Does ArteFill Work for Cheek Augmentation?

You may see from my several other posts how opposed I am to fillers of this nature.

I wil'll tell you about my experience with this filler and the unfortunate patients who suffered long term complications requiring surgery.

Artefill is not approved by the FDA for cheek implants, and should not be routinely advocated for that purpose.

Cheek augmentation requires a relatively large volume to achieve an effect. Depending on the position of the augmentation, it may be above the zygomatic (cheek) bone or the midfacial muscles of expression. The poly methyl methacrylate beads contained in Artefill get into tissues. They do not stay exactly where you place them.

Large volumes of synthetic substances injected into the face are particularly worrisome. The body cannot develop a blood supply in the injected material to defend itself against the bacteria that are in the region.

I have personally surgically removed many such deposits of many different semipermanent fillers, some available only in Europe (Aquamid for instance) and replaced them with LiveFill (fascial fat grafts). The surgical removal is difficult and fraught with problems because the material can migrate around deep nerves and cause chronic pain syndromes; surgery to remove the material will necessarily involve dissection around the nerves and is by its nature incomplete since the material infiltrates the tissues themselves. In the cheek the infraorbital nerve is particularly vulnerable.

If you develop an infection years later, or a chronic inflammatory reaction, you may have no way of removing the Artefill. Likewise if the Artifill beads migrate over time and the appearance changes or becomes deformed, there is no way to remove them completely.

If however you have a silastic cheek implant, these implants can typically be removed from inside the mouth easily and completely and replaced with a different implant or LiveFill (fascial fat grafts) if they should become visible or the patient does not like their shape. Many patients in our practice have LiveFill grafts placed in well defined pockets. These completely autologous (natural to the patient) grafts maintain their shape and volume over time as studied by 3-D CT scans and clinical photographs.

As with many treatments, the correct treatment is not necessarily the cheapest or most convenient.

Artefill is great for cheek augmentation. It can last 5 - 10 years or more so it can be a great value. Some patients wonder why anyone would get other fillers due to its longevity. It is a more expensive filler, and is considered semi permanent which is its down side (if not placed correctly), as well as its upside (fantastic longevity). It has a smooth, natural feeling, and is developing one of the best safety profiles in the injectable market. It can be injected very close to the surface for precision correction of small wrinkles as well as injected deep to push things up for fuller cheeks.

The concept of permanence is very appealing in a filler, for obvious reasons.  You have a filler injected and the result lasts forever, right? Wrong.  Aging is multifactorial and dynamic.  Regardless of what a person has done aesthetically, the face will continue to change with age.  I have seen patients 5 years and longer after having PMMA (the key ingredient of Artefill) injected with swelling, lumps, and other issues.  My best advice is to be careful of permanent products, whihc may last in ways that you don't want them to.