2) Product Migration and Diffusion: PMMA is known for its tendency to migrate and diffuse into the surrounding tissue after injection. This can lead to asymmetrical and unwanted cosmetic results, as well as increase the risk of long-term complications, such as the formation of nodules and irregularities in skin texture.
3) Risk of Infection and Inflammatory Reactions: Due to the permanent nature of PMMA, there is an ongoing risk of infection and chronic inflammatory reactions after the procedure. The material can serve as an ideal substrate for bacterial growth, increasing the risk of local and systemic infection, which can be difficult to treat and require prolonged antibiotic therapy.
4) Lack of Long-Term Safety Evidence: Although PMMA is considered safe by the FDA for use in cosmetic procedures, there is still a significant lack of long-term safety data to support its continued use. The lack of adequate long-term patient follow-up raises concerns about unknown potential adverse effects in the future.
5) Personal Experience and Clinical Observations: In my practice as a plastic surgeon, I have personally witnessed the disastrous consequences of PMMA fillers in many patients. Serious complications such as chronic inflammation, tissue necrosis and permanent facial deformities are common in patients undergoing this procedure.
Based on these considerations, it is my professional opinion that filling with polymethylmethacrylate (PMMA) is not a safe or effective option for cosmetic procedures. I strongly recommend the use of safer and more proven alternatives, such as hyaluronic acid dermal fillers, which offer predictable results and a better established safety profile.
Bibliographic references:
- Lemperle, Gottfried, et al. “PMMA Microspheres for Intradermal Implantation: Part I. Animal Research.” Annals of Plastic Surgery 38.6 (1997): 553-559.
- Narins, Rhoda S., and Kenneth A. Beer. “Liquid injectable silicone: a review of its history, immunology, technical considerations, complications, and potential.” Plastic and Reconstructive Surgery 118.3S (2006): 77S-84S.
- Narins, Rhoda S., et al. “A randomized, double-blind, multicenter comparison of the efficacy and tolerability of Restylane versus Zyplast for the correction of nasolabial folds.” Dermatologic Surgery 27.10 (2001): 868-874.
- Goodstein, William, et al. “Complications of polymethylmethacrylate microspheres for soft-tissue augmentation: how well are we monitoring them?” Dermatologic Surgery 34.3 (2008): 285-289.
- Lemperle, Gottfried, et al. “PMMA Microspheres for Intradermal Implantation: Part II. Clinical and Histologic Studies.” Annals of Plastic Surgery 38.6 (1997): 553-559.