A sad story coming out of South America: a former Miss Argentina, Solange Magnano, has recently died after having injections into her buttocks of PMMA (Polymethylmethacrylate) in an attempt to enlarge them. She suffered a massive pulmonary embolism, likely due to the product being injected into her blood stream and then travelling to her lungs. When this happens the person can die almost instantly. I've seen it happen in people during my general surgery residency years, and this is the most dreaded complication in plastic surgery today (short of death).
How can this have been prevented? PMMA is a permanent filler (like silicone) that is not in widespread use here in the U.S. The two most common ways to augment the buttocks are are to use a solid silicone implant or fat grafting. Because Solange is so thin, she likely was not a good candidate for fat grafting, and decided against a buttock augmentation, possibly due to the invasiveness of the procedure. The surgeon likely used large needles to inject the PMMA deep into the buttocks (creates a nicer contour than superficial injections) and inadvertantly injected into a major vein. The PMMA then likely travelled back to her lungs, clogged the major vessel, and she could no longer get enough oxygen into her body, killing her. This could have been prevented by using a blunt cannula, like the one I use when grafting fat into the buttocks. The cannula is so flat and blunt that it's nearly impossible to inject into a blood vessel. Or, I suppose, she could have just left her buttocks alone.
Safety should always be the top priority of any physician. If you consider having plastic surgery abroad, make sure you find a plastic surgeon who is an international member of the American Society of Plastic Surgeons.
For more information, check out the excellent article in In Your Face.
Thanks for reading.
Michigan-based Plastic Surgeon
Anthony Youn, M.D.:
5 comments:
Thanks for the technical info about the cannula, and thanks also for ID'ing the filler as polymethylmethacrylate.
I looked up the filler on the 'net, and my first reaction was horror upon reading that it's used as a "shatterproof replacement for glass". But I see it's also used in orthopedic surgeries. It seems like it would not be a good material to plump up flesh, wouldn't it be too rigid?
It is a pity. She was so beautiful. the biggest risk in a plastic surgery is the formation of the doctors.
As a response to the previous post, PMMA can make a very good filler - at least on the face. Basically (somebody correct me if I'm wrong here), microscopic beads of PMMA suspended in a gel of some sort are injected. Inside the, the body recognizes it as foreign, and attacks it, wrapping collagen around it. This is what gives the plump - almost all the plump coming from the body's own collagen wrapped around the PMMA. The plump sticks around because the beads are too large for the body to flush away and dispose of (in theory).
It seems in this case, the problem was not so much the material used, but simply that a foreign substance was injected directly into a major vein/artery clotting things up and starving the body and brain of oxygen.
it actually is very scary.
Another candidate for the Darwin Awards.
Thanks for the info, other anon. So it seems like PMMA would be a good filler for big areas, like buttocks, where it can be injected deeply so that any lumpiness would be hidden below PMMA-free flesh. Not good therefore as a facial filler.
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