Artefill is a permanent injectable wrinkle filler. Invented by a German plastic surgeon, it has been used for more than 13 years in the UK where it goes by the name of Artecoll. It is reputedly responsible for Liz Hurley's pout.

Artecoll has not been without controversy. There have been numerous cases in the UK and Canada of the product migrating unbidden to areas of the face that were not injected and causing something called granulomatous (nasty bumps and lumps).

It is a pretty simple mixture of 80% bovine collagen and 20% PMMA, polymethylacrylate, or as you and I would more likely recognize it, acrylic or Plexiglas. Its consistency is not unlike toothpaste. The bovine collagen eventually disappears leaving the acrylic, which is more than permanent: just think, it will be still be there long after you are gone. Talk about getting your money's worth. As one doctor and early adopter who has since stopped administering to his patients, Claudio de Lorenzi said, the only way to remove it, is to cut it out.

It was FDA approved for the US a couple of years ago, with some minor changes. Artefill was required to reduce the bead size and make more uniform the PMMA, use only local cattle herds for the collagen and manufacture the product in an approved US facility.

One of the problems with Artecoll/Artefill is that the adverse effects can take years to develop. One woman is reported in a European medical journal as developing granulomatous about 12 years after the injections were carried out.