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Brazilian Consensus Recommendation on the Use of Polymethylmethacrylate Filler in Facial and Corporal Aesthetics

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Abstract

Background

Considering that aesthetic benefits can be obtained with the use of permanent filling materials, this work focuses on the development of a consensus regarding the facial and corporal use of polymethylmethacrylate (PMMA) filler in Brazil.

Methods

A questionnaire regarding PMMA treatment, which included items on the main indication, application site, volume of product applied, criteria for selection of the material, complications, contraindications, and individual professional experience, was distributed to the Expert Group members. In addition, the responses were summarized, constituting the starting point for the debate regarding the use of PMMA-based fillers on The First Brazilian PMMA Symposium to create a guideline to be followed in PMMA facial and corporal treatments.

Results

This survey involved 87,371 cases. PMMA treatment is recommended for restorative and aesthetic purposes in facial and corporal cases, particularly for facial balance. PMMA 30% filler is recommended in specific facial sites (nose, mentum, mandible angle, zygomatic arc, and malar). PMMA filler is contraindicated in other sites (lips) regardless of concentration. With regard to facial treatment, the juxtaperiostal is the application plane most recommended. For PMMA corporal application, intramuscular is the application plane most indicated, while intradermal and justadermal planes are contraindicated. The submuscular plane application is relative to PMMA filler concentration. The experts also inquired regarding the amount of PMMA recommended in each corporal site (50 mL in the calf, 100–150 mL in the gluteal region).

Conclusion

These recommendations provide a guideline for physicians, supporting them to perform safe and efficacious treatment with PMMA fillers.

Level of Evidence V

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 Table of Contents or the online Instructions to Authors www.springer.com/00266.

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References

  1. American Society of Plastic Surgeons (2016) ASPS cosmetic plastic surgery statistics, cosmetic procedure trends. American Society of Plastic Surgeons. https://www.plasticsurgery.org/documents/News/Statistics/2016/cosmetic-procedure-trends-2016.pdf

  2. Funt D, Pavicic T (2013) Dermal fillers in aesthetics: an overview of adverse events and treatment approaches. Clin Cosmet Investig Dermatol 6:295–316

    PubMed  PubMed Central  Google Scholar 

  3. International Society of Aesthetic Plastic Surgery (2014) ISAPS international survey on aesthetic/cosmetic procedures performed in 2014. International Society of Aesthetic Plastic Surgery. https://www.isaps.org/news/isaps-global-statistics

  4. Buck DW, Alam M, Kim JY (2009) Injectable fillers for facial rejuvenation: a review. J Plast Reconstr Aesthet Surg 62:11–18

    Article  PubMed  Google Scholar 

  5. Requena L, Requena C, Christensen L, Zimmermann US, Kutzner H, Cerroni L (2011) Adverse reactions to injectable soft tissue fillers. J Am Acad Dermatol 64:1–34 (quiz 35–36)

    Article  CAS  PubMed  Google Scholar 

  6. Murray CA, Zloty D, Warshawski L (2005) The evolution of soft tissue fillers in clinical practice. Dermatol Clin 23:343–363

    Article  CAS  PubMed  Google Scholar 

  7. Sanchez-Carpintero I, Candelas D, Ruiz-Rodriguez R (2010) Dermal fillers: types, indications, and complications. Actas Dermosifiliogr 101:381–393

    Article  CAS  PubMed  Google Scholar 

  8. Carvalho Costa IM, Salaro CP, Costa MC (2009) Polymethylmethacrylate facial implant: a successful personal experience in Brazil for more than 9 years. Dermatol Surg 35:1221–1227

    Article  CAS  PubMed  Google Scholar 

  9. Lemperle G, Sadick NS, Knapp TR, Lemperle SM (2010) ArteFill permanent injectable for soft tissue augmentation: II. Indications and applications. Aesthetic Plast Surg 34:273–286

    Article  PubMed  Google Scholar 

  10. Brasil (2009) Manual de tratamento da lipoatrofia facial : recomendações para o preenchimento facial com polimetilmetacrilato em portadores de HIV/aids. In: Ministério da Saúde, Secretaria de Vigilância em Saúde, Departamento de DST, Aids e Hepatites Virais. https://www.saudedireta.com.br/docsupload/1340370403man_lipoatrofia03-web.pdf

