The principle of PMMA injections- When injected inside the wrinkles and underneath the skin, the PMMA microspheres (micron sized plastic beads) are delivered into the tissue alongside with the collagen gel. After a few months, the collagen gel is broken down and absorbed and body’s newly formed collagen replaces its place by surrounding and encapsulating the PMMA microspheres.
While mostly claimed to be permanent, the world of plastic surgery only refers to PMMA fillers as being semi-permanent and only effective to use for the treatment of medium-to-deep wrinkles, folds and furrows, particularly nasolabial folds. It can also be used to fill out pitted scars and to augment thin lips.
Besides the traditional PMMA injections using collagen gel as carrier, a new generation of PMMA is told to be developed in Latin America which is reported to use a water-based carrier. This product has been developed in Brazil and mostly available in South American countries.
PMMA injections were developed based on the same principle as free fat transfer (FFT) in order to fill tissue gaps and defects with longer lasting results. As with fat injections which needs a solid surrounding supportive tissue in order to revascularize and fill out a gap, PMMA injections require a solid collagen and soft tissue surrounding structure in order to a) stay put where injected and b) for the injected collagen/ water-based solution to be absorbed and replaced by the body’s natural collagen.
A large number of plastic surgeons utilize PMMA injections for facial rejuvenation and wrinkle reduction. The results reported are usually very well documented and associated with mild to moderate side effects- again, if injected in the right area of the body.
While reviewing past and current literature, many plastic and reconstructive surgeons do warn of the use of PMMA and other dermal fillers in areas larger than small wrinkles; in fact, many report revisional surgeries performed on patients with horrific side effects after PMMA injections in appropriate parts of the body.
“Artefill is a PMMA containing filler that is FDA approved for correction of the Nasolabial folds. Although originally manufactured by Artes Medical (reportedly bankrupt), it has been picked up by Suneva for distribution. It is 80% Bovine (cow) Collagen and 20% PMMA. Each 1cc syringe when administered by a physician may range from $1000-2000. Clearly this is available for use as an off-label indication. However the economic costs are not the reason why physicians do perform the procedure. There are concerns with granuloma formation and other possible side effects.”
“PMMA injections are NOT approved by the FDA for soft tissue augmentation. No REPUTABLE Plastic surgeon will do them because it involves placing small, hard particles in soft tissue which leads to irreversible scarring and lifelong complications. DO NOT DO IT.”
“As you can see every single person on the panel is against both of the products. What other info could you possibly need? PMMA is not reversible and I saw a patient today using a walker for the last 2 years after having PMMA.”
“Once a week I see a patient who went abroad for discount surgery and had problems. If you want to be educated and get information seek it from a qualified Plastic Surgeon in the good old USA. We may be more expensive, but you know who we are, we have malpractice insurance if you have a problem and we have peer review and usually follow good ethical morals. Nothing is approved for injection into the butt for augmentation.”
“The complications I have seen are horrific, even though not deadly.”
Aesthetic Plast Surg. 2012 Aug;36(4):955-63. doi: 10.1007/s00266-012-9871-8. Epub 2012 Mar 22.
Various alloplastic materials have been used for filling depressions and for body contouring. Among them, polymethylmethacrylate (PMMA) has provoked many clinical compilations in both the acute and chronic phases. This study shows the correlation between the clinical application of PMMA and the physiopathology of the acute and late complications.
The injection of PMMA within the tissues can cause severe complications and side effects in both acute and chronic phases. Initially, the complications are related to vascular compromise, but at the late phase they are a consequence of capsular contracture that involves particles of PMMA. The contracture causes local tissue hardening and clinical nodulation of the implanted areas, ending with extrusion of the filler material.
As with all types of surgical procedures, PMMA Penile Augmentation procedures can also be associated with general complications such as swelling, bleeding, pain, hematoma, and infection. Risks and complications specifically reported with PMMA Penile Augmentation procedures are based on two general pathophysiological mechanisms:
A) Injection of a free gel inside a pocket between the penile shaft and shaft skin
Specific risks and complications:
B) Injection of an army of micro-beads inside the same pocket
Specific risks and complications: