Permanent Fillers

Injectable permanent fillers (Sculptra, ArteFill and Silikon-1000).

  • Liquid injectable silicone (Silikon-1000 and Adato-Sil 5000) are used “off label” by many physicians. For the vast majority of patients, silicone injections are well tolerated. However, rare dermatitis reactions may cause a permanent bumpy appearance of the skin in a small percentage of patients. Having seen these results from other physicians, I do not use silicone.

Case 1. Combination Artefill and Fat Transfer Procedure. The lady shown here has atrophy of her mandibular area from dentures, a heavy wrinkle under the chin and smokers wrinkles.

The mandible was filled with 10 cc of fat. Fat transfer of 10 cc of costs $2,000. In contrast, about .8 cc of Artefill was used to fill the heavy wrinkle under the chin permanently. The cost of Artefill is $2,000 per .8 cc.

If we had used Artefill to fill the volume of the mandible, the cost would have been $12,500. Thus fat is much more cost-effective that ArteFill for volumes over one syringe of Artefill (.8 cc).

Meanwhile the smoker’s wrinkles were treated with fractional resurfacing, which also improved her skin tone and complexion.

  • ArteFill is a permanent filler that is FDA approved for nasolabial folds. Artefill comes mixed with local anesthetic, so there is virtually no discomfort during the injection process. The unique microspheres in Artefill are not absorbed by the body and therefore provide the support the skin needs for long lasting natural feeling results. This is different from temporary dermal fillers that are made of different kinds of natural or synthetic materials that are completely absorbed by the body over time and require repeat injections to maintain wrinkle correction. A skin test is required approximately 4 weeks before treatment.
  • Fat transfer is an excellent semi-permanent material. Unlike permanent fillers, injected fat may be removed (by liposuction) or accentuated at any time. However, fat cells are living tissue and only about 30-40% of the fat cells transferred to the face “take” permanently. This means that the fat transfer procedure will need to be repeated 2-3x to get the final result. However, large volume transfer to the face (over 2 cc) is very cost effective-see case 1 below.

Case 2: Surgiform Implants. Surgiform Implants are excellent for the nasolabial fold or for lip augmentation. Surgiform implantation is $2,000 for the nasolabial folds, which is the same as ArteFill injections.

Unlike injectable permanent fillers, Surgiform implants are very easy to remove after they are placed. Surgiform implants are placed with a local anesthetic as a walk-in procedure. The procedure takes about 30 minutes. No pain relief medication is required after the procedure.

In the case shown here, the patient would have needed 2 syringes of ArteFill ($4,000) to achieve the same effect he got with Surgiform ($2,000). Compared to fat transfer, ArteFill only needs to be performed once to get the same effect. Thus, in some cases, Surgiform implants are more cost effective than either Artefill or fat transfer.