TOPIC: Infections, Complications, Risks of PMMA?

I\'m thinking of going through PMMA and I\'ve read this board several times and even was a member on the old board for a while. I know there are many that say there are no risks but there are some people who say there are risks. I\'m 22 and I have a long ways ahead of me before I feel I won\'t be using my buddy anymore so I just want to make sure before I go through with this that people who HAVE had it and people who are looking into it.. know what the truth is. Has Dr. C confirmed that risks and complications are low? I know I\'ve seen some with little bumps that appear that they have something injected in them to make them disappear but..is that common? I guess myself and others are probably curious and I figured I\'d make a topic on the risks, infections and complications alone because basically.. TJ doesn\'t scare me, Dr. C doesn\'t scare me, a bigger penis definitely doesn\'t scare me...but the risks do. Thanks for any help.

I also have similar concerns, i am 23 and i am leaning towards this being the best route. How on this board has had PMMA injected the longest?

Whoever said there were no risks were mistaken or misinterpreted. This procedure carries basic risks found universally in all medical facilities... the risk of bacterial infection due to negligence (i.e. lack of sterilization)... although these risks are greatly minimized by medical staff, even the finest clinics and hospitals deal with freak incidents. This particular risk is an obvious (and minimal) one, but it should be noted.
Complications as a direct result of PMMA have been attributed more to poor technique and/or poor grade of PMMA versus an actual adverse reaction to PMMA. While there is still debate on the matter, the only complications known to have arisen from PMMA injections have been limited to granulomas (a tissue growth induced by an inflammatory response). Conceivable complications like migration or rejection have not been reported with the use of medical grade PMMA in Dr. C\'s practice.
Relatively speaking, in the short term PMMA has a remarkable safety record. I believe Smartman is our longest reporting PMMA-Penis member at 3 years, and GSXR is our longest reporting Dr. C patient at 7 months (correct me if I\'m mistaken). Evil Pneivel did appear to have some type of nodule formation (although was never diagnosed as a granuloma) which was painless and benign. This was resolved with kenalog injections which he details here phalloboards.websitetoolbox.com/post?id=5360270 . I believe we had another member (will look to find his name from the old board) who had some sort of fluid build up (edema-like) in his shaft that eventually subsided. Outside of these significant reports, no other major complications have been reported from forum members.
It\'s also important to note that Artefill, an FDA approved brand of PMMA for use in the U.S. has shown no sign of migration, injection, or rejection.
There is a good convo going on in the primary PMMA thread regarding the relevance of PMMA brands and their respective \"qualities,\" and how that could potentially increase the chance for complication. Dr. Casavantes uses New Plastic, and some contend this product is not as \"pure\" as the American-approved Artefill.
My take:
I personally think Dr. Casavantes has established a portfolio and reputation that deserves consideration with respect to the brand of PMMA being used. He has been working with PMMA for a while and has his trust behind the New Plastic product. It is his faith in the product that reinforces my faith in the product. Simple as that.
As for my feelings on the risks with PMMA... I buy the (obviously plausible) scenario that most complications have arisen from poor technique and/or poor grade of PMMA.
I believe Artefill\'s high cost coupled with the complexity of masterful injection technique (especially in an organ as dynamic as the penis) makes this procedure uncommon, at least as far as the U.S. is concerned. It is, however, commonly practiced in Mexico and South America and in my belief, will eventually trend in the states when the prices are brought down and there is an increase in qualified injectors.
If I had to note any noticeable issue that required some attention it would be a non-visible ring of slightly palpable bumps that make a semi-circle just outside the base of my shaft. I believe these to be scar tissue spots from the entry points used, and was told that they will lessen in time. I was also told injections can help reduce them if they persist. These bumps are hardly noticeable yet palpable but you have to really inspect them closely, and they don\'t seem to cause any pain to the touch.
I do have a minor aesthetic issue where there is little to no PMMA between the glans and the upper part of my shaft, but I don\'t consider this a negative because it was to be expected (the doctor recommends 2 rounds because contour issues are almost inevitable given the unpredictability of PMMA\'s settlement after the first round).
Otherwise, there was virtually no pain after the procedure, just mild tenderness. There has been no pain since, nor any major change in sensitivity (although if I were to consider pre-op at 100% sensitivity, I did dip to 95% before returning to 100%...which may be explained by the creation of new nerves ?? ). The function of the penis is unchanged and the erections are remarkably firmer (it seems the collagen is slightly tougher than the pre-pmma tissue).
All in all, keep in mind anything phalloplasty possesses risks, but in my opinion, this one possesses the least of all the semi-permanent and permanent options available. Be sure your decision to entertain the idea of penis enlargement via medical intervention is a sound, healthy, and rational one. I\'m not judging those who choose to get it for sheer vanity, but I express caution. Otherwise, those who are undersized or wish to enhance sex for their significant others are the best candidates in my humble opinion.
Good luck.

