Resumen
Objetivo: Evaluar las principales complicaciones e indicaciones asociadas al uso de polimetilmetacrilato (PMMA) en dermatología y explorar prácticas recomendadas para la seguridad de los pacientes. Métodos: Revisión integrativa con recopilación de datos en PubMed Central sobre artículos publicados entre 2014 y 2024, en inglés. Tras la selección inicial de 648 artículos y la aplicación de criterios de inclusión y exclusión, se seleccionaron 14 estudios. Resultados: El uso de PMMA se asocia con complicaciones inmediatas, como dolor y edema, y tardías, como granulomas y cicatrices hipertróficas, requiriendo un seguimiento continuo. Las principales indicaciones son el relleno facial y el tratamiento de cicatrices, con resultados duraderos, especialmente en piel oscura. Sin embargo, áreas como la región periorbital presentan mayor riesgo. La técnica de inyección y la cuidadosa selección de pacientes son esenciales para minimizar riesgos. En comparación con el ácido hialurónico, el PMMA tiene menor riesgo de embolismos vasculares, pero es menos adecuado para tratamientos reversibles. El manejo de complicaciones puede incluir corticosteroides o, en casos graves, extracción quirúrgica. Consideraciones Finales: El uso de PMMA, a pesar de sus indicaciones, se relaciona con complicaciones, subrayando la necesidad de estudios adicionales sobre su seguridad y eficacia a largo plazo.
Referencias
AHN CS, RAO BK. The life cycles and biological end pathways of dermal fillers. Journal of Cosmetic Dermatology, 2014; 13: 212-223.
CARPANEDA EM CARPANEDA CA. Adverse Results with PMMA Fillers. Aesthetic Plastic Surgery, 2012; 36: 955–963.
COHEN S, et al. Five-Year Safety and Satisfaction Study of PMMA–Collagen in the Correction of Nasolabial Folds. Dermatologic Surgery, 2015; 41: S302-S313.
DURKIN AJ, et al. Surgical management of polymethylmethacrylate-collagen gel complications in the lower eyelid: A case series. Annals of Plastic Surgery, 2023; 90(1): 12-18.
FRIEDMANN DP, et al. Delayed granulomatous reactions to facial cosmetic injections of polymethylmethacrylate microspheres and liquid injectable silicone: a case series. Journal of Cosmetic and Laser Therapy, 2016; 18(3): 170-173.
GALADARI H. A randomized, prospective, blinded, split‐face, single‐center study comparing polycaprolactone to hyaluronic acid for treatment of nasolabial folds. Journal of Cosmetic Dermatology, 2015; 14(1): 27-32.
GOLD MH, SADICK NS. Optimizing outcomes with polymethylmethacrylate fillers. Journal of Cosmetic Dermatology, 2018; 17(3): 298-304.
GOLDMAN A, WOLLINA U. Intralesional neodymium YAG laser to treat complications of polymethylmethacrylate. Open access Macedonian journal of medical sciences, 2018; 6(9): 1636.
KARNIK J, et al. A double-blind, randomized, multicenter, controlled trial of suspended polymethylmethacrylate microspheres for the correction of atrophic facial acne scars. Journal of the American Academy of Dermatology, 2014; 71 (1): 77–83.
LIMONGI RM, et al. Complications and Management of Polymethylmethacrylate (PMMA) Injections to the Midface. Aesthetic Surgery Journal, 2016; 36(2): 132-135.
MACHADO RA, et al. Adverse reactions to the injection of face and neck aesthetic filling materials: a systematic review. Medicina Oral Patologia Oral y Cirugia Bucal, 2023; 28(3): e278-84.
MANFRO AG, et al. Case reports of hypercalcemia and chronic renal disease due to cosmetic injections of polymethylmethacrylate (PMMA). Brazilian Journal of Nephrology, 2020; 43: 288-292.
MEDEIROS CCG, et al. Complications after polymethylmethacrylate (PMMA) injections in the face: a literature review. Gerodontology, 2014; 31(4): 245-250.
MORAGAS JSM, et al. Systematic review of “filling” procedures for lip augmentation regarding types of material, outcomes and complications. Journal of Cranio-Maxillofacial Surgery, 2015; 43 (6): 883–906.
NIE F, et al. Risk Comparison of Filler Embolism Between Polymethyl Methacrylate (PMMA) and Hyaluronic Acid (HA). Aesthetic Plastic Surgery, 2019; 43: 853-860.
ORTIZ-ÁLVAREZ J, et al. Cutaneous and ganglion sarcoidosis induced by polycaprolactone facial filler: a new expression of ASIA syndrome?. European Journal of Case Reports in Internal Medicine, 2021; 8 (6).
PAULUCCI BP. PMMA safety for facial filling: review of rates of granuloma occurrence and treatment methods. Aesthetic Plastic Surgery, 2020; 44: 148-159.
RIVKIN A. PMMA-collagen gel in nonsurgical rhinoplasty defects: a methodological overview and 15-year experience. Plastic and Reconstructive Surgery–Global Open, 2022; 10(8): e4477.
SIGNORINI M, et al. Global Aesthetics Consensus: Avoidance and Management of Complications from Hyaluronic Acid Fillers—Evidence- and Opinion-Based Review and Consensus Recommendations. Plastic and Reconstructive Surgery, 2016; 137(6): 961e-971e.
SOUZA TAB, et al. Brazilian Consensus Recommendation on the Use of Polymethylmethacrylate Filler in Facial and Corporal Aesthetics. Aesthetic Plastic Surgery, 2018; 42: 1244-1251.
URDIALES-GÁLVEZ F, et al. Preventing the Complications Associated with the Use of Dermal Fillers in Facial Aesthetic Procedures: An Expert Group Consensus Report. Aesthetic Plastic Surgery, 2017; 41: 667-677.
