Is Silikon 1000 a safer permanent filler compared to artefill?

Question

I'm seeking a permanent non-surgical nose job filler. However after reading many reviews on artefill, it seems like granulomas are common. A few surgeons have told me that granulomas were common with the old artefill formula but not with the new one. I do see that silkon-1000 is often used for non-surgical rhinoplasty and the percentage of satisfaction seems much higher. Is silikon 1000 safer than artefill? If injected correctly would granulomas still occur several years down the line?

Eric M. Joseph, MD · Answer

In our experience, microdroplet Silikon1000 treatments are well suited for permanent nonsurgical rhinoplastic treatments, depending on your exam. Liquid injectable silicone (LIS) has a 60 year track record of precision, permanence, and safety especially when used to add volume to the nose. ArteFill has PMMA which may be more likely to cause an adverse reaction - and lead to vascular occlusion. With LIS, there have been no instances of necrosis or blindness. Consider re-asking your question with photos. Hope this helps. Dr Joseph

Raffy Karamanoukian, MD, FACS · Answer

I am the leading expert on the removal of silicone and artefill. I see far too many complications with these fillers to cite them as safe. I would avoid them both. Best, Dr. Karamanoukian#Realself100 Surgeon

Lawrence Kass, MD · Answer

Like everything, there may be many different opinions on this question.  But in my opinion, the short answer is yes.  I have used silikon 1000 for about 7 years for non-surgical rhinoplasty and for general facial filling and, using the micro-droplet technique, the results have not only been outstanding, they are also PERMANENT!

Robert Kotler, MD, FACS · Answer

Dear Anonymousgirl89:

Some
people have granulomas with Artefill;  plus, how long Artefill lasts is
somewhat variable. Silikon-1000 has been
successfully used for over 50 years in the United States; Silikon-1000 is the
trade name for medical-grade silicone, an FDA-approved product for inside the eyeball. But it is appropriately
used, off-label, as a microdroplet injection underneath the skin of the nose.Non-surgical rhinoplasty works because tiny drops of Silikon
1000 are injected just under the nasal skin. Over time, the body walls off
those drops with new tissue which provides the plumping action to fill in
divots or marks in the nose. The same effect can happen with plain salt water
to provide a preview how the nose will look on completion of treatment. The Kotler Saline Demo lasts perhaps two
hours, but long enough to take a photo of what the finished nose will look
like.Best wishes,

Robert
Kotler, MD, FACS

Jan Zemplenyi, MD · Answer

I believe that several clarifications to be made to your excellent question. Artefill contains polymethyl methacrylate as the permanent component. Any time that a foreign material is  injected the body's response can be an inflammatory granuloma. Very specifically, Artefill (as opposed to Artecoll) has been formulated and mandated by the FDA to contain a small size of microspheres (30-50 microns) so that granuloma reactions are very INFREQUENT. I have been injecting Artefill since 1987 not having seen any foreign body granulomas. For a larger volume augmentation such as a "non-surgical" rhinoplasty I feel comfortable with Artefill, and certainly more comfortable than any "microdroplet" technique that I am able to generate with Silikon 1000 that I also inject. By the way, the only foreign body reaction I have seen to a filler was with Sculptra - a non-permanent colllagen inducer substance.

Is Silikon 1000 a safer permanent filler compared to artefill?

Answers (5)

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