Prevention and Treatment of Complications after Polymethylmethacrylate-Microspheres Injections

Julia Vent; Gottfried Lemperle

doi:10.1055/s-0034-1396703

Facial Plastic Surgery, Table of Contents

Facial Plast Surg 2014; 30(06): 628-634
DOI: 10.1055/s-0034-1396703

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Prevention and Treatment of Complications after Polymethylmethacrylate-Microspheres Injections

Julia Vent

¹Department of Otorhinolaryngology, Head and Neck Surgery, University of Heidelberg, Medical Center at Mannheim, Mannheim, Germany

,

Gottfried Lemperle

²Private Practice, Frankfurt am Main, Frankfurt, Germany

³Clinical Professor, University of California-San Diego, San Diego, CA

› Author Affiliations

Abstract

The present article focuses on the peculiarities of polymethylmethacrylate as facial filler highlighting the injection technique, known adverse effects, and all options for complication management. Supplemented by a historical overview and case series, the authors share their experience with this widespread and in the last decade heavily criticized injectable filler substance.

Keywords

Artecoll - Artefill - Metacrill - PMMA - granuloma - adverse event - complication management

Full Text

References

References
1 Lemperle G, Hazan-Gaúthier N, Lemperle M. PMMA microspheres (Artecoll) for skin and soft-tissue augmentation. Part II: Clinical investigations. Plast Reconstr Surg 1995; 96 (3) 627-634
2 Knapp TR, Kaplan EN, Daniels JR. Injectable collagen for soft tissue augmentation. Plast Reconstr Surg 1977; 60 (3) 398-405
3 Lemperle G, Ott H, Charrier U, Hecker J, Lemperle M. PMMA microspheres for intradermal implantation: Part I. Animal research. Ann Plast Surg 1991; 26 (1) 57-63
4 Lemperle G, Knapp TR, Sadick NS, Lemperle SM. ArteFill permanent injectable for soft tissue augmentation: I. Mechanism of action and injection techniques. Aesthetic Plast Surg 2010; 34 (3) 264-272
5 Lemperle G, Sadick NS, Knapp TR, Lemperle SM. ArteFill permanent injectable for soft tissue augmentation: II. Indications and applications. Aesthetic Plast Surg 2010; 34 (3) 273-286
6 Cohen SR, Berner CF, Busso M , et al. Five-year safety and efficacy of a novel polymethylmethacrylate aesthetic soft tissue filler for the correction of nasolabial folds. Dermatol Surg 2007; 33 (Suppl. 02) S222-S230
7 Narins RS, Cohen SR. The 5-year investigator study group. Novel polymethylmethacrylate soft tissue filler for the correction of nasolabial folds: Interim results of a 5-year long-term safety and patient satisfaction study. Dermatol Surg 2010; 36 (Suppl. 01) 766-774
8 Hilinski JM, Cohen SR. Soft tissue augmentation with ArteFill. Facial Plast Surg 2009; 25 (2) 114-119
9 Epstein RE, Spencer JM. Correction of atrophic scars with artefill: an open-label pilot study. J Drugs Dermatol 2010; 9 (9) 1062-1064
10 Mills DC, Camp S, Mosser S, Sayeg A, Hurwitz D, Ronel D. Malar augmentation with a polymethylmethacrylate-enhanced filler: assessment of a 12-month open-label pilot study. Aesthet Surg J 2013; 33 (3) 421-430
11 Dansereau A, Hamilton D, Kavouni A , et al. A report on the safety of and satisfaction with particle-based fillers, specifically polymethylmethacrylate microspheres suspended in collagen. Cosmet Derm 2008; 21: 151-156
12 Solomon P, Sklar M, Zener R. Facial soft tissue augmentation with Artecoll(®): A review of eight years of clinical experience in 153 patients. Can J Plast Surg 2012; 20 (1) 28-32
13 Haneke E. Polymethyl methacrylate microspheres in collagen. Semin Cutan Med Surg 2004; 23 (4) 227-232
14 De Boulle K. Critical reflections on ArteFill, a permanent injectable product for soft tissue augmentation: mechanism of action and injection techniques, indications, and applications. Aesthetic Plast Surg 2010; 34 (3) 287-289
15 Wang YC, Luo SK. Volumetric facial rejuvenation with dermal filler (Artecoll) in Chinese women. Aesthetic Plast Surg 2014; ; In press
