| Silva and Curi35 (2004) |
Blindness and total ophthalmoplegia after aesthetic polymethyl methacrylate injection |
To describe the case of a female presenting amaurosis and total ophthalmoplegia after PMMA injection |
Case report |
The authors believe this is the first report of blindness following PMMA microsphere injection, demonstrating the risk of its administration into the glabellar area |
| Medeiros et al.25 (2014) |
Complications after polymethyl methacrylate (PMMA) injections in the face: a literature review |
To review several PMMA-associated complications |
Literature review |
PMMA is widely used due to its affordability, availability, and easy application. However, some complications are severe and permanent, and they can be confused with other types of oral lesions |
| Kurimori et al.23 (2019) |
Severe complication due to inappropriate use of polymethyl methacrylate: a case report and current status in Brazil (Complicação grave do uso irregular do PMMA: relato de caso e situação brasileira atual) |
To report a severe complication of inappropriate PMMA use and discuss the current Brazilian reality |
Case report and literature review |
The seriousness of the reported case highlights the need to combat bad practices by unqualified professionals and the stricter control of PMMA commercialization by regulatory entities |
| Haneke24 (2014) |
Adverse effects of fillers and their histopathology |
To address the types of fillers, their histopathological findings, and therapeutic modalities |
Narrative review |
It is essential that doctors have the proper qualification and use appropriate techniques, and that patients correctly follow postprocedure guidelines to avoid complications |
| Carle et al.36 (2014) |
Cosmetic facial fillers and severe vision loss |
To describe three patients experiencing sudden vision loss after injection of three different dermal fillers |
Case report |
The filler likely enters the central retinal artery through the external-internal carotid anastomoses and becomes embedded in the retinal tissues, potentially leading to severe or irreversible vision loss |
| Lee et al.37 (2020) |
Ocular complications of soft tissue filler injections: a review of literature |
To investigate visual impairment secondary to filler injection and discuss the related vascular anatomy, pathophysiology, and prevention of filler-related ocular complications |
Literature review |
A previous study reported that the injection site most commonly associated with blindness was the glabella; however, the site currently most commonly associated with blindness after filler injections is the nose. Extreme care is required to avoid the internal carotid artery branches |
| Castro et al.38 (2007) |
Extensive facial necrosis after infiltration of polymethyl methacrylate (Necrose facial extensa após infiltração com polimetilmetacrilato) |
To report the case of a female patient who developed necrosis in the right hemiface due to infection after PMMA infiltration in the nasolabial fold |
Case report |
This report demonstrates the risk of injections in the nasolabial region, especially with alloplastic materials used in bioplasty |
| Carpaneda and Carpaneda39 (2012) |
Adverse results with PMMA fillers |
To demonstrate the correlation between the clinical application of PMMA and the pathophysiology of acute and late complications |
Retrospective observational study |
Initial complications result from vascular impairment, but later events occur due to capsular contracture involving PMMA particles. The contracture causes local tissue hardening and clinical nodulation at the implanted areas |
| Paulucci40 (2020) |
PMMA safety for facial filling: review of rates of granuloma occurrence and treatment methods |
To review and compare granuloma rates in published studies and to compare therapies and their efficacies |
Literature review |
Considering the actual risks and benefits of PMMA, the authors say it is a safe filler; doctors and patients should be aware of the potential risks when deciding whether to use it |
| Liu, Beynet, and Gharavi42 (2019) |
Overview of deep dermal fillers |
To analyze semipermanent and permanent injectable fillers |
Literature review |
Dermal fillers yield excellent cosmetic outcomes with short recovery time. The future development of new dermal fillers will advance the ability to optimally reshape the aging face |
| Tachamo et al.43 (2018) |
Hypercalcemia associated with cosmetic injections: a systematic review |
To systematically review the published literature on cosmetic injection-associated hypercalcemia |
Literature review |
Hypercalcemia resulting from cosmetic injections can be severe and may occur years after the procedure. Granulomas are a potential cause, especially in middle-aged women with non-parathyroid hormone-related hypercalcemia and, sometimes, with elevated calcitriol levels |
| Woodward, Khan, and Martin44 (2015) |
Facial filler complications |
To define facial filler complications and their treatment, providing suggestions to avoid serious adverse outcomes |
Literature review |
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| Souza et al.41 (2016) |
Late complication of cutaneous filling after a facelift: a case report (Complicação tardia de preenchimento cutâneo após facelift: relato de caso) |
To present the case of a patient who underwent a facelift with a chin prosthesis implant to correct a PMMA application after 7 years |
Case report |
Clinical treatment is the first option for complications. Surgery is reserved for selected cases with unsuccessful clinical treatment, as in this case |
| Rosa and Macedo46 (2005) |
Adverse reactions to subdermal filler substances (Reações adversas a substâncias de preenchimento subcutâneo) |
To present four cases of adverse reactions after using the following filling materials: polyacrylamide, polymethyl methacrylate, and poly(dimethylsiloxane) |
Case series |
