Injecting Plexiglass? A champion cried foul. Bodybuilding’s response raises more questions

A former champion at the biggest event in women’s bodybuilding recently rocked the sport with a sensational claim about the physical appearance of current champion Natalia Coelho.Sarah Villegas, a four-time former champion, accused Coelho of getting injected with a Plexiglas substance to build fake “plastic” muscles and win the crown for best physique at Ms. Olympia.“I can't believe I have to explain why plastic muscle implants have no place in a sport founded on building actual muscle through human effort,” Villegas told USA TODAY Sports in an interview. “It's called bodybuilding, not plastic building.”And that’s just the tip of this “plastic” iceberg. To wit:∎ Coelho didn’t deny the claim when given the chance.∎ Villegas wasn’t making this up out of thin air. She had received unsolicited “firsthand” information about it from a health professional at a clinic in Brazil where the procedure allegedly was performed. USA TODAY reviewed this information and confirmed with this person they shared it with Villegas. This person did not want to be identified because they feared retaliation.Villegas told USA TODAY Sports this matter is an “existential threat” to bodybuilding. She noted the health risks of such injections and said she didn’t want her sport to become a “competition of who has the best cosmetic surgeon.”∎ The governing body of the sport has a financial interest in disregarding the controversy and didn’t announce any investigation into it. Nor did it respond to several messages about it from USA TODAY Sports.∎ Meanwhile, top personalities in the business have blamed Villegas for making it an issue and described her as a sore loser. They have claimed there are no rules against the alleged injections. That includes the “Voice of Bodybuilding” Bob Cicherillo, who hosts the prestigious Olympia competition.“I really don't care what anybody's doing,” Cicherillo said on his podcast. “I don't have any moral or ethical fight here of what anybody is doing. I don't care whether… you got Cheez Whiz or anything else that you're putting in your physique. We only get judged on what goes on that stage.”Former Mr. Olympia says 'This is cheating'Such is the state of pro bodybuilding, the same sport that once produced entertainment icons Arnold Schwarzenegger and Lou Ferrigno, otherwise known as The Incredible Hulk. It’s also a sport where bodybuilders historically have used steroids and other enhancing drugs to boost their physiques and impress judges who determine the winners based on the muscle in their poses and other factors.So then what’s the big deal if some are now trying to win with artificial Plexiglas muscles?“This is cheating,” said Samir Bannout, the 1983 Mr. Olympia.In this case, Coelho is accused of using a form of polymethyl methacrylate (PMMA), also known as Plexiglas, to enhance her appearance before winning the women’s physique crown at the Ms. Olympia competition in 2025, beating Villegas, the runner-up. Coelho then won it again in Las Vegas in late September, while Villegas finished third.Villegas’ coach and husband, Ali Taktak, said the person who provided the information about Coelho’s PMMA injections also identified the clinic and doctor where she allegedly got them in Brazil — Fernando Vitor at the Instituto Lappidare.Current champion Coelho declined to confirm or deny allegationUSA TODAY Sports confirmed the person who provided this information to Villegas is a licensed health professional in Brazil and that Coelho appeared at this clinic with Vitor, according to a video on Instagram.Vitor and his clinic have financial ties to the sport’s governing body through Tamer El-Guindy, a promoter of bodybuilding events and producer at the Olympia event.Coelho, who grew up in Brazil, hasn’t denied or confirmed whether she received PMMA injections. Cicherillo asked Coelho about the controversy at a public seminar in September.“If I get into that, I’m not doing any good for the sport,” Coelho said. Coelho didn’t return several messages seeking additional comment. Vitor and El-Guindy also didn’t’ return messages.'We don't have any rules' against Plexiglas musclesThe governing body of the sport is the IFBB Pro League, originally known as the International Federation of Body Builders. The organization and its president Jim Manion also did not return several messages seeking comment by phone and email. Nor did Jake Wood, owner of the Olympia event, the top event in the sport.After Villegas received this information about Coelho last year, Villegas said her coach, Taktak, shared it with league leadership. In response, Villegas said the IFBB Pro League stated it “has no rules prohibiting PMMA plastic muscle implants” and that “no one is asked to submit a resume of what they did to attain their physique before stepping on stage.”This response echoed top personalities in the sport who criticized Villegas for speaking out. Shawn Ray, a 13-time Mr. Olympia finalist, said on a podcast with Cicherillo that Villegas “sounds like a sore loser” after getting beat by Coelho for the crown. He and others said there are no rules against this, and it’s up to the judges to pick a winner based on what they see, much like a beauty pageant. Because of that, they defend Coelho.Cicherillo has called Villegas' allegations "very unprofessional."