Abstract
Study Background: Soft tissue temporary and semi-permanent fillers continue to increase in popularity worldwide for facial rejuvenation. The study aims to review the cosmetic use and complication rate in large retrospective case series of Polymethyl Methacrylate (PMMA) microspheres in facial rejuvenation.
Methods: The study is a retrospective case series of 779 patients that underwent PMMA filler by one senior provider (NM) for facial rejuvenation to 7 consistent and reproducible areas of the face determined from chart review in order of preference: Peri-oral (589), Infra-orbital (395), Nasolabial folds (379), Temporal (212), Cheek (161), Glabella (99), and Scar area (8) from February 2009 to September 2015 and the chart review was completed in May 2016.
Results: The average age at first injection was 51.4 years old with standard deviation of 12.2 years. Seven hundred and six patients were female and 73 were male. Forty-three (5.4%) patients injected with PMMA had nodular complications. The average time to first sign of complication was 1.2 years with a range of .02 to 4.61 years. Prior blepharoplasty, rhytidectomy, rhinoplasty, Fitzpatrick skin classification, or history of autoimmunity was not significant to nodular complication. Thirty-four patients resolved with multiple steroid injections averaging 3.7 injections to resolution. Five were lost to follow up. Four have had ongoing injections with one undergoing surgical resection for multiple infra-orbital and peri-oral nodules.
Conclusions: Injection of permanent PMMA filler using a subdermal technique in the context of facial rejuvenation is possible with clinically significant cosmetic benefit. Since this is an off-label use of PMMA filler, caution must be taken with full disclosure to the patient leading to informed consent.
Citation
Mani N, Mani M, Sauder DN and Bothwell MR. Polymethyl Methacrylate Microspheres in the Treatment of Facial Rejuvenation: A Large Retrospective Series. SM Dermatolog J. 2016; 2(1): 1006.