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Adverse results with PMMA fillers
Erick de Melo Carpaneda1, Carlos Augusto Carpaneda
1Instituto de Cirurgia do Lago Ltda., SHIS QI 09 Cj. E Bl. 1, Salas 1 a 6, Lago Sul, Brasília/DF, 71625-009, Brazil. carpaneda@carpaneda.com.br
Background:
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.
Methods:
Histological studies were performed on biopsy samples from patients who presented with side effects and acute and late complications after PMMA injections given at other health-care centers or aesthetic services.
Results:
The histological findings of the samples that were harvested from patients who developed clinical complications or side effects caused by injection of PMMA disclosed not only normal tissues from the implanted areas but also development of capsules that involved individual microspheres of PMMA, and when the capsules were close together they formed concentric capsular groups involving various sets of microspheres and their capsules.
Conclusions:
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.
Level Of Evidence Iv:
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors at www.springer.com/00266.
Insights
Polymethylmethacrylate (PMMA) injections can cause severe acute and chronic complications. Histological analysis reveals capsular contracture around PMMA microspheres, leading to tissue hardening and potential extrusion.
Area of Science:
- Plastic Surgery
- Dermatology
- Histopathology
Background:
- Polymethylmethacrylate (PMMA) is used for body contouring and filling depressions.
- PMMA injections are associated with significant acute and chronic clinical compilations.
- This study investigates the link between PMMA use and the physiopathology of its complications.
Purpose of the Study:
- To correlate the clinical application of PMMA with the physiopathology of acute and late complications.
- To analyze histological findings in patients experiencing side effects from PMMA injections.
Main Methods:
- Histological examination of biopsy samples from patients with PMMA-related complications.
- Samples were obtained from individuals who received PMMA injections at external facilities.
Main Results:
- Histological findings showed tissue encapsulation of individual PMMA microspheres.
- Concentric capsular groups formed around multiple PMMA microspheres.
- These capsules were observed in patients with clinical complications and side effects.
Conclusions:
- PMMA injections can lead to severe acute and chronic complications.
- Acute complications involve vascular compromise.
- Late-phase complications result from capsular contracture around PMMA particles, causing hardening, nodulation, and potential extrusion.