smartman wrote: @EQ,
Lets say the migration of these small beads is true :-
...
So from these points ( it is like human experiments and not animal experiments ) wouldn\'t be enough to show at least one ill-patient???
EQ I am only trying to get the truth as all of us from the whole thing, Dr. Cohen will make it easier for us if he can show us at least one patient , could you help us to get this information from him or from other doctors , I have tried but he unfortunately didn\'t answer my Q. (i.e. our Q.) .

@smartmanI was not sure if you were serious implying that there were no studies recording serious issues with (PMMA) Newplastic. Here are 3 I quickly found on the web. I suspect Portuguese speakers could find a bunch more fairly quickly'The Polymethylmethacrylate Effects on Auricle Conchal Cartilage: Report of 21 Cases' by Caldellas et alhttp://www.ncbi.nlm.nih.gov/pubmed/20601571'Extensive facial necrosis after infiltration of polymethylmethacrylate' de Castro et al www.scielo.br/scielo.php?script=sci_artt...lng=en'Complications after polymethylmethacrylate injections: report of 32 cases' by. Salles et alhttp://www.ncbi.nlm.nih.gov/pubmed/18454007 That\'s 54 cases after just a 3 minute search!!

Did these reported cases of complications mention the grade/brand of PMMA, the doctor performing the injections, and the instruments used to inject PMMA? Given that PMMA proponents contend that complications arise from the use of poor technique and/or PMMA-grade, it is paramount all such info surrounding these purported complications are shared in the same light.

Both articles you linked did nothing to address the very contentions made by PMMA proponents.
If we are talking about getting an unknown brand of PMMA injected to us by unqualified persons, then sure, by all means avoid PMMA for tissue augmentation. I can only imagine how many underground injection parties go on in Mexico and South America...hell they even go on in the states.
The above lady was the first ever reported case of her \"type,\" and the article failed to mention ANY background on her injections.

Skeptical One wrote: Both articles you linked did nothing to address the very contentions made by PMMA proponents.
If we are talking about getting an unknown brand of PMMA injected to us by unqualified persons, then sure, by all means avoid PMMA for tissue augmentation. I can only imagine how many underground injection parties go on in Mexico and South America...hell they even go on in the states.
The above lady was the first ever reported case of her \"type,\" and the article failed to mention ANY background on her injections.

I am very surprised by your reactions. The Caldellas paper specifically stated that he and his team did the procedures that were part of the 21 cases studied. They are a Brazilian Clinic and he specifically stated Newplastic was the PMMA product used.The de Castro paper on the facial Necrosis is also a Brazilian publication. He stated that the procedure was 'a bioplasty with PMMA, performed by an experienced plastic surgeon.' We know that the product is not Artefill given the locale and description 'In its injectable form, it is made up of microspheres spread within a colloid medium of carboxymethylcellulose'.The Salles, also a Brazilian hospital, case review detailed 'Sixteen injection procedures were performed by certified plastic surgeons, nine by dermatologists, two by urologists, and one by a nonphysician'.As far as satisfying 'proponents of PMMA' I am not sure who or what you are referring to. I am just attempting to present factual articles which were presented in established peer reviewed publications. If this a problem please let me know. EDIT: removed incorrect conclusion of the PMMA brand.

