Artefill is most useful for correctiing pitted acne scars where small quantities are injected.  Its other use is in correcting subtle nasal bone asymmetry after rhinoplasty. In my opinion it should not be used in large quantities. It should be injected in sub dermal or deep dermal plain. When used for lip augmentation patients should be advised that they will likely  have palpable textural changes and possible lumps in their lips.

 Artefill is different from temporary injectable wrinkle fillers. The unique microspheres in Artefill are not absorbed by the body and provide the support your skin needs for natural, long lasting results.

You must be skin tested prior to treatment with Artefill. The carrier of the unique microspheres in Artefill is collagen. If no reaction to the skin test after four weeks, you may be treated with Artefill that day. Most people require more than one treatment to reach the level of correction that they want.

Artefill is technique sensitive as it must be injected mid to deep dermis. You will want to choose a Doctor who has experience injecting Artefill due to the importance of placement of the filler. 

I would advise against silicone injections as silicone tends to migrate and I have treated patients 10-15 years post silicone injections of face and other areas who present with delayed hypersensitivity reactions, granulomas and persistent edema.