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Question: Dr. Pierone, I would like to know if PMMA fillers are safer that checks implants, Thanks, Dr.O. Perez

Answer:  There are no studies that I am aware of that directly compare PMMA to cheek implants for restoring volume. Both procedures are effective in restoring long-term cheek volume and of course both have potential risks. There are a few risks associated with cheek implants (this is true for chin implants or temple implants as well) that I have seen. The first is that surgical operations carry risks of bleeding and anesthetic risks, although anesthesia has become much safer. There is a low, but measurable risk of infection, and this would lead to a second procedure to remove the implant. Wrong size selection or improper positioning is another potential issue. Late implant slippage and migration is another uncommon event. There is also social downtime related to the surgery for facial implants. You generally don’t go back to work the next morning after implantation.

The best data for safety of PMMA fillers comes from the recently completed 5 year FDA mandated study of Bellafill. This study showed a rate of granuloma formation of 1.7% over the 5 years of follow up. Granulomas are late reactions to the PMMA in which the immune system presumably shifts from tolerance of the PMMA to intolerance. This presents as inflamed nodules in some or all of the areas of implant injection. Granulomas are tricky to manage, and it may take weeks or months for treatment to reduce the inflammation and nodules and restore a normal appearance. The treatment is usually with injection of corticosteroids and/or fluorouracil. Rarely, the nodules may need to be surgically removed.

I hope that this information helps and best of luck to you!

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