Goisis Mario, Zecchetto Sara, Veronese Sheila, Quintero Sierra Lindsey Alejandra, Ossanna Riccardo, Bernardi Paolo, Nicoletti Maria Maddalena, Khabouri Sima, Sbarbati Andrea
De Clinic, Viale Regina Giovanna 39, 20129, Milan, Italy.
Aesthetic Medicine Clinic - Dr. Sara Zecchetto, Piazza del Popolo 16, 37132, Verona, Italy.
Aesthetic Plast Surg. 2024 Dec 16. doi: 10.1007/s00266-024-04586-x.
Polymethylmethacrylate (PMMA) fillers are permanent fillers known for their possible side effects. In case of complications, the only possible treatment is surgical removal, followed by procedures to minimize resulting deformity. The aims of this study were (1) to analyse the morphology of the PMMA material in the nodules, (2) to demonstrate that treatment by acoustic wave therapy (AWT) can help the removal of the nodules, and (3) to present an easy procedure to solve deformities.
The data of 9 patients who underwent AWT, surgical PMMA removal, and deformity correction by enriched nanograft and dermagraft injections between April 2021 and May 2024 were presented. The leftover aspirated material was analysed by histology and scanning electron microscopy.
AWT resulted in no complications in all patients. After removal and correction surgeries, minor complications were observed in 5 cases. All the patients were delighted with the aesthetic outcome. In all patients, an important improvement of the deformities, with correction of the volume of the face, was observed. A substantial resolution of the initial clinical symptoms was documented. The ultrastructural analysis highlighted that PMMA appears in the form of laminar or prismatic formations with a paracrystalline structure.
AWT acted directly on PMMA to facilitate its removal and reduce fibrosis around the PMMA filler. The lack of volume correlated with PMMA removal was resolved with the enriched nanograft and dermagraft injections, which led to very satisfying aesthetic results.
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聚甲基丙烯酸甲酯（PMMA）填充剂是永久性填充剂，其可能存在副作用。出现并发症时，唯一可行的治疗方法是手术取出，随后采取措施尽量减少由此产生的畸形。本研究的目的是：（1）分析结节中PMMA材料的形态；（2）证明声波疗法（AWT）有助于结节的去除；（3）介绍一种解决畸形的简便方法。
呈现了2021年4月至2024年5月期间9例接受AWT、手术取出PMMA以及通过注射富集纳米移植物和真皮移植物进行畸形矫正患者的数据。对吸出的剩余材料进行组织学和扫描电子显微镜分析。
所有患者接受AWT均未出现并发症。取出和矫正手术后，5例出现轻微并发症。所有患者对美学效果都很满意。所有患者均观察到畸形有显著改善，面部体积得到矫正。记录到初始临床症状有实质性缓解。超微结构分析突出显示PMMA呈具有准晶体结构的层状或棱柱状形态。
AWT直接作用于PMMA以促进其去除并减少PMMA填充剂周围的纤维化。通过注射富集纳米移植物和真皮移植物解决了与PMMA取出相关的体积缺失问题，从而带来了非常令人满意的美学效果。
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