Complications and management of polymethylmethacrylate (pmma) injections to the midface

• Autor(a) principal: Roberto Murillolimongi
• Data de Publicação: 2016
• Outros Autores: Jeremiah Tao, André Borba, Filipe Pereira, Ana Rosa Pimentel de Figueiredo, Patrícia Akaishi, Antônio Augusto Velasco e Cruz
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UFMG
• Texto Completo: http://hdl.handle.net/1843/54522; https://orcid.org/0000-0002-7569-986X
• topic: Polymethylmethacrylate; Adverse effects; Injections; Polimetil Metacrilato; Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos; Injeções

Background: Polymethylmethacrylate (PMMA) has been used as an injectable filler to treat hollows and reduce rhytids. PMMA injections have been associated with several side effects, however, the literature is scarce on periorbital complications and their treatments.Objectives: The purpose of this study is to report a series of complications after periorbital PMMA injections to the midface and to describe their management.Methods: Retrospective chart review, including photography and histopathology when available. Results: The authors identified 11 cases of complications of PMMA injections to the midface. Patient ages ranged from 36 to 62 years (mean, 47 years;median, 44 years). Two (18%) were males and 9 (82%) were females. Adverse effects began between 2 to 24 months after injection (mean, 7.2 months;median, 6 months). All patients had edema, erythema, and contour irregularity. Seven (64%) patients had nodules, 4 (36%) had yellow, xanthomatousskin changes, and 2 (18%) had eyelid malposition. Histopathology demonstrated a giant cell inflammation in 5 of 6 cases. Corticosteroid injection was tried in 6 cases but was associated with minimal clinical improvement. Surgical debulking of the implanted material was performed in 9 (82%) cases and was effective in improving edema, erythema, and nodularity.Conclusions: PMMA injection to the midface may be associated with chronic inflammation, fibrotic nodules, yellowing of the skin, and eyelid malposition. Intralesional corticosteroid injections yielded minimal or no improvement; surgical debulking achieved favorable results.