Blanco Souza Túlio Armanini, Colomé Letícia Marques, Bender Eduardo André, Lemperle Gottfriede
Clínica Prime - Rua Tiradentes, 3292, Uruguaiana, RS, 97501-630, Brazil.
Programa de Pós-graduacão em Ciências Farmacêuticas, Universidade Federal do Pampa-UNIPAMPA, BR 472, Km 592, Uruguaiana, RS, 97500-970, Brazil.
Aesthetic Plast Surg. 2018 Oct;42(5):1244-1251. doi: 10.1007/s00266-018-1167-1. Epub 2018 Jun 5.
Considering that aesthetic benefits can be obtained with the use of permanent filling materials, this work focuses on the development of a consensus regarding the facial and corporal use of polymethylmethacrylate (PMMA) filler in Brazil.
A questionnaire regarding PMMA treatment, which included items on the main indication, application site, volume of product applied, criteria for selection of the material, complications, contraindications, and individual professional experience, was distributed to the Expert Group members. In addition, the responses were summarized, constituting the starting point for the debate regarding the use of PMMA-based fillers on The First Brazilian PMMA Symposium to create a guideline to be followed in PMMA facial and corporal treatments.
This survey involved 87,371 cases. PMMA treatment is recommended for restorative and aesthetic purposes in facial and corporal cases, particularly for facial balance. PMMA 30% filler is recommended in specific facial sites (nose, mentum, mandible angle, zygomatic arc, and malar). PMMA filler is contraindicated in other sites (lips) regardless of concentration. With regard to facial treatment, the juxtaperiostal is the application plane most recommended. For PMMA corporal application, intramuscular is the application plane most indicated, while intradermal and justadermal planes are contraindicated. The submuscular plane application is relative to PMMA filler concentration. The experts also inquired regarding the amount of PMMA recommended in each corporal site (50 mL in the calf, 100-150 mL in the gluteal region).
These recommendations provide a guideline for physicians, supporting them to perform safe and efficacious treatment with PMMA fillers.
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to Table of Contents or the online Instructions to Authors www.springer.com/00266 .
考虑到使用永久性填充材料可获得美学效果，本研究聚焦于巴西关于聚甲基丙烯酸甲酯（PMMA）填充剂在面部和身体应用方面达成共识。
向专家组成员发放了一份关于PMMA治疗的问卷，其中包括主要适应症、应用部位、产品用量、材料选择标准、并发症、禁忌症以及个人专业经验等项目。此外，对回复进行了总结，作为在第一届巴西PMMA研讨会上讨论基于PMMA的填充剂使用的起点，以制定PMMA面部和身体治疗应遵循的指南。
本次调查涉及87371例病例。推荐将PMMA治疗用于面部和身体的修复及美学目的，尤其是面部平衡。推荐在特定面部部位（鼻子、颏部、下颌角、颧弓和颧骨）使用30%的PMMA填充剂。无论浓度如何，PMMA填充剂在其他部位（嘴唇）均为禁忌。对于面部治疗，最推荐的应用层面是骨膜下。对于PMMA身体应用，最推荐的应用层面是肌肉内，而皮内和真皮浅层层面为禁忌。肌肉下层面的应用与PMMA填充剂浓度有关。专家们还询问了每个身体部位推荐的PMMA用量（小腿50毫升，臀部100 - 150毫升）。
这些建议为医生提供了指南，支持他们使用PMMA填充剂进行安全有效的治疗。
证据水平V：本刊要求作者为每篇文章指定证据水平。有关这些循证医学评级的完整描述，请参阅目录或在线作者指南www.springer.com/00266 。