  11. Dornelas MT, Corrêa MPD, Netto GM, Barra FML, Alves SGS, Dornelas MC, Corrêa LD, Cunha LAC, Soares CE, Cruz G (2012) Bioplasty for lipodystrophy in patients with HIV/AIDS. Rev Bras Cir Plast 27:387–391

    Article  Google Scholar 

  12. Goldberg DJ (2009) Breakthroughs in US dermal fillers for facial soft-tissue augmentation. J Cosmet Laser Ther 11:240–247

    Article  PubMed  Google Scholar 

  13. Luebberding S, Alexiades-Armenakas M (2013) Facial volume augmentation in 2014: overview of different filler options. J Drugs Dermatol 12:1339–1344

    CAS  PubMed  Google Scholar 

  14. Salles AG, Lotierzo PH, Gemperli R, Besteiro JM, Ishida LC, Gimenez RP, Menezes J, Ferreira MC (2008) Complications after polymethylmethacrylate injections: report of 32 cases. Plast Reconstr Surg 121:1811–1820

    Article  CAS  PubMed  Google Scholar 

  15. Lam SM (2015) Periocular injectables with hyaluronic acid and polymethyl methacrylate using microcannulas. In: Hartstein M, Facs M, Massry MD, Facs G, Holds MD, Facs J (eds) Pearls and pitfalls in cosmetic oculoplastic surgery. Springer, New York

    Google Scholar 

  16. Lemperle G, Gauthier-Hazan N, Wolters M, Eisemann-Klein M, Zimmermann U, Duffy DM (2009) Foreign body granulomas after all injectable dermal fillers: part 1. Possible causes. Plast Reconstr Surg 123:1842–1863

    Article  CAS  PubMed  Google Scholar 

  17. Li D, Luo SK, Wang YC, Lemperle G (2017) Facial volume restoration with permanent dermal filler (artecoll-4) in chinese women. Facial Plast Surg 33:537–544

    Article  CAS  PubMed  Google Scholar 

  18. Zielke H, Wolber L, Wiest L, Rzany B (2008) Risk profiles of different injectable fillers: results from the injectable filler safety study (IFS study). Dermatol Surg 34:326–335 (discussion 335)

    CAS  PubMed  Google Scholar 

  19. Piacquadio D, Smith S, Anderson R (2008) A comparison of commercially available polymethylmethacrylate-based soft tissue fillers. Dermatol Surg 34(1):S48–S52

    CAS  PubMed  Google Scholar 

  20. Nácul AM (2007) Bioplastia: a plástica interativa, 1a edn. Santos, São Paulo

    Google Scholar 

  21. Yoho RA, Romaine JJ, O’Neil D (2005) Review of the liposuction, abdominoplasty, and face-lift mortality and morbidity risk literature. Dermatol Surg 31:733–743 (discussion 743)

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Clínica Prime - Rua Tiradentes, 3292, Uruguaiana, RS, 97501-630, Brazil

    Túlio Armanini Blanco Souza

  2. Programa de Pós-graduacão em Ciências Farmacêuticas, Universidade Federal do Pampa—UNIPAMPA, BR 472, Km 592, Uruguaiana, RS, 97500-970, Brazil

    Letícia Marques Colomé & Eduardo André Bender

  3. Division of Plastic Surgery, University of California, 9500 Gilman Drive, La Jolla, CA, 92093, USA

    Gottfriede Lemperle

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  1. Túlio Armanini Blanco Souza
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  2. Letícia Marques Colomé
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  3. Eduardo André Bender
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  4. Gottfriede Lemperle
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Correspondence to Letícia Marques Colomé.

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Blanco Souza, T.A., Colomé, L.M., Bender, E.A. et al. Brazilian Consensus Recommendation on the Use of Polymethylmethacrylate Filler in Facial and Corporal Aesthetics. Aesth Plast Surg 42, 1244–1251 (2018). https://doi.org/10.1007/s00266-018-1167-1

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  • DOI: https://doi.org/10.1007/s00266-018-1167-1

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