Observational studyAesthetic plastic surgery2025
Hypercalcemia and Renal Complications Following High-Volume Polymethyl Methacrylate (PMMA) Injections: A Case Series.
Observational study in Aesthetic plastic surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
1 citing paper in PubMed.
- Three-dimensional Magnetic Resonance Imaging Segmentation for Preoperative Planning in Gluteal Polymer Complications.Plastic and reconstructive surgery. Global open · 2026Article
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPolymethyl methacrylate (PMMA) is a permanent filler. It has been associated with hypercalcemia and renal complications when injected in large volumes. This study investigated cases of hypercalcemia, hypercalciuria, nephrolithiasis, and renal insufficiency that arise following PMMA injections.
methodsA multicenter observational study was conducted involving Brazilian patients who developed hypercalcemia, hypercalciuria, nephrolithiasis, or renal insufficiency after PMMA injections in the gluteal region. The research explores clinical presentations, comorbidities, laboratory findings, imaging results, treatments and outcomes.
resultsTwelve women aged 23 to 70 years (mean: 44.3 years) received PMMA injections ranging from 150 to 900 mL (mean: 415 mL) in the gluteal region. The onset of complications varied, occurring from 40 days to eight years after the injection (mean onset: 27 months). All patients exhibited hypercalcemia or hypercalciuria, while renal dysfunction was observed in 83.3% of cases, and nephrolithiasis occurred in 50.0%. Laboratory test results revealed elevations in creatinine (83.3%), urea (75%), 1.25-OH vitamin D and ionized calcium (91.6%), and total calcium (66.6%). Parathyroid hormone (PTH) levels were supressed in 90% of patients, while 25-OH-vitamin D levels remained normal for all patients. Treatments included corticosteroids, denosumab, and bisphosphonates. Improvement of laboratory parameters was noted in two out of three patients following PMMA removal surgery. Elevated creatinine levels persisted in 83.3% of patients, indicating persistent renal dysfunction.
conclusionInjecting large volumes of PMMA poses a risk of significant hypercalcemia and renal complications. This study calls for stricter regulations regarding PMMA use and emphasizes the importance of long-term nephrological follow-ups. LEVEL OF EVIDENCE IV: 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 the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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