Abstract
Introduction The demand for minimally-invasive esthetic procedures has boosted the use of polymethyl
methacrylate (PMMA) as a dermal filler, which was initially approved for human immunodeficiency
virus (HIV)-related lipodystrophies. Improper PMMA use can lead to severe complications,
including inflammation, material migration, infections, and systemic repercussions.
The present review investigated PMMA-related risks and complications reported in the
literature over the past 20 years.
Materials and Methods We conducted an integrative review of descriptive studies on PMMA complications published
from 2004 to 2024 and retrieved from PubMed, Scientific Electronic Library Online
(SciELO), and Scopus. We analyzed 38 studies, encompassing 587 cases, and excluded
articles published outside the specified period and those not meeting the inclusion
criteria.
Results We identified 587 cases of PMMA-related complications, 64% of them occurring in Brazil.
The most common complication site was the malar region, followed by the nasolabial
fold, the gluteal area, and the lips. The complications ranged from immediate to delayed,
and from mild to severe. The most frequent complications included erythema (26%),
pruritus (16%), edema (11%), granulomas (21%), nodules (14%), and skin changes (8%).
Severe cases included renal failure, hypercalcemia, septic shock, infections, and
tissue necrosis. The volume injected ranged from 1.9 to 900 mL. The treatment predominantly
involved steroids, antibiotics, and surgical interventions, including excisions, abscess
drainage, and debridement.
Conclusion The use of PMMA fillers may lead to severe complications, often unrelated to the
correction of HIV-related lipodystrophies; PMMA presents significant risks, including
systemic complications, requiring surgical removal.
Keywords case reports - dermal fillers - polymethyl methacrylate - review - risk
Bibliographical Record
