PMMA-Microspheres (Artecoll) for long-lasting correction of wrinkles: refinements and statistical results.

The corium is diminished to about half of its thickness in skin defects and wrinkles. All biological materials that increase the thickness of the corium are resorbed within a certain time. Therefore, a lasting effect can be achieved only with nonresorbable synthetic substances. Artecoll consists of microspheres of 30-40 microm in diameter, of exceptional surface smoothness, purity, and homogeneity related to PMMA. These microspheres are suspended in atelocollagen which serves as a vehicle for subdermal implantation. Due to its smooth surface and consequential lack of electrical charges, each single microsphere is immediately encapsulated with the patient's own collagen fibers, thus preventing dislocation. Within 3 months, collagen (making up 75% of Artecoll) is replaced by the body's own connective tissue. The microspheres (25% of Artecoll) serve merely as a stimulus to the fibroblasts. Indications for Artecoll are all facial folds, lip- and philtrum augmentation, chin- and malar augmentation, dark-shadowed eyelids, enophthalmos, bony defects in face and hands, nipple reconstruction and augmentation, and urinary incontinence. Questionnaires were sent to all patients who had received Artecoll in 1993 and 1994. Of a total of 950 questionnaires sent, 515 were returned by September 1995. Satisfaction was rated "very good" in 29%, "good" in 38%, "satisfactory" in 23%, and "no difference" in 8% of the patients. The question, "Would you repeat the treatment again?" was answered by 91% of the patients with "yes." The overall complication rate was 3%. Strictly subdermal implantation will prevent longer lasting redness or visibility of the Artecoll.