This report covers survey results and discussions of the safety of polymethylmethacrylate (PMMA) fillers. The results presented are from a recent survey of 1032 patients on their satisfaction with Artecoll (the first PMMA dermal implant). The data show a high level of patient satisfaction from 1993 to 2007. There has been speculation and controversy about the safety of permanent and semipermanent particle-based fillers. The authors, selected for their long-term experience with these fillers, discuss the use of particle-based PMMA fillers (Aphrodite Gold, Artecoll, ArteFill, and ArteSense). The safety profiles and potential preventive measures of side effects of PMMA fillers are reviewed. Treatment methods for granulomas, which occur rarely—in fact, only 9 patients experienced granulomas out of 18,472 syringes injected by the group—are also described. There was consensus that extensive training is imperative to achieve successful patient outcomes.