Filling with PMMA is definitive, difficult to remove and generates deformations

Aesthetic procedures with fillers are increasingly sought after by men and women who want to give more volume to some parts of the face and body. These interventions become more popular and desired as celebrities like singer Anitta openly talk about what they’ve done to feel more beautiful.

Last month, comedian Rico Melquiades, champion of the last edition of the reality show A Fazenda, showed on his social networks that he used PMMA to increase thighs and glutes. The revelation sparked a debate about the safety of this product.

Polymethylmethacrylate, known as PMMA, is a definitive filler in the form of a gel used in aesthetic procedures and for correction of lipodystrophy, a change in the amount of fat in the body that can occur in patients with HIV.

It is a plastic component, so it is not resorbable by the body. Once introduced into the body, it adheres to structures such as muscle, skin and bone, so that its complete removal is almost impossible even with surgery.

The dermatologist Newton Morais, director of Clínica Mais, in São Paulo, does not recommend the use of the product. “Most people are deluded with the idea of ​​being something definitive, but that’s a negative aspect for a filler with an aesthetic purpose”, he says.

“The aging process is continuous and our body is constantly changing over the years. Our skin thins, there is loss of fat and muscle, bone resorption. So that definitive filler that had a satisfactory result today, will no longer be in harmony with the person’s face ten years from now”, he observes.

That’s what happened to beautician Yllana Maiara de Freitas Figueiredo, 32. She says that four years ago, after filling in with hyaluronic acid a few times – a substance present in the human body, but which can also be produced in the laboratory – she decided to choose by the final product. “I did it with a plastic surgeon and it was applied in the region of the nasolabial folds”, she says.

“I was deformed. Too much product was placed and it migrated from place”, explains the beautician, who did not want to go back to the same doctor to complain about the result.

“I waited for about four months to deflate, I thought it would decrease, that it was just a phase. When I got real, I started looking on the internet for doctors who took the product and I was shocked to discover that very few professionals do this procedure”, she reports.

Yllana has already had four surgeries to get rid of polymethylmethacrylate, the last one a month ago. “I’m recovering, still a little swollen. In total, about 95% of PMMA is gone, but you can never take it all out.”

Today she is part of a WhatsApp group that brings together women who have had problems with cosmetic procedures of various types.

Many of them met through the profile Victims of Bioplasty, on Instagram, which publishes reports of patients who had reactions with PMMA, industrial silicone — a substance whose application in the human body is prohibited — and other aesthetic interventions.

The profile is managed by Simone, who prefers not to disclose her surname because she says she is threatened by professionals who perform these procedures. In 2018, she underwent a rhinomodeling with PMMA and liked the result so much that she decided to increase her glutes with the same product.

Shortly after the procedure, the administrator says that she felt very ill, had a fever and could not breathe properly. Simone went to another doctor, had an ultrasound exam and found that it was industrial silicone, not PMMA, that she had in her body.

Simone has already had two surgeries to remove the substance. In 2020, after some wounds appeared on her nose, she also had the substance removed.

“Every day I receive messages from women who have had their bodies mutilated. I don’t post even half of what I get,” he says.

Sought by the report, the SBCP (Brazilian Society of Plastic Surgery) says that it does not recommend the use of polymethylmethacrylate because the product can cause complications that are difficult to resolve. The exception only applies to patients with HIV lipodystrophy.

“PMMA is not absorbable and, in the event of a complication, there is no way to dissolve it. Among the undesirable occurrences are the appearance of nodules, inflammatory and infectious processes and irreversible damage”, he highlights in a note.

Plastic surgeon Alberto Goldman has been performing surgery to remove the substance for 15 years. “The complications I see in the office are usually granuloma formations [nódulos de caráter inflamatórios], functional difficulties, such as speaking and smiling, depending on where polymethylmethacrylate was introduced. I get a lot of patients with facial asymmetries, with major inflammatory reactions, who swell and swell from time to time,” he says.

The removal of the product must be very well planned, reinforces the surgeon, since it is practically impossible to remove it completely due to adherence to muscles, skin and bones.

Polymethylmethacrylate, however, is released by Anvisa (National Health Surveillance Agency) for aesthetic and repair purposes.

Asked about the safety of the product, the agency replied in a note that PMMA “should only be administered by trained medical professionals. For each case, the doctor must determine the injected doses and the number of injections necessary, depending on the skin, muscular and osteocartilaginous lesions of each patient, the areas to be treated and the type of indication”, he emphasizes.

Physician Túlio Souza, with an international specialization in cosmetic surgery, has been making fillings with polymethylmethacrylate for 14 years and trusts in the safety of the product. He states that, like other medical procedures, the indication must be evaluated according to the needs and particularities of each patient.

“In general, PMMA should be used for deeper volumizations. In the jaw muscle, for example. In more superficial regions it is possible to use lower density polymethylmethacrylate, but in these cases, in most cases, hyaluronic acid has better results”, he reveals.

Currently, the two products based on polymethylmethacrylate that are endorsed by Anvisa are Biossimetric, manufactured by MTC Medical, and Linnea Safe, by the Lebon laboratory.

MTC Medical declares that swelling, inflammation and infection are not caused by the product itself. “Any procedure (cut, injection, surgery), especially with an infiltrated foreign body, will generate a swelling reaction.”

​The manufacturer reinforces that no event or serious undesirable effect has been observed to date since the launch of the product in 2008, provided that the indications, recommendations, implantation techniques and care with handling are observed.

The Lebon laboratory highlights that Linnea Safe has been registered with Anvisa since 2006 and is also marketed in Mexico, Ecuador and Argentina, being approved by the regulatory agencies of the respective countries.

“In addition, filling with PMMA is recommended by Conitec (National Commission for the Incorporation of Technologies in the Unified Health System), proving the safety, efficacy and quality of the product for the recommended purposes”, he says in a note.