“We don't have any rules set forth and we don't have any testing procedures,” Cicherillo said on a podcast last year after Villegas spoke out against Coelho. “This is anything but a 'natural' federation."Ray agreed.Even if Coelho did use PMMA, "What rule would she be breaking?" Ray asked. "If you can find the rule book, what rule book is she breaking?... So where does Sarah have a foot to stand on?"Cicherillo and Ray didn't return messages seeking comment.View this post on InstagramBrazil recently banned such injections after woman's deathVillegas and others say obtaining artificial muscles tramples the spirit of the competition. Instead of building muscle through hard work and nutrition over time, they say PMMA injections skip all of that and render it meaningless.Such injections also can risk disfigurement or worse. In the U.S., the medical use of PMMA is approved by the U.S. Food and Drug Administration only when used as a dermal filler to treat nasolabial folds and acne scars — not to enhance physiques in bodybuilding. In Brazil, PMMA was banned for aesthetic purposes in June shortly after a 48-year-old woman died following a PMMA injection for a cosmetic buttocks augmentation procedure. A government official in Brazil noted the injections could cause “irreversible damage and even death."Substance is designed to 'add volume' for cosmetic reasons in U.S.In the U.S., cosmetic PMMA injections consist of PMMA microspheres in bovine collagen — a product known as Bellafill. California doctor Steven Williams told USA TODAY Sports the idea of using it to enhance muscle artificially "makes some sense" because "a little volume goes a long way" with aesthetic concerns."After injection, the bovine collagen is absorbed leaving the (PMMA) beads to create more volume," said Williams, a member of the American Society of Plastic Surgeons. "Because it can add volume some people have tried using it to add volume in other parts of the body."Williams told USA TODAY Sports that using it for muscle volume in the U.S. would be considered "off label," which means the FDA hasn't studied its safety for this purpose or legitimized the claimed benefits.In bodybuilding, using PMMA to enhance physiques has been talked about for years with scant public confirmations of actual usage. Many in the business say bodybuilder Rich Piana was known for it before he died in 2017 at age 46.Longtime bodybuilders who consider it cheating say it's different than using steroids because using steroids still required hard work to build those muscles. That’s not the case with PMMA."It’s a joke," Bannout said. Anybody enhancing muscles this way "is making a mockery of the sport."View this post on InstagramIs there really no ban on this in pro bodybuilding?This is another strange part of this controversy. As of early November, the IFBB Pro League's website doesn't list any rules forbidding muscle implants or artificial muscle augmentation, except for during "natural" drug-tested contests that are far less popular and lucrative than lesser regulated pro competitions such as Mr. and Ms. Olympia.The Olympia event is the Super Bowl of pro bodybuilding where winners reap prize money and attention that leads to even more lucrative sponsorships. It is not a "natural" contest subject to "natural" rules.But the IFBB Pro league’s website still says pro competitors "cannot wear watches, bangles, pendants, chains, bracelets (wrist or ankle), ornamentation or artificial aids to the physique," which seems to imply a prohibition on external enhancements.Separately, an old IFBB Pro League rulebook from 2007 was posted on an internet message board in 2008 that states muscle implants and "any artificial improvement of the muscle" are rules violations punishable by disqualification and possible suspension. But it's apparently not still valid, according to those statements from top voices in the sport.The IFBB Pro League, based in Pennsylvania, is separate from the global IFBB organization for amateurs, based in Madrid, which does have testing for prohibited performance enhancers and has banned methods that violate "the spirit of the sport."Financial ties between clinic and bodybuilding leadersVillegas sat next to Coelho at an Olympia news conference in September and was booed by the crowd when she said her own physique would be difficult to top "no matter what means are being used" by her competition.The crowd’s reaction raised questions about who's invested in disregarding the issue.Vitor, the doctor who allegedly gave the injections to Coelho, is a business partner of Tamer El-Guindy, a producer of the Olympia event and CEO of Musclecontest International, a major promoter of bodybuilding events that are sanctioned by the IFBB Pro League. This means El-Guindy’s company is bringing in big revenue to the IFBB Pro League through sanctioning and registration fees.Vitor’s clinic in Brazil sponsors Musclecontest’s bodybuilding events. Vitor also is a co-founder of a prominent bodybuilding gym in Brazil with El-Guindy.In other words, the leadership of the sport is financially tied in with the doctor and clinic where Coelho allegedly got her injections and has been shown with Vitor as a patient on Instagram.“You cannot have a sport built on real muscle be in any way financially intertwined with a business that sells plastic muscle,” said Taktak, who won the Mr. Texas bodybuilding title in 2017. “Nor is it appropriate for a cosmetic surgeon who sells artificial muscle implants to be in financial partnership with Olympia leadership. That becomes a sports integrity concern. When the people responsible for protecting fair competition maintain financial relationships with the very business that undermines it, you have a fundamental conflict of interest.”Taktak also asked a question:“Are decisions being made to protect fair competition, or to protect the money?"The IFBB Pro League hasn’t responded to calls and emails seeking comment.Follow reporter Brent Schrotenboer @Schrotenboer. Email: bschrotenb@usatoday.comThis article originally appeared on USA TODAY: Injecting Plexiglass? A champion cried foul. Bodybuilding’s response raises more questions