Is PMMA the only type of permanent filler for facial lipoatrophy? If not, what are the others. Also, I am told there are many different "brands" of PMMA (e.g. ArteFill). Are there studies or anecdotal information about which is best? Thanks.

Hello, and thanks for posting.

There are several permanent fillers that are available for treatment of facial lipoatrophy and these include PMMA, silicone, and Bioalcamid.

In the United States, Artefill is the brand of PMMA that is FDA approved. However, it is currently unavailable because the company that manufactures it has declared bankruptcy. Some providers may still have an inventory of Artefill, but this is rapidly being depleted.

Other brands of PMMA include Metacrill, New Plastic, and Artecoll. In addition, there are generic PMMA products that are made available through compounding pharmacies, mainly in South America. Comparative trials suggest that Artefill is the best quality PMMA, although it is extremely expensive.

Silicone is a permanent filler that has been used for facial lipoatrophy, and when micro droplet technique is used, the results are quite good. However, very few providers are expert in this injection technique.

Bioalcamid is available in Canada as a permanent filler. However, the risk of late infection related to this product has dampened enthusiasm for its use.

I hope this information helps and best of luck to you.