My reaction was to a photo uploaded with the intent to demonstrate the extreme deformities related to PMMA without the relevant background to go along with it. The Caldellas and Castro studies you stated are NOT in relation to the picture shown above and therefore are irrelevant. I\'m just not a big fan of showing pictures of Necrosis without any sufficient background, that is all. Pardon me if my reaction seemed harsh.
As for the studies themselves, \"a bioplasty with PMMA, performed by an experienced plastic surgeon\" further explains my \"reaction\" to the general criticism of this technique/product. Rather than assume, why not simply state the doctor and brand of PMMA in question?? Precise, Metracil, and perhaps lesser known brands could obviously have been candidates...and a plastic surgeon (keyword surgeon) doesn\'t imply they are skilled in the art of Bioplasty nor does it mean they were using modern instruments that Dr. Casavantes insists reduces (drastically) the incident(s) of inflammation, infection, etc.
Proponents of PMMA are those who use it in their practices, and to some extent, those who have had it put in them. Again, pardon what may appear as a harsh reaction, but the above picture elicited tales of past Phalloplasty tragedies, albeit not intentional on your part.

Although I\'m interested in having the procedure, I wouldn\'t say I\'m a proponent or an opponent of PMMA. That said, I don\'t think we can just assume that the brand of PMMA is newplastic in the articles where it isn\'t specifically identified. For years, PMMA production wasn\'t regulated in Brazil and many physicians used \"compounded\" PMMA, which could basically be made by anyone without conforming to certain standards of gov\'t regulation.

Skeptical One wrote: My reaction was to a photo uploaded with the intent to demonstrate the extreme deformities related to PMMA without the relevant background to go along with it. The Caldellas and Castro studies you stated are NOT in relation to the picture shown above and therefore are irrelevant. I\'m just not a big fan of showing pictures of Necrosis without any sufficient background, that is all. Pardon me if my reaction seemed harsh....

The picture is from the de Castro paper. The link to the paper is right under the picture and contains the full paper. The paper clearly has a discussion on bioplasty and it\'s use of micro canulas etc. As far why the paper did not state the doctor or brand of PMMA the obvious litigation concerns exist. You are correct that I cannot be 100% sure that the de Castro product is Newplastic it could also be Metacril which is also Brazil FDA approved. So from now on we should always state the PMMA brand in all our posts and not use the generic PMMA label?

\"Dr. Casavantes insists reduces (drastically) the incident(s) of inflammation, infection, etc.\"

I have not come across information supporting the use of a cannula in the reduction of any complication outside of Necrosis. Can you ask Dr. C to provide us with the literature on which he is basing these claims?

There was a full study I linked in forum v 1 that categorized type of complication, injector training, and PMMA brand. I recall New Plastic was associated with several forms of complications, not just Necrosis.

@Eqstudent
The PMMA brands used in patients have become significant as of late, mostly due to its discussion in other threads (you and others have helped bring to the attention of our community). The significance of the debate was whether or not the \"less pure\" alternatives to Artefill could pose increased risks in the long run.
It isn\'t that we need to state the brand of PMMA in all our posts... but we certainly can\'t assume the patient with facial Necrosis had New Plastic (or any other brand) without any proof. You said in an earlier post that \"it is reasonable to assume,\" and I took objection, hence my reaction.
Yes microcannulas were discussed but after some reading, the type of microcannula used is very important to identify when trying to piece together the reasons for these types of complications. With the growing debate on the relevance of PMMA quality, more and more factors are becoming relevant when trying to figure out why things go wrong.
You\'re right, the Castro paper does contain that picture, and I misspoke.

sparticus wrote: \"Dr. Casavantes insists reduces (drastically) the incident(s) of inflammation, infection, etc.\"

I have not come across information supporting the use of a cannula in the reduction of any complication outside of Necrosis. Can you ask Dr. C to provide us with the literature on which he is basing these claims?

I am simply stating what Dr. Casavantes and his office feels about the product and their technique. It\'s his medical & professional opinion and not mine. I was not asserting that there was or was not medical literature backing up this claim in my statement. I was more-or-less relaying what I\'ve learned from them.
Another member mentioned that the Doctor would use alternative brands, i.e. Artefill, assuming the patient was willing to pay the difference in cost. It doesn\'t seem that he has some kind of financial stake with New Plastic, just a professional preference.

sparticus wrote: There was a full study I linked in forum v 1 that categorized type of complication, injector training, and PMMA brand. I recall New Plastic was associated with several forms of complications, not just Necrosis.

I\'m looking through all of your links from the previous forum and re-reading some, while \"Text searching\" others for the term \"New Plastic,\" and was having trouble finding it. You submitted a lot of articles so I may have missed it, was curious if you could re-link it here, thanks