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Author: Vanessa Ngan, Staff Writer, 2002.


What is polymethyl-methacrylate?

Polymethyl-methacrylate (PMMA) is a suspension of microscopic synthetic polymer beads (microspheres) in a vehicle such as bovine collagen, hyaluronic acid or some other colloidal suspending agent. Artecoll® (PMMA suspended in bovine collagen) and MetaCrill® (PMMA suspended in a chemical colloid) are two brands of PMMA injectable augmentation products.

The resin has long been used by orthopaedic surgeons in bone cement for joint replacement or to replace a skull bone defect.

Where can PMMA implantation be used?

PMMA implantation can be used to improve the skin's contour and reduce depressions in the skin due to scars, injury or lines. They are used to correct facial lines and features that could have been treated with collagen replacement therapy or hyaluronic therapy, but where a more permanent solution is wanted.

Facial lines and features that can be corrected using PMMA implantation
  • Frown lines that run between the eyebrows (glabellar lines)
  • Smoker's lines which are vertical lines on the mouth (perioral lines)
  • Marionette lines at the corner of the mouth (oral commissures)
  • Worry lines that run across the forehead (forehead lines)
  • Crow's feet at the corner of the eyes (periorbital lines)
  • Deep smile lines that run from side of the nose to corners of the mouth (nasolabial furrows)
  • Cheek depressions
  • Redefining lip border
  • Acne scars
  • Some facial scars

Am I suitable for PMMA augmentation?

Almost all people are suitable for augmentation with PMMA. PMMA microspheres are biologically inert and should be well tolerated by most people. Possibly a few individuals (0.1%) may react to PMMA. However, suitability for PMMA augmentation is also dependent on the vehicle that the PMMA is suspended in. If Artecoll® is being used then the patient needs to be tested for bovine collagen sensitivity; approximately 3% of the population is allergic to bovine collagen. Testing for bovine collagen sensitivity is done with collagen skin testing (see collagen replacement therapy for details on this procedure).

How is PMMA treatment given?

Treatments are carried out at your doctor's rooms.

Procedure for PMMA treatments
  1. Wash your face thoroughly with soap and water.
  2. Treatment area wiped with an antiseptic.
  3. Injection deep into the skin (reaching the dermal level) using the tunnel or threading technique (intradermally placed needle is withdrawn as the PMMA is injected).
  4. Depending on the area treated, the skin may be lightly massaged.
  5. Immediately after injection the site may be red and swollen. This usually disappears within a week.

How long do PMMA implants last?

PMMA implantation is considered permanent. Within the first 1 to 3 months after treatment with Artecoll®, the bovine collagen vehicle degrades and is replaced with the body's own new collagen tissue. This binds to and encapsulates the PMMA microspheres into place thus preventing migration. The full effect of the augmentation may not be seen until this process is complete. A similar encapsulation process occurs with PMMA microspheres when Metacrill® is used.

Are there any side effects from PMMA therapy?

PMMA therapy is generally very well tolerated. At the time of treatments most patients report minor discomfort. This is minimized by the use of a local anaesthetic. Immediately after treatment the area may be red, swollen and tender, this usually improves within a few days.



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