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CC BY 4.0 · Revista Brasileira de Cirurgia Plástica (RBCP) – Brazilian Journal of Plastic Surgery 2025; 40: s00451810589
DOI: 10.1055/s-0045-1810589
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Complications of Polymethyl Methacrylate Use in Esthetic Procedures: A Review

Article in several languages: português | English

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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. Ensaio Clínico Não.
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Abstract

The search for alternatives to counteract the signs of aging has been increasing. One of these alternatives is polymethyl methacrylate (PMMA), a synthetic polymer and permanent dermal filler that is a low-cost and minimally-antigenic material which yields good esthetic outcomes. However, due to the potential complications, PMMA injections can be disastrous. Since the literature on the topic is scarce and healthcare professionals must be aware of these complications, the present study aimed to establish the relationship between PMMA use in esthetic procedures and its consequences. We conducted a review on the PubMed, Virtual Health Library, and SciELO databases, searching for articles published in any language from 2003 to 2023. The review included 27 studies. Early PMMA complications include pain, erythema, edema, allergies, hematomas, nodules, and tissue necrosis, which results from vascular obstruction and may lead to loss of tissue. In addition, there are reports of blindness and fat embolism resulting from improper PMMA application. Late complications can arise years after injection, and they include chronic inflammation, persistent granulomas, ulceration, allergic reactions, filler migration, infections, severe hypercalcemia, and renal failure. The use of PMMA in esthetic procedures can lead to severe complications, ranging from acute inflammations to permanent and fatal deformities, due to improper administration, lack of regulation, and the pursuit of quick outcomes. Therefore, it is essential to implement stringent regulatory and educational measures to protect the health and safety of the patients.

Keywords

cosmetic techniques - dermal fillers - imprudence - polymethyl methacrylate - postoperative complications

Study conducted at Universidade Cesumar, Maringá, PR, Brazil.




Publication History

Received: 09 July 2024

Accepted: 20 May 2025

Article published online:
09 September 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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Bibliographical Record
Henrique Cian da Cruz, Luana Tavares Neves, Júlia Tirloni Ramires, Natália Camila Correia Mendes, Giovana Beraldo Borges de Melo, Luísa Benincá Trentini, Ellen Fonseca Fumagale, Audrei Pavanello. Complicações do uso de polimetilmetacrilato em procedimentos estéticos: Uma revisão. Revista Brasileira de Cirurgia Plástica (RBCP) – Brazilian Journal of Plastic Surgery 2025; 40: s00451810589.
DOI: 10.1055/s-0045-1810589
 

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