FOREIGN BODY GRANULOMAS CAUSED BY POLYMETHYLMETHACRYLATE (PMMA) LONG-TERM/PERMANENT FACIAL FILLERS: A LITERATURE REVIEW

Abstract

<h3>Objectives</h3> To conduct a literature review regarding the characteristics of foreign body granuloma (FBG) caused by permanent facial fillers consisting of polymethylmethacrylate (PMMA). <h3>Study Design</h3> We searched articles in the following databases: PubMed, Scopus, Web of Science, Science Direct, and Scielo. The search included all articles published up to 2021, with no time restrictions. <h3>Results</h3> Permanent injectable facial fillers are used to treat wrinkles, loss of volume, and facial structures caused by aging. Fillers containing PMMA are associated with many adverse events. The formation of FBG is considered one of these events, with a frequency of 0.01%. FBG usually appear 6 to 24 months after PMMA injection; however, there are reports of lesions appearing up to 10 years after injection. FBG presents as hardening, swelling, color change, and sensitivity in the affected area. Its etiology is related to the host's response, infection, and/or flaws in filling techniques. Treatment requires corticosteroids or antibiotics and oral nonsteroidal anti-inflammatory drugs. Surgical removal can be performed if the lesion is well demarcated. All treatment modalities result in complete resolution. <h3>Conclusions</h3> Patients must be informed about the injection technique and the adverse effects related to permanent injectable fillers composed of PMMA.