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Clinical experience with polymethylmethacrylate microsphere filler complications
Tae Hwan Park1, Sang Won Seo, June-Kyu Kim
1Department of Plastic and Reconstructive Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108 Pyung-Dong, Jongno-Gu, Seoul, 110-746, Korea. hard-piano@hanmail.net
Abstract:
Polymethylmethacrylate (PMMA) filler is widely used for the correction of wrinkles because of its relative long-lasting cosmetic improvements and the rarity of reported complications. However, early and delayed complications, ranging from minor to severe, can occur following PMMA filler injection. We evaluated and treated 13 cases of PMMA filler-related complications that were referred to our institution from July 2005 to June 2010. Of these patients, 92.3% were female and 7.7% were male. Complications were roughly classified as (1) nodular masses, (2) inflammation, (3) allergic reactions, and (4) discoloration. Affected locations were the lips, periocular wrinkles, nasolabial folds, forehead, marionette wrinkles, and cheeks. As there is no standard treatment modality for PMMA filler complications, patients were managed with various treatments aimed at minimizing morbidity. In the cases of lip granuloma, we recommended intralesional steroid injection first, followed by surgical excision, including lip mucosa and orbicularis oris muscle in intractable cases. Additional studies should be conducted to determine the safety of PMMA injection, reduce the occurrence of adverse reactions, and identify risk factors that are associated with higher complication rates.
Insights
Polymethylmethacrylate (PMMA) filler injections can cause complications like nodules and inflammation. Early and delayed adverse reactions require varied treatments due to the lack of standard protocols.
Area of Science:
- Dermatology
- Plastic Surgery
- Cosmetic Procedures
Background:
- Polymethylmethacrylate (PMMA) is a common filler for wrinkle correction, valued for lasting results and low complication rates.
- Despite its benefits, PMMA filler injections can lead to various early and delayed complications.
- This study reviews complications encountered at a single institution over a five-year period.
Observation:
- Thirteen cases of PMMA filler complications were evaluated and treated.
- The patient demographic was predominantly female (92.3%).
- Common complications included nodular masses, inflammation, allergic reactions, and discoloration affecting facial areas like lips and cheeks.
Findings:
- Complications presented as nodular masses, inflammation, allergic reactions, and discoloration.
- Affected sites included lips, periocular areas, nasolabial folds, forehead, marionette lines, and cheeks.
- Treatment varied due to the absence of standardized protocols, with intralesional steroids and surgical excision used for lip granulomas.
Implications:
- The findings highlight the need for further research into PMMA injection safety and risk factors.
- Developing standardized treatment protocols for PMMA filler complications is crucial.
- Minimizing morbidity associated with PMMA filler adverse events requires ongoing investigation and improved management strategies.