The development of an ideal substance to fill soft tissues has not occurred yet. Therefore, these procedures may result in adverse reactions due to the substance used or an error in the application technique |
| Goldman and Wollina45 (2019) |
Polymethyl methacrylate-induced nodules of the lips: clinical presentation and management by intralesional neodymium: RAG laser therapy |
To review PMMA fillers, known associated adverse events, and treatment options |
Literature review |
These events may develop several years after filler placement. Treatment is complex, but intralesional laser, alone or with surgery, seems a promising tool |
| Manfro et al.13 (2021) |
Case reports of hypercalcemia and chronic renal disease due to cosmetic injections of polymethyl methacrylate (PMMA) |
To report clinical cases of hypercalcemia and chronic kidney disease after cosmetic PMMA injections |
Case reports |
A multidisciplinary collaboration may help to unravel the actual frequency and relevant aspects of hypercalcemia and renal damage associated with PMMA fillers |
| Cannata-Ortiz et al.14 (2016) |
Small vessel microembolization and acute glomerulonephritis following infection of aesthetic filler implants |
To highlight the risks of esthetic fillers and emphasize monitoring for potential renal complications |
Case report |
Esthetic filler implants can cause small vessel microembolization. Recognizing the characteristic morphology can speed up diagnosis |
| Oliveira et al.22 (2020) |
Fat embolism syndrome secondary to the use of polymethyl methacrylate in bioplasty: a systematic review (Síndrome da embolia gordurosa secundária ao uso de polimetilmetacrilato na bioplastia: uma revisão sistemática) |
To highlight clinical studies regarding fat embolism syndrome in patients undergoing PMMA infiltration in bioplasty |
Systematic review |
The study highlights that knowledge of PMMA composition, physiological tissue reactions, absorption time, and persistence is essential |
| Lemperle, Romano, and Busso26 (2003) |
Soft tissue augmentation with artecoll: 10-year history, indications, techniques, and complications |
To clarify PMMA advantages, effects, indications, contraindications, implantation technique, potential side effects, and complication treatment |
Literature review |
The authors consider PMMA reliable and predictable, attributing potential complications to the lack of skill and familiarity of doctors with it |
| Shah et al.27 (2017) |
Allergic contact dermatitis caused by polymethyl methacrylate following intradermal filler injection |
To report the case of a patient who underwent a procedure to increase the tip of the nose with PMMA and developed allergic contact dermatitis |
Case report |
The application of PMMA can lead to sensitization and development of an allergic reaction, which can evolve into unfavorable outcomes |
| Friedmann, Kurian, and Fitzpatrick28 (2016) |
Delayed granulomatous reactions to facial cosmetic injections of polymethyl methacrylate microspheres and liquid injectable silicone: A case series |
To report four cases of late granulomatous reactions to PMMA and injectable liquid silicone developing years after application |
Case series |
Delayed granulomatous reactions to permanent fillers can occur months to years after the procedure and are often refractory to treatment |
| Christensen et al.29 (2005) |
Adverse reactions to injectable soft tissue permanent fillers |
To investigate the cause of adverse inflammatory reactions in facial tissues after the application of different types of permanent synthetic fillers |
Observational study |
Inflammatory nodules appear to be linked to low-grade bacterial infections maintained by biofilms on the injected materials. Some fillers have shown a greater tendency to form late nodules with bacteria, necrosis, and fibrosis |
| Rayess et al.30 (2018) |
A cross-sectional analysis of adverse events and litigation for injectable fillers |
To determine the risks of injectable fillers and analyze factors raised in litigation due to injectable fillers |
Cross-sectional study |
Despite variations in material and application site, injectable fillers can cause adverse effects such as swelling, infection, and, in severe cases, necrosis and blindness |
| Sun et al.31 (2023) |
Early warm compress treatment can promote recanalization of vascular embolisms and reduce tissue necrosis after polymethyl methacrylate injection |
To build a model of intravascular injection embolism and observe the effectiveness of warm and cold compresses in controlling the condition |
Randomized controlled clinical trial |
Early-stage warm compress after intravascular PMMA injection leads to vascular embolism recanalization and reduces tissue necrosis |
| Vent and Lemperle32 (2014) |
Prevention and treatment of complications after polymethyl methacrylate-microspheres injections |
To analyze the particularities of PMMA as a facial filler, addressing the application technique, adverse effects, and complication management |
Literature review |
PMMA is a viable option when used judiciously by experienced professionals with proper technique. Knowledge of the risks and potential complications is essential to ensure safety and good clinical outcomes |
| Salles et al.33 (2008) |
Complications after polymethyl methacrylate injections: report of 32 cases |
To report and analyze complications resulting from PMMA use in procedures performed by professionals from different specialties |
Case series |
Complications ranged from acute to late manifestations, with different origins, including technical, infectious, and immunological |
| Limongi et al.34 (2016) |
Complications and management of polymethyl methacrylate (PMMA) injections to the midface |
To analyze and report complications associated with PMMA facial application |
Literature review |
Surgical treatment has been shown to be more effective than conservative approaches, such as corticosteroids |
Complications of Polymethyl Methacrylate Use in Esthetic Procedures: A Review