PMMA (polymethyl methacrylate): what it is and the risks

PMMA stands for polymethyl methacrylate, a synthetic polymer used in medicine for decades, for example in bone cements and lenses. As an injectable filler, it is formulated as microspheres suspended in a carrier, usually collagen or another gel. The carrier is absorbed, and the microspheres stay in the tissue, surrounded by the body's fibrous reaction.

That is why PMMA is a permanent filler: the body does not break the material down. This is the feature that most sets it apart from hyaluronic acid and from absorbable collagen biostimulators.

Which complications are described?

The literature and health alerts describe complications that can appear right after the injection or years later:

• Nodules and granulomas, sometimes delayed and hard to treat.
• Inflammatory reactions and persistent infections.
• Product migration and contour irregularities.
• Vascular occlusion, with a risk of necrosis and serious complications, as with other injectables.
• Systemic complications associated with large volumes, reported in cases of improper use.

Since there is no enzymatic reversal, unlike hyaluronidase for hyaluronic acid, managing complications is more limited.

Why is aesthetic use controversial?

Its permanent nature means the result does not keep pace with the aging of the face, which keeps changing around the product. Combined with the profile of late complications, this leads many professionals and organizations to view PMMA with caution in facial aesthetics. The rules on indication and use vary and should be checked with Anvisa (Brazil's health regulatory agency) and the standards of each professional council.

This page is informational and does not recommend the use of any product.

Also called: polymethyl methacrylate, methacrylate, permanent filler.