What Can I Do About Lumps from a PMMA Product Like Artefill or Artecoll?

asked 3 years ago by wwills in Austin, TX
Latest answer by Peter Malouf, DO
Question viewed 4,122 times
Tags: granuloma, lumps, restore

Hi
I have developed a granuloma under each eye in the tear trough area from a product called "Precise," which is a PMMA product I received in Mexico 2 years ago. This product is essentially the same as Artefill/Artecoll.
I have been to see several doctors and have done extensive research on the internet. It appears I have two real options, the first is to have the product removed doing micro-lipo suction with a fine needle to scrape out the particles, which should not cause scarring, and the other is to have it surgically removed. I tried steroid injections but the change was minimal and short lived.
Here are my questions:
Is it possible to remove PMMA with micro-lipo if the product is encapsulated or embedded?
Would surgically removing from the tear trough area cause serious scarring or can it be handled in a way to leave scars that are manageable?

I welcome and appreciate any answers or insight !!

Thanks.

5 answers to What Can I Do About Lumps from a PMMA Product Like Artefill or Artecoll?

If you could roll back the clock, you wouldn't have done this

Permanent fillers are bad. Period. They cannot be removed and long term, they can develop granulomas and infections. They also can emerge as you age like islands coming out of the ocean. I sincerely wish patients would get the message that these are bad products and ones to avoid. Yes, it is painful and costly to have to reinject temporary fillers, but this is the only safe way to go. That being said, other than direct excision, I don't think you can remove the product and remember that... more

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon

PMMA

PMMA is a permanent product that is extremely difficult to remove. Liposuctioning will probably not be successful. Yes, excision will leave scarring. Tough decision to make.

Steven Wallach, MD
Manhattan Plastic Surgeon

Precise granulomas

This is a very difficult problem and is probably due to the variability in particle size of precise. Anything less than 80 microns can be gobbled up (phagocytized) by macrophages in your immune system. So in this case, your body is attempting to attack and wall off the particles. If it were my choice I would carefully use very dilute amounts of steroid injections over many months gradually with massage and hold off on procedures that can trade one problem for another... more

Peter Malouf, DO
Dallas Dermatologist

PMMA can be removed easily from the tear trough

I am a trainer for Sculptra and consequently have been referred problem cases. Problems outside of the lids and lips are very rare. These products should not be used in the lids because they are best under thicker skin and in a deeper level that does not exist in the eyes. However, i have removed the material from the lids by just making a tiny slit in a wrinkle and working the firm material out. It DOES NOT RESPOND TO LIPOSUCTION because it is too dense... more

Nathan Mayl, MD
Fort Lauderdale Plastic Surgeon

Lumps from permanent fillers

First of all, to everyone reading this, don't have a permanent filler placed under the eyes. They have never been recommended for this area, for good reason!Unfortunately, most people do far less self-education on cosmetic treatments before they get them than after. Second, stay at home for your cosmetic treatments and choose Board Certified Dermatologists or Board Certified Plastic Surgeons for cosmetic treatments. The FDA assures that rigorous testing is done in clinical studies with... more

Nissan Pilest, MD
Irvine Dermatologic Surgeon

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