Reconstructive surgeons hesitate to use alloplastic materials when autogenous alternatives are available. Our experience using large volumes of methyl methacrylate stabilized by microscrews has been reviewed in a sample of 25 consecutive cases with a follow-up of at least two years. The conclusion of the study was that methyl methacrylate, if securely stabilized, is safe to use, predictable, and pleasing aesthetic results can be obtained in a single-stage procedure. This is especially true for reconstruction of complex three-dimensional contour deformities of the craniofacial skeleton. This material has only been used in patients in whom facial growth has ceased.