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Does PMMA Cause Severe Buttock Hardening?
Sep 27, 2010

My plastic surgeon, a prominent, respected, trustworthy doctor here in Los Angeles who is at the forefront of Lipodystrophy and atrophy treatments nationwide, told me when I asked his opinion about my going to Tijuana for PMMA treatment on my butt by Dr. Casavantes, that he himself would never use PMMA on his patients. The reason he gave is that PMMA hardens to an almost cement-like consistency, easily detectable by intimates and most certainly by medical professionals who attempt to administer an IM shot in that vicinity. Now I am frustrated and confused. My face has been restored through treatment with Sustiva and Silicone, however my backside remains in ruins. This affects me both emotionally and physically. The emotional toll comes from having a once prominent and often complimented on part of my anatomy vanished into practically a crater, seeing a reasonably healthy, nice looking, well kept man in the mirror, then turning sideways and gazing at ravaged remains, feeling self conscious about wearing jeans or trousers which hang baggy and empty in the rear, et al. Physically, the toll is perhaps worse, with constant sciatic pain to deal with, inability to ride far or remain seated for any significant length of time, the fear and misery of having only a thin layer of tissue covering the bones upon which my body sits, and more. Can you please explain or describe both the short and long-term side effects of PMMA used to correct Lipoatrophy of the buttocks? I would not want to go to the trouble and expense of having my ass restored, only to have sex partners think they were in bed with a marble statue, or to have doctors and nurses breaking needles when attempting to inject me with an important medicine. Thank you for your opinions, educated advice, personal experience, innate knowledge which you share in issues of The Body.

Response from Dr. Pierone

Hello and thanks for posting.

The notion that PMMA hardens to a cement-like consistency is contrary to the real world clinical experience for facial rejuvenation or buttock restoration.

I did see a patient once with PMMA induced granuloma which produced firm buttock nodules, but this would be considered a rare complication. The great majority of patients treated with PMMA for buttock lipoatrophy have very good results. There is no other treatment that I am aware of that performs better for this indication.

I am curious to know what alternatives the plastic surgeon offered you for treatment of buttock lipoatrophy. The only other options that I know of that are available in the United States are silicone buttock implants and structural fat grafting. Silicone implants can usually be felt, and contracture around the implant is a major problem. Fat grafting works well when it does work, but fat transfer is plagued by insufficient fat survival and irregularities of fat distribution in the implant. This approach is typically more useful for women with fat available for grafting who are seeking larger, soft/spongy buttocks.

I hope that this information helps and best of luck to you!



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