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Novel use of polymethyl methacrylate ( PMMA ) microspheres in the treatment of infraorbital rhytids
Author(s) -
Mani Nasrin,
McLeod Jasmine,
Sauder Maxwell B,
Sauder Daniel N,
Bothwell Marcella R
Publication year - 2013
Publication title -
journal of cosmetic dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.626
H-Index - 44
eISSN - 1473-2165
pISSN - 1473-2130
DOI - 10.1111/jocd.12065
Subject(s) - medicine , ecchymosis , surgery , polymethyl methacrylate , blepharoplasty , erythema , eyelid , microsphere , allergic reaction , dermatology , allergy , materials science , polymer , immunology , chemical engineering , engineering , composite material
Summary Aim To demonstrate safety with the use of polymethyl methacrylate ( PMMA ) microspheres in the infraorbital eyelid area using a deliberate conservative injection in the treatment of rhytids. Methods A retrospective case series of 289 patients in an outpatient cosmetic dermatology clinic evaluated and treated by one senior provider ( NM ) of infraorbital rhytids with PMMA from D ecember 2010 to M arch 2011. Statistical analysis was performed for race, skin type, history of hypertrophic scar, autoimmunity, history of “sensitive skin” and history of prior procedures such as prior facelift, rhinoplasty, and blepharoplasty. Results Two hundred ninety‐one patients underwent at least 1–6 injections of PMMA microspheres into bilateral under eye area. Early complications were edema and ecchymosis. Late complications were identified in 4 of 289 patients who developed small granulomas. All patients who developed granulomas had had a previous lower blepharoplasty ( P = 0.00). A history of “sensitive skin” was approaching statistical significance ( P = 0.15). Conclusion This study has shown that PMMA microsphere injection is a safe subdermal technique in the correction of infraorbital rhytids. Safety was demonstrated in 289 patients with only 4 minor complications of small lateral granuloma which all resolved within 4 weeks after intralesion triamcinolone injection. However, this is an off‐label use of a permanent filler not approved for use in the infraorbits and significant caution must be taken with full disclosure to the patient leading to informed consent. Caution in PMMA microsphere injection should be given in the patient with prior blepharoplasty. The advantage of PMMA microsphere is that the result seems to be predictable and natural.