LAM FACIAL PLASTICS

Hello, dear Doctor!

I have read and heard what happens with fat, and you have said that the plumpness obtained by the transplanted fat seems to "go away" a few months after the injection, to later "reappear", "fill in" again.

I was wondering if the same happens with fillers that lead to "fibrosis" in the area.

My friend had Artefill done (I know Artefill is no longer available, but the doc had syringues still valid stored properly) with not negative side effects whatsoever and she looked great. About a month later, she says she has the sensation that her face is slimmer than it was, as if some of the filler had disappeared already. I look at her and I believe that yes, she has lost some volume already(not awfully so, but compared to the "before" pic, one would not say there is a dramatic difference, while the "after" pic of a month ago would show a clear improvement in her plumpness)... but then I wonder if it is temporary. As far as I read in google concerning Artefill descriptions, Artefill fills the area where it is injected out of the collagen it contains plus the beads of PMMA. I read the collagen eventually dissolves, the beads do not, and the beads lead to new collagen/tissue formation in the area.

I said I would ask you first, but wonder, is it remotely possible that she might regain some volume as the formation of new fibers and tissues around the beads will go on?
Is it possible that at first she had more plumpness as a result of the mix of the filler (collagen plus PMMA particles) PLUS the natural inflammatory response of our body (even if natural looking) as it happens in any area where something is injected?

Is it possible that now that the inflammatory response went away and/or the collagen reabsorbed, it would be only logical that she would notice some loss of volume?
Could the body reaction to the beads of PMMA build up more volume and make her regain some of the fullness as days will go by?

Or I am saying nonsense?

I just thought of the fat transplantation issues you often speak of (that it looks worse some time after, before it looks better and better) and wondered if in some way artefill or something that has something reabsorbed and something not reabsorbed could have an effect somewhat alike. I know the whole way the fat transplantation works, versus the filler work, is different. But maybe in that sense there is a "it gets less good until it gets good again" - moment??

Second question: my friend liked her Artefill injections very much. I likes how it looks on her. She suggests me to try it. Looking at her it is hard not to be tempted. But I wonder whether or not having it could jeopardize having fat injections with you later on (some years from now). Would it?

Hugs :)

many questions, many answers:
1. first, artefill is back on the market. since the demise of artes medical, suneva has bought it and will be distributing it again.
2. i am cautiously looking at artefill for very select purposes since i like their new long-term safety data. i plan on using it mainly for smile lines and marionette.
3. would it interfere with fat? hard to say. i just don't know how it will age in the cheek, etc. always cautious.
4. the bovine collagen in artefill tends to be much more robust than the collagen that your body replaces it with so you typically get a result that diminishes over time. you do not truly get a 1:1 replacement of bovine collagen with your own collagen in most cases. what you are thinking about with other fillers i do sort of see for example with micro silicone for acne scarring. first they like it because it is swollen, then they like it less, then the needling effect of silicone and the micro encapsulation of the beads can make the result slightly (not substantially) better over 3 to 4 months. now, as you know, fat is totally different, since it is relying on blood supply after 3 to 6 months to build it back up again not collagen growth. in short, artefill typically leads to underfilled results that may only be partially offset with some native collagen growth.
best,
sml

SUPER clear

great!