16 Serra MS, Oyafuso LK, Trope BM, Munhoz Leite OH, Ramos-e-Silva M. An index for staging facial lipoatrophy and evaluation of the efficacy of the treatment with polymethylmethacrylate in HIV/AIDS patients: a pilot study. J Eur Acad Dermatol Venereol 2013; 27 (8) 990-996
17 Piacquadio D, Smith S, Anderson R. A comparison of commercially available polymethylmethacrylate-based soft tissue fillers. Dermatol Surg 2008; 34 (Suppl. 01) S48-S52
18 Salles AG, Lotierzo PH, Gemperli R , et al. Complications after polymethylmethacrylate injections: report of 32 cases. Plast Reconstr Surg 2008; 121 (5) 1811-1820
19 Gelfer A, Carruthers A, Carruthers J, Jang F, Bernstein SC. The natural history of polymethylmethacrylate microspheres granulomas. Dermatol Surg 2007; 33 (5) 614-620
20 Castro AC, Collares MV, Portinho CP, Dias PC, Pinto Rd. Extensive facial necrosis after infiltration of polymethylmethacrylate. Braz J Otorhinolaryngol 2007; 73 (6) 850
21 Winslow CP. The management of dermal filler complications. Facial Plast Surg 2009; 25 (2) 124-128
22 Grunebaum LD, Bogdan Allemann I, Dayan S, Mandy S, Baumann L. The risk of alar necrosis associated with dermal filler injection. Dermatol Surg 2009; 35 (Suppl. 02) 1635-1640
23 de Figueiredo JC, Naufal RR, Zampar AG, Mélega JM. Expanded median forehead flap and abbé flap for nasal and upper lip reconstruction after complications of polymethylmethacrylate. Aesthetic Plast Surg 2010; 34 (3) 385-387
24 Al-Qattan MM. Complications related to Artecoll injections for soft tissue augmentation of the hand: 3 case reports. J Hand Surg Am 2011; 36 (6) 994-997
25 Omranifard M, Taheri S. Filler augmentation, safe or unsafe: A case series of severe complications of fillers. J Res Med Sci 2011; 16 (12) 1627-1631
26 Requena L, Requena C, Christensen L, Zimmermann US, Kutzner H, Cerroni L. Adverse reactions to injectable soft tissue fillers. J Am Acad Dermatol 2011; 64 (1) 1-34 , quiz 35–36
27 Quirino MR, Neves AC, Campos MS, Brandão AA, Anbinder AL. Oral granuloma formation after injection of cosmetic filler. J Craniomaxillofac Surg 2012; 40 (7) e194-e197
28 de Melo Carpaneda E, Carpaneda CA. Adverse results with PMMA fillers. Aesthetic Plast Surg 2012; 36 (4) 955-963
29 Park TH, Seo SW, Kim JK, Chang CH. Clinical experience with polymethylmethacrylate microsphere filler complications. Aesthetic Plast Surg 2012; 36 (2) 421-426
30 Medeiros CC, Cherubini K, Salum FG, de Figueiredo MA. Complications after polymethylmethacrylate (PMMA) injections in the face: a literature review. Gerodontology 2014; 31 (4) 245-250
31 Ozturk CN, Li Y, Tung R, Parker L, Piliang MP, Zins JE. Complications following injection of soft-tissue fillers. Aesthet Surg J 2013; 33 (6) 862-877
32 Faria KM, Fonseca FP, Silva WG , et al. Fine needle aspiration cytology in the diagnosis of perioral adverse reactions to cosmetic dermal fillers. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 117 (5) e393-e395
33 Lemperle G, Gauthier-Hazan N, Wolters M, Eisemann-Klein M, Zimmermann U, Duffy DM. Foreign body granulomas after all injectable dermal fillers: part 1. Possible causes. Plast Reconstr Surg 2009; 123 (6) 1842-1863
34 Silva MT, Curi AL. Blindness and total ophthalmoplegia after aesthetic polymethylmethacrylate injection: case report. Arq Neuropsiquiatr 2004; 62 (3B) 873-874
35 Lemperle G, Anderson R, Knapp TR. An index for quantitative assessment of lip augmentation. Aesthet Surg J 2010; 30 (3) 301-310
36 Lemperle G, Gauthier-Hazan N. Foreign body granulomas after all injectable dermal fillers: part 2. Treatment options. Plast Reconstr Surg 2009; 123 (6) 1864-1873
37 Lemperle G, Nicolau P, Scheiermann N. Is there any evidence for biofilms in dermal fillers?. Plast Reconstr Surg 2011; 128 (2) 84e-85e
38 Vent J, Lefarth F, Massing T, Angerstein W. Do you know where your fillers go? An ultrastructural investigation of the lips. Clin Cosmet Investig Dermatol 2014; 7: 191-199