TOPIC: PMMA neocollagenesis process

I suppose this is less specific to your practice or to any specific procedure so much as a question around PMMA. And there may not be any definitive answer so it might be worth asking multiple doctors, but...
I know that the microspheres are permanent, but is the collagen? Or is the body constantly refreshing it so long as the microspheres are in place?

I know that the body ships fibroblasts to the site of the PMMA as part of the inflammatory process, and that the fibroblasts recruit collagen to encapsulate the PMMA.

The question is whether old collagen will "die off" and be refreshed, or does it stay. Likewise with the fibroblasts.

I ask this because realistically somebody could grow or shrink to some extent based upon how good of a job their body is doing at replenishing collagen at a given point in time. Potentially I mean. If it is a constant process of replenishment and replacement, then somebody could grow or shrink based upon how healthy of a lifestyle they are living.

I guess it's also possible this replenishment exists, but is so slow that the fluctuation would never really materialize unless someone made changes long-term, and then they might see a fluctuation over the course of 10 years or 20 years, so this line of thinking isn't really worth chasing.
But if the collagen is being replenished on a fairly rapid dynamic basis, then somebody with significant amounts of filler could see a non-trivial fluctuation in collagen volume based upon their diet and lifestyle (and obviously genetics)

The collagen produced in response to PMMA is not permanent because the body is constantly undergoing a cycle of collagen production, breakdown, and renewal. However, the PMMA microspheres remain in place as a stable nidus, continuously stimulating new collagen production at the site of their placement.

Fibroblasts play a key role in this process. They migrate to the PMMA site as part of the body's inflammatory response and actively produce collagen to encapsulate the microspheres. Over time, older collagen is broken down and replaced in a process known as remodeling. Similarly, fibroblasts have a lifespan and are replaced by new fibroblasts over time. This cycle continues throughout life, though it slows with age, contributing to sagging skin and wrinkles. Various factors influence this cycle—catabolic factors (like smoking, illness, and stress) break down collagen, while anabolic factors (such as sleep, good nutrition, and exercise) promote its production.

Because of this ongoing remodeling, someone’s collagen levels can fluctuate based on their lifestyle choices. Engaging in anabolic behaviors will lead to greater collagen production, while catabolic factors will reduce it. Even so, everyone continues to make some level of collagen, even smokers. However, these changes can be noticeable over a relatively short period. For example, a patient who quits smoking can show dramatic improvements in skin quality within months.

Given this, someone with significant amounts of PMMA filler may experience variations in collagen volume depending on their diet, lifestyle, and genetics. Optimizing collagen production is straightforward—eat well to minimize free radicals, avoid smoking, get enough sleep, exercise, and manage stress. These are all good things to do for your overall health, so you should aim for them regardless. That said, a couple of syringes of Bellafill are probably the equivalent of being perfect at all these things. So if you’re not hitting every mark - who is?—you’re probably better off just doing an extra syringe of Bellafill and calling it a day.

That...answers every question I had, completely, and clearly.
This is exceptionally useful info, especially for guys who are looking at longer lasting collagen stimulating fillers.

Not that it's going to lead to a wild fluctuation, but it's good.inducement for some of us - like myself especially - to get our asses in gear and better look after our health. We spend good money on these procedures only to flush a portion of it down the drain with a sedentary lifestyle and bad diet.

Thank you for taking the time to explain that!

I had asked Dr. Lemperle about this topic after my infection after the third round, I cannot risk a future procedure and I asked about PMMA and the permanence of the my Girth for future years. His response: Fibroblastes have a very different "turnover" of a few months, depending on whether they are in a fresh wound area or in an old "wound" such as between quiet foreign PMMA microspheres.
Collagen fibers, on the other hand, have a very low turnover, i.e. a half-life of about 15 years (!!) after they have been produced by the fibroblasts, i.e. they can coat a single microsphere for up to 30 years!
So don't worry too much about your collagen fibers in the penis : there are no studies yet that they are decimated by smoking .... like those in the skin ! The effect of a "healthy life" has also not yet been proven in studies. But it is certainly not wrong.

I hope sharing this information helps those who need answers. Dott. Lemperle: The feeling of the stones at the beginning was right because all the cellulose was absorbed leaving the hard globules lumpy - and then soft tissue grew in between so the implants feel like chewing gum now and forever . Here is the difference under the microscope : a) after 1 month all cellulose disappeared and all PMMA-microsphere clump and feels stony hard .
b) after 10 years : all red are your collagen fibers which cause the elasticity like jewing gum

Source?
Was it this?

www.robertochacur.com/en/cellulite-treat...ing-skin-structures/