PMMA: what it is, what it is used for, how it is applied and risks


PMMA, or polymethylmethacrylate, is a plastic substance in the form of microspheres that is normally indicated to correct small deformities or the loss of facial fat in people with HIV, and is not recommended by the Brazilian Society of Plastic Surgery for aesthetic treatments.

This substance allows a permanent correction of the affected skin region, as it is not reabsorbed by the body, like hyaluronic acid or collagen, for example.

The application of PMMA must be discussed with a doctor, as it is a treatment that has several risks, which can cause complications such as infection or allergy, and is not indicated for use in large areas of the body such as the buttocks or legs, for example.

What is it for

PMMA is indicated to correct small deformities or the loss of facial fat in people with HIV, and is not recommended for aesthetic purposes, due to the risk of complications.

The application of PMMA should not be used in large areas of the body, such as the buttocks or calves, for example, as it is a plastic substance that, when used in large quantities or deeper into the skin, can cause serious complications, such as stiffening or even necrosis, which is the death of tissue in the applied region.

How PMMA is applied

PMMA is applied in a small region through injections in the subcutaneous tissue, in deeper layers of the skin, filling the volume and correcting small skin deformities.

PMMA injections are usually formulated with lidocaine, a type of anesthetic to reduce pain during injection, and bovine collagen, a protein that is absorbed into the skin within a few days of injection. However, PMMA is not absorbed by the body, allowing a permanent and lasting correction of deformities, and the results can be noticed after 1 or 2 months of treatment.

It is recommended that a PMMA allergy skin test be performed 4 weeks before first use, as the bovine collagen in the PMMA formula can cause an allergy.

Possible risks of PMMA

PMMA can cause redness or swelling of the skin in the area where it was applied, which usually improves within 24 hours, or bruising that disappears 3 to 7 days after application.

However, when PMMA is applied in large amounts or injected into muscles, it can cause serious health risks that include:

  • Necrosis of the skin or muscles;
  • Severe allergic reaction;
  • Infection at the application site;
  • Chronic inflammation;
  • Rigidity or deformity of the region;
  • Formation of nodules on the skin;
  • Rejection by the body.

In addition, the application of PMMA can cause vascular thrombosis, especially when it affects a blood vessel, causing symptoms of shortness of breath, chest pain, headache, changes in vision or speech, weakness, drowsiness or loss of consciousness and can put the person’s life at risk.

It is important to seek immediate medical help or the nearest emergency room if any of these complications are suspected.

Who should not use PMMA

PMMA should not be used by children under the age of 18, pregnant or nursing women, by people who have had other cosmetic treatments within the past 6 months, or by people who are receiving ultraviolet light therapy. Furthermore, PMMA should not be used for aesthetic purposes.

The application of PMMA is also not indicated for people who have:

  • Allergic reaction to the skin test;
  • History of allergies or anaphylactic reaction;
  • Allergy to lidocaine or other anesthetics;
  • Allergy to bovine collagen;
  • Tendency to the formation of thick scars;
  • Skin sores or infections;
  • Pimples or cysts on the skin.

In addition, it is important to inform the doctor of all medications used regularly, as the application of PMMA should also not be done in people who use immunosuppressive drugs to treat cancer, intestinal inflammatory disease or rheumatoid arthritis, or anti-inflammatory drugs such as acetylsalicylic acid, ibuprofen or diclofenac, for example, as they may increase the risk of bruising or bleeding at the injection site.

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