Artecoll Granuloma: A Rare Adverse Reaction Induced by Microimplant in the Treatment of Neck Wrinkles

Kim, Kyoung-Jin; Lee, Hae-Woong; Lee, Mi-Woo; Choi, Jee‐Ho; Moon, Kee‐Chan; Koh, Jai‐Kyoung

doi:10.1111/j.1524-4725.2004.30174.x

Cited by 40 publications

(35 citation statements)

References 14 publications

(39 reference statements)

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“…5, below, and 13, above) have been reported since 1994 7,10,36,50,[77][78][79][80][81][82][83] and, from all the cases reported to the manufacturers worldwide, the occurrence is estimated at 0.02 percent (Tables 2 and 3). Rofil calculated that 400,000 patients had received Artecoll so far.…”

Section: Polymethylmethacrylate Microspheres (Arteplast/artecoll)mentioning

confidence: 99%

“…has collected a total of 52 foreign body granulomas from Rofil's files, the literature, and his worldwide contacts, including seven among his calculated 3500 patients. Recently, Alcalay et al, 80 Kim et al, 81 and Carruthers and Carruthers 82 described granuloma formation in glabellar, nasolabial, and horizontal neck folds, which finally resolved after Kenalog (Bristol-Myers Squibb, New York, N.Y.) injections or even spontaneously. In one patient, 82 a longstanding lesion after a pencil poke of graphite in the forehead became inflamed at the same time as the onset of granuloma.…”

Section: Polymethylmethacrylate Microspheres (Arteplast/artecoll)mentioning

confidence: 99%

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Foreign Body Granulomas after All Injectable Dermal Fillers: Part 1. Possible Causes

Lemperle

Gauthier-Hazan

Wolters

et al. 2009

Plastic and Reconstructive Surgery

217

243

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Summary Genuine granuloma formation following implantation of injectable dermal fillers is a rare complication, with incidences ranging from one in 100 patients (1 percent) to one in 5000 (0.02 percent). Foreign body granulomas occur several months to years after injection at all implantation sites at the same time. Without treatment, they may grow to the size of beans, remain virtually unchanged for some years, and then resolve spontaneously. Three clinical and histologic types of foreign body granulomas can be distinguished: 1. Cystic granulomas (synonyms: inflammatory, palisading, collagenolytic): these are caused mainly by injected biological gels such as collagens and hyaluronic acids. Their clinical signs are fluctuation (sterile abscess), extreme redness, and induration. Cystic granulomas are small and superficial, occur within the first year, and disappear spontaneously within another year. They are surrounded by a significant number of giant cells. 2. Edematous granulomas (synonym: lipogranuloma): these are caused by artificial fluids such as silicone and polyacrylamides. They appear suddenly years after injection with extensive swelling and are surrounded and infiltrated by mononuclear and inflammatory cells. 3. Sclerosing granulomas (synonyms: sarcoidal and xanthelasmic): these are caused by particulate injectables composed of polymethylmethacrylate, polylactic acid, hydroxyethylmethacrylate, calcium-hydroxylapatite, or dextran microspheres. Sclerosing granulomas occur generally 6 months to 3 years after implantation and are visible, often bluish confined nodules. Histologically, the implant is infiltrated by many macrophages and giant cells, fibroblasts, and collagen fibers but few inflammatory cells. Permanent implants are not characterized by a higher rate of foreign body granuloma per se than temporary implants; however, their clinical appearance is more pronounced and their persistence longer if not treated adequately. (Plast.

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Section: Polymethylmethacrylate Microspheres (Arteplast/artecoll)mentioning

confidence: 99%

Section: Polymethylmethacrylate Microspheres (Arteplast/artecoll)mentioning

confidence: 99%

Foreign Body Granulomas after All Injectable Dermal Fillers: Part 1. Possible Causes

Lemperle

Gauthier-Hazan

Wolters

et al. 2009

Plastic and Reconstructive Surgery

217

243

View full text Add to dashboard Cite

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“…Therefore, mainly shortor mid-term reactions, like immediate sensitivity reactions, formation of granulomas and swelling, could be picked up in these studies. In a number of case reports, long-term complications occurring after more than 12 months and even more than three years were described [8,16,19,44,[54][55][56][57][58][59][60]. These case reports indicate that more extended follow-up periods are needed to determine long-term effects of permanent fillers.…”

Section: Permanent Tissue Fillersmentioning

confidence: 99%

“…Not specified/ not known [120] PMMA in collagen or carboxymethyl-cellulose [16,19,54,55,58,59,121,122] Polyethyl methacrylate (copolymer HEMA and EMA) in hyaluronic acid…”

