I have PMMA in my butt. Can I still do a BBL?

Question

Approximately 9 month as ago I was convinced to inject PMMA Shots into my behind. Which I honestly didn’t noticed much of a difference. I did already contemplate on getting a “bbl” done but for some reasons I did not I went the easier route and did the pmma injections and now I want to do the bbl. Can I? Or I have to add more PMMA??

George Marosan, MD · Answer

Thank you for your question. PMMA is not used in the US for buttock shaping and filling due to its prohibitive cost. One syringe 1-1.5cc costs $800-1000. To see improvement with PMMA one would need 200-300cc of the product. I trained in using PMMA, Radiesse and other biostimulators in Brazil and I'm the only licensed GoldIncision plastic surgeon in the US. PMMA or polymethylmethacrylate are 40 micron spherules (extremely tiny) injected in a carrier which is bovine collagen in the US, it's 20% PMMA and 80% Collagen. Outside of the US, it has a synthetic carrier which gets metabolized just like the collagen. The cost abroad, especially in Brazil is significantly cheaper than here. BTW, the PMMA cannot be removed, it becomes a living implant. The small spheres are surrounded by the body's tissues. It becomes a vascularized implant. Removing it is close to impossible without destroying the surrounding tissues. I would strongly advise against it. Now you did not say or know, if the PMMA was injected into the buttock fat compartment or it was injected intramuscularly into the gluteus maximus muscle. PMMA is often confused with several gel fillers used in Europe and South America in the past, which can lead to disastrous results. 
Back to the BBL. Fat is the best natural filler for shaping and enhancement of the buttocks. Yes you can have a BBL with the PMMA in place if it's done by a board certified plastic surgeon experienced in advanced body sculpting techniques. Good luck.

Emmanuel Mallol Cotes, MD · Answer

Thanks so much for your question,

Having PMMA (polymethylmethacrylate) in your buttocks adds complexity to a Brazilian Butt Lift (BBL) procedure, but it doesn’t automatically rule it out.  Your surgeon would need to assess the areas containing PMMA and evaluate how much natural tissue is available for grafting. In some cases, surgeons may recommend fat grafting only to specific regions around the PMMA, aiming to create volume without disturbing the PMMA-enhanced areas.

Because of the complexities involved, it’s essential to consult a highly experienced surgeon who can evaluate your specific anatomy and advise on the safest and most effective approach.

Sincerely, 
Dr. Emmanuel Mallol

Mats Hagstrom, MD (license on probation) · Answer

Personally, I would be apprehensive of doing fat transfer after PMMA injections.
Unlike HA fillers, which blend into the tissue, PMMA tends to create pockets of fluid. 
My concern is injecting high volumes of fat into these pockets which could lead to complications. 
Other providers will probably have different views. 
I’ve only managed one patient with PMMA injections. She asked me to remove the filter which took multiple treatments and I was unable to drain all of the filler. I’m not a fan of PMMA
Mats Hagström MD

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