PMMA microspheres (Artecoll) for skin and soft-tissue augmentation. Part II: Clinical investigations.

Artecoll is an injectable implant for long-lasting correction of wrinkles and other skin defects. Artecoll consists of fine polymethyl-methacrylate (PMMA) microspheres suspended 1:3 in a 3.5% collagen solution. The microspheres are characterized by exceptional surface smoothness, homogenicity, and purity. The size of the microspheres of 30-40 microns diameter is small enough to allow subdermal implantation using a 27-gauge needle. Phagocytosis and dislocation of the implant is prevented by fast encapsulation of each single microsphere with connective tissue. Increased scarring but no granuloma formation has been detected as is common with other injectable implants with irregular surfaces. The experience from more than 600 patients and a prospective study in 118 patients with 200 implantation sites were evaluated. The good early results have continued for 5 years. Of the patients evaluated, 89.5 percent were satisfied and would ask for the treatment again. The overall complication rate is very low, and prolonged redness or visible granules are due to implantations that are too superficial. Other applications in soft-tissue augmentation are discussed.