Section: Five-year Viewmentioning

confidence: 99%

Clinical data on injectable tissue fillers: a review

Vries

Geertsma

2013

Expert Review of Medical Devices

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Treatment with injectable tissue fillers for aesthetic purposes is increasingly popular. In parallel with this success, questions related to the safety of these treatments and the products involved are being raised more prominently. To gain insight in the safety aspects of injectable tissue fillers, we performed a literature review to collect studies reporting clinical data of injectable tissue fillers. We found several case reports where serious complications after more than three years are described. However, there are only a limited number of well-defined prospective clinical studies available with follow-up periods longer than three years. Furthermore, causes of complications, that is, treatment or product related, are often not specified in literature. Considering the intended functional period of fillers in combination with the known occurrence of long-term complications, there is a need for well-defined prospective clinical studies. In order to be able to discriminate between product failure (a product safety issue) or application methodology (a physician expertise or training issue), better identification of observed complications and whether they are product or treatment related, is needed. For the safe use of the fillers it is important that treatment with injectable tissue fillers is performed by a trained physician, who knows the product specifications and its applications. . Moreover, it is expected that due to increase in life expectancy, the demand for anti-aging treatments, like tissue augmentation with injectable tissue fillers, will grow [2]. Their success has been attributed to the fact that treatments with injectable tissue fillers are fast and appear to be relatively easy [2]. Only a relatively 'simple' subcutaneous injection is needed. Today, various injectable tissue fillers with different characteristics are available, for example, duration of the effect, material type and intended anatomical location.Although the application of an injectable tissue filler seems to be relatively simple and safe, reports of serious adverse effects have appeared in the literature [2][3][4][5][6][7][8]. Estimates of the occurrence of severe complications after treatment with various types of injectable tissue fillers range between 1:80 and 1:50,000 patients [9,10]. Adverse side effects can be caused by incorrect injection techniques (treatment related) or by the characteristics of the products (product related) [11,12]. Short-, mid-and long-term complications can be discerned (TABLE 1) [2,13-15]. Short-term complications like pain, swelling, fever, immediate hypersensitivity reactions, occur immediately or within several days past treatment and disappear after several weeks. A more severe short-term complication is necrosis [5,16]. Necrosis occurs immediately or within a few days if blood vessels are obstructed by the filler material or if they are injured during the treatment [17]. Mid-term complications such as delayed inflammatory reactions, ulceration and granuloma reaction may occur after 2-12 months. I...

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“…Granuloma formation a er Artecoll treatment is a reported complications, but very rare: only four cases of granuloma were reported a er injection of an earlier generation of Artecoll, and two of the pateints with potential granuloma were treated with intralesional corticosteroid (triamcinolone) injections. Surgical resection should be the last option [29].…”

Section: Adverse Eventsmentioning

confidence: 99%

Comparison of Artecoll, Restylane and silicone for augmentation rhinoplasty in 378 Chinese patients

Chen¹,

Liu²,

Yu³

et al. 2014

CIM

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Comparison of Artecoll, Restylane and silicone for augmentation rhinoplasty in 378 Chinese patients Abstract Purpose: Dermal llers have been proven to be safe in so tissue augmentation; however, their e cacy in modeling the noses of Asian patients has not been demonstrated. Methods:In this study, 378 patients were included and underwent augmentation rhinoplasty (Artecoll, n=126; Restylane, n=126 and silicone implants, n=126). e subjective and objective outcomes were evaluated on day 1, and months 1, 3, 6, and 12 a er injection rhinoplasty.Results: All patients achieved signi cant improvement in nasal shape and contour immediately a er surgery. Patients treated with Restylane failed to maintain the nasal shape and contour 1 year a er surgery, whereas patients undergoing Artecoll rhinoplasty completely maintained the post-treatment nasal shape and contour. More patients with silicone implants experienced adverse events and the severity of these events was greater in the silicone group compared to those in the Restylane and Acetoll groups.Conclusion: Artecoll rhinoplasty has a low incidence of adverse e ects and the shape and contour of the nose are maintained for a prolonged period.

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Artecoll Granuloma: A Rare Adverse Reaction Induced by Microimplant in the Treatment of Neck Wrinkles

Abstract: To our knowledge, this case is the first report of an extensive Artecoll-induced granuloma on the neck. Our findings suggest that Artecoll not be used as implant material in thin and constantly movable skin, such as that of the neck.

Cited by 40 publications

References 14 publications

Foreign Body Granulomas after All Injectable Dermal Fillers: Part 1. Possible Causes

Foreign Body Granulomas after All Injectable Dermal Fillers: Part 1. Possible Causes

Clinical data on injectable tissue fillers: a review

Comparison of Artecoll, Restylane and silicone for augmentation rhinoplasty in 378 Chinese patients

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