PMMA: understand the pros and cons of this type of filling
PMMA is an acronym for polymethylmethacrylate and is a material that fills tissue volumes, used in fills that alter some body shapes, a procedure called by some bioplasty professionals. It is a type of plastic, presented in a microsphere format.
However, its use receives a number of caveats. It has typically been used for body and facial fillers, but ideally it should be used in small quantities mainly due to the poor quality of some of its products on the market. It should only be used with the prescription of a specialist, in the case a dermatologist or plastic surgeon, and in the amounts recommended by him, after all is a definitive implant and can cause complications such as nodule formation, stiffening of the region, infection, allergies, chronic pain, organ rejection and even tissue necrosis.
Some types of PMMA are prohibited from being used in Brazil by the National Agency of Sanitary Surveillance (Anvisa)
Indications of PMMA
PMMA has the effect of filling certain regions. The procedure is usually more used on the face, because the method allows to change the region of the cheek apples (malar and zygomatic region), chin, wrinkles and contour of the jaw, making it more delimited and accented. Some people report having applied it to the buttocks and calves, but the application of large amounts is controversial because of the high potential for complication. PMMA application can also be used to correct facial lipoatrophy in patients with AIDS, or the fat loss that HIV-positive patients present and gives them a more aged appearance. In these cases, PMMA filling is one of the possible techniques that help the patient regain an appearance more suited to their chronological age.
PMMA is injected into microspheres. It must be purified so that the diameters of the spheres exceed 50 microns (i.e., 0.05 mm). The very small spheres cause complications like inflammatory reaction and allergies, as they are attacked and absorbed by the cells of the immune system. Only a minority of manufacturers achieve this quality, and these products are much more expensive. Therefore, it is not financially feasible to apply large quantities of PMMA.
Irrespective of the quantity applied, chronic inflammatory reactions, chronic pain, infections, nodule formation, regional stiffening, organ rejection and even tissue necrosis may occur.
When applied in large volumes, PMMA can also spread to other regions of the body. There is still the appearance that the product is injected into the deep layers of the skin and its total removal is very difficult and complicated, which makes it a definitive implant.
How PMMA is used
PMMA is applied through microcânules, similar to a tipless needle. The method consists of the implantation of polymethylmethacrylate (PMMA). It is worth mentioning that filling with PMMA is an outpatient procedure, ie it should be done in a hospital setting.
Care before PMMA application
Before PMMA is applied, a medical consultation, including a clinical history and an adequate physical assessment. Only in special cases are laboratory tests requested. The preoperative treatment consists of the hygiene of the region and the application of topical or local anesthetic.
Care after the application of PMMA
Only on the first day is it important to avoid lowering your face or making too much effort. In general, after the procedure there is no need for extra care, but it is recommended to use painkillers and avoid excessive movement of the site. If the region becomes a little swollen, it is necessary to apply cold or cold compresses. It is also important not to expose the direct action of the sun and to use sunscreen with SPF above 30.
To be submitted to the PMMA application it is necessary to have a medical indication and be in good health. > Before and after PMMA
After PMMA the results vary according to the region applied: there is improvement of the facial contour, increase of the apple of the face and reduction of nasogenian folds (the famous Chinese mustache). The technique attenuates the consequences of skin and muscle aging and also increases the volume of regions such as glutes and calves. But the method is also used to model, for example, the nose.
Replace the hydrogel with ...
This method is safer because silicone, although it is a plastic, is protected in the prosthesis, with no risk of spreading through the body. Its use can help gluteal augmentation in gluteoplasty.
Hyaluronic Acid This filler is considered much safer by the Brazilian Society of Plastic Surgery. This occurs because acid is a natural substance in the skin, which over time is absorbed by the body without damage. In addition, it rarely causes allergies, and when this occurs there is an enzyme, called hyaluronidase, itself to remove it. Sources
Plastic Surgeon André Eyler (CRM-RJ: 667,862), member of the Brazilian Society of Plastic Surgery and the American Society of Plastic Surgery
Mesotherapy consists of the application of medicinal substances to the skin, below it or in the muscles, for specific purposes. Usually it is applied for treatment of white streaks, localized fat and even hair loss. Several compounds can be applied, which are mixed according to the patient's complaint.
Plastic surgery is a technique that must be planned so that everything goes well. A great result depends not only on the appropriate surgical procedure, but also on the appropriate postoperative period. As important as surgery is to schedule the intraoperative steps and, in the postoperative period, maintain the results obtained.