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DOI: 10.1055/s-0044-1801343
The Risks of Polymethyl Methacrylate: An Integrative Review of 587 Complication Reports
Article in several languages: português | English Financial Support The authors declare that they did not receive financial support from agencies in the public, private or non-profit sectors to conduct the present study.Ensaios Clínicos Não. | Clinical Trials None.
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.
Authors' contributions
MMCS: data analysis and/or interpretation, final manuscript approval, conceptualization, study conception and design, methodology, writing – original draft preparation, writing – review & editing, and supervision; ALC: data analysis and/or interpretation, statistical analysis, study conception and design, methodology, writing – original draft preparation, and writing – review & editing; LHMCV: methodology, writing – original draft preparation, and writing – review & editing; PBSM: data analysis and/or interpretation, writing – original draft preparation, and writing – review & editing; IMAS: statistical analysis, writing – original draft preparation, and writing – review & editing; and MARM: final manuscript approval, project management, writing – review & editing, and supervision.
Publication History
Received: 14 August 2024
Accepted: 29 September 2024
Article published online:
27 January 2025
© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)
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Marcelo Moura Costa Sampaio, Alessandra Lima Costa, Luiz Henrique Megale Conteville Vianna, Pedro Burlacchini Sanches Marinho, Ionara Maria de Almeida Santos, Mariana Alcantara Rodrigues de Moraes. Os riscos do polimetilmetacrilato: Revisão integrativa de 587 casos de complicações. Revista Brasileira de Cirurgia Plástica (RBCP) – Brazilian Journal of Plastic Surgery 2024; 39: s00441801343.
DOI: 10.1055/s-0044-1801343