A complex market:

Wrinkle killer

The popularity of collagen was overtaken by a feeling of uncertainty among the public after the BSE crisis. It is made out of cattle collagen. Not a single BSE-case was proved to have been passed on that way. Moreover, the probability of this going to happen is extremely low. Yet public reactions follow their patterns.

Various filling materials have since been on offer on the market: Restilane, Perlane, Dermalive, Dermadeep, Allo Derm, Outline, Juvéderm, Aquamid, PMS 350 (silicone fluid!), ProFILL, Artecoll, NEW-FILL, Hyal System… Some synthetic materials are absor-bable and transitory, others are not degradable in the body. The clear advantage is that you do not need to repeat the procedure after one or two years. The disadvantage is that with most products we cannot refer to long-term results, long-term consequences are unknown.

NEW FILL is a synthetic polylactic acid (PLA) hydrogel. At the last conference held by the German Society of Aesthetic-Plastic Surgery on November, 30, 2002, the German cosmetic surgeon Dr. Christine Decker reported she has been using the substance for three years. On three patients she detected unusual developments. 1-1,5 years after treatment of an organic infection process (Angina, bowels infection etc.) the injected parts hardened. They became visibly and physically detectable underneath the skin.

ARTECOLL is made of PMMA, a material that has been used as bone substitute, or as cement for artificial joints for 50 years. Dr. Lemperle managed to finetune it into micro pearls of 30-40 micrones and used it for wrinkle treatment with a 3,5% collagen carrier substance and 0,5% local anesthetic since the beginning of the 1990s. Initially some problems were detected when the substance was injected directly into the skin as was the common method with collagen. Reddish, or white stripes on the skin developed which, in worst cases, had to be cut out. Since the substance was injected underneath the skin (subcutaneous injection), the phenomenon has disappeared.
ARTECOLL-ARTEFILL. In order to introduce a new substance to the US-market, you need to prepare yourself for endless bureaucratic and financial harassment. Dr. Lemperle & Son succeeded after five years and 10 Mio US$ investments to establish their product. A decision by the extremely strict American Food and Drug Administration (FDA) and its commission presented with 4:1 a positive result: 3 plastic surgeons and one dermatologist were in favour, one statistician was against it. The final shortly-awaited approval, , does not face any further serious obstacles. The substance will slightly be modified and will be named "ARTEFILL" in the US.

The manifold varieties in the complex sector of wrinkle fillers make it extremely difficult for the clinician to estimate the reliability, or dangers of new products. The lack of long-term results with possible long-term consequences must clearly be presented to the patient. Even more urgent seems to be a warning against women receiving a subcutaneous injection at a cosmetician. At the cosmetician, our patients are called ‚clients' which makes a big difference.

In our next edition of GESAPS - AN we will have a contribution on this subject by a competent author.

Befor and after an Artecoll-Treatment