TOPIC: Infections, Complications, Risks of PMMA?

@EQ
Thank you very much EQ for bringing this point for me:-
In his e-mail was he talking about a serious distant organ complication from the migration of the phagocytosed small beads or he was talking only about the chances of foreign body formation from these small beads ??(which Dr.Cohen said the best treatment for FBG is to leave it alone for spontaneous remission).
He mentioned only that small beads can cause FBG . And the chances of FBG formation in the Brazilian products are higher.
So are you saying FBG is a very serious complication and it is the biggest fear for you.

have a read of this page
web.me.com/drcasavantes/PMMA_Monograph/Welcome.html

and this one
web.me.com/drcasavantes/PMMA_Monograph/C..._Brands_of_PMMA.html

and this is most relevant to this topic
web.me.com/drcasavantes/PMMA_Monograph/PMMA.html

(the friend who forwarded it to me said this site is still a work in progress)

FROM ARTICLE

Approximately 20 days after grafted, fibroblasts migrate to the area and start producing collagen around the micro-spheres. It is important to remember that the inflammatory response has two synergic phases: inflammation and Repair.
The first phase is intended to destroy, dilute or isolate offensive agents and affected cells; the second phase cures and reconstructs the harmed tissues.
The Repair phase begins simultaneously with the inflammatory phase, but ends when the offensive factor is controlled.
This explains why the micro-spheres of PMMA must be between 40 and 60 microns in diameter: if they were smaller than 20 microns, they would be phagocyted; if they were between 20 and 40 microns, they will be phagocyted, but the macrophages will die creating a chronic inflammatory process. If the particles were larger than 60 microns, they will trigger a foreign body reaction.
The picture on the left shows the distribution of PMMA ranging from 40-60 microns, 6 months after the grafting in human tissues.

@ eq and smartman

do we know how long after her injections her Necrosis started?

I think I did find the proof that skin necrosis complication depends mostly on the technique of the doctor more than the filler per se so it can happen with any other safe absorbable products :-
(1) I think most of us had or heard about Lidocaine 2% injection (a local anesthesia).
Did any one hear that this drug can cause tissue necrosis ??
jcp.sagepub.com/content/49/7/872.extract
So does it mean we should not let our doctors to inject us with any local anesthesia?? lol
(2) Did anyone hear that temporary fillers (biodegradable fillers) e.g Hyaluronic acid or collagen fillers can also cause skin necrosis ??
They said the nasal area, the perioral region and the glabella are the most dangerous areas .
a) www.cosmetic-medicine.jp/list/fillers.htm
also in this paper they mention Nasal Alar necrosis can happen and also they mention Granuloma formation can happen after the injection of temporary filler e.g. Hyaluronic acid :-
b) www.drdayan.com/pdfs/risk-of-alar-necrosis.pdf

(3) Some people said that FFT is the safest technique and has no serious complications , actually there are serious complications from this technique (liposuction & fft injection) :-
Acute Respiratory Distress , central nervous system , skin and retina
www.scielo.br/scielo.php?pid=s1806-37132...=sci_arttext&tlng=en

I am not trying to frighten anyone about these complications from these products I just want to prove for everybody that the Technique of the Doctor is the most important and the area ( e.g. Glabella)
There is another paper which prove that :-
onlinelibrary.wiley.com/doi/10.1111/j.15...006.32052.x/abstract
injection necrosis is a rare but clinically important potential complication caused by interruption of the vascular supply to the area by compression, injury, and/or obstruction of the vessel(s).

In conclusion :- These papers prove that skin necrosis if it did happen (reported esp. in the face) it can happen with any products and not only with Newplastic .

@ justabitmore- It usually occurs if it did happen approximately between12-72 hrs post injection and not before 6 hrs .

Smartman,

The site of injection and tool used (syringe vs cannula) can play a role in whether the injected product will enter a vein or artery when syringe is used. I\'m not sure who you are arguing against as the text becomes mashed together on page two leaving much of it unreadable. However, almost anything solid injected into a vein or artery can cause an embolism.
All procedures have risks, though FFT has been documented to have the LOWEST known risks of any current PE procedure.

I don\'t think the major concern with PMMA is Necrosis from injection as cannulas are now used, rather the concern is the possible effects from migration.

Sparticus,
So we agree now it depends on the site of the injection and the technique of the doctor and NOT on the product per se (e.g.Newplastic) in regard of Necrosis.

(( I don\'t think the major concern with PMMA is Necrosis from injection as cannulas are now used, rather the concern is the possible effects from migration )) .

In regard of migration, I agree with you we should talk about it, but I have some points I need somebody to help me in answering these Q.\'s :-

We have read that the migration could happen with the small beads, correct me if I am wrong??
1- As we know the worst PMMA product was Arteplast (1989-1994) it had the highest number of small, irregular and electrostatic charges beads, correct? So it was injected in people around 22 years ago. I had never heard of one case of distant organ disease ( I am not saying there is NO proof of migration of these small beads what I am saying if it did happen--> there is no serious illness from this ). BTW I have mentioned before that Dr.Cohen said about Arteplast it has only 2.5% a chance of FBG formation and the best treatment for it just leave it it will go away by itself, and he did not mention about migration or serious illnesses of these old products.
In my opinion If I want to check for any complication (e.g. migration and its complications) for any product , it\'s 1st generation will be my best material for any research, sure it will have the worst complications, I hope we all agree about this point ??
2- If it was true that Artefill contains <1% small beads (<20 micron).
Why don\'t we have serious ill-patients from it during the last 5 yrs ?

3- Many ladies (not only from the US) travel to Brazil and Mexico for Butt\'s enhancement (each one has e.g. > 500 cc of Brazilian product in her Butt) 10x more than the penis.
So why there is no one case of serious ill-patient (e.g. lung or liver) in these ladies (e.g.in the US) I am not talking about lumps or FBG.

4- Also many HIV-patients with lipodystrophy from the US and from other countries travel to Brazil and Mexico (as you know they are immunocompromised patients so they are more prone to serious complication).
No serious organ disease in the US has been shown from any migration of the small beads.

5- Believe me I dont need any proof for that , I just want to help the others about PMMA ((the bad and the good informations)) .
In our Forum there are guys who have PMMA for few months (short period) and I have it for 15 yrs (I think it is a long period) I am still healthy (no liver or lung problem but in regard of my brain ?? I dont know, lol).
Of course I understand if somebody says I dont believe you SM that you had Artecoll 15 yrs ago, I will tell him I agree with you absolutely and I cannot prove it for you but do you believe that there are patients did have PMMA injection in 1989 ???
I will always like and support healthy discussion and I will never argue and force people to believe my points, I think you do remember sparticus when I have mentioned before about the need of an antibiotic for PMMA injection and I said actually you dont need it (that was the words of Lemperle) you did disagree with him (you said as far as I remember it is a serious statement and he shouldn\'t say that) and I didnt argue with you that time, I said he is right he should be worried about a risk of infection, and then you asked me if I could ask Dr.Cohen (who is affiliated with Artefill) directly, I accepted your request and I did ask him the same Q. his answer was the same as Lemperle.
Everyone should know the truth about any product and it\'s possible complications (i.e. complications due to the product per se and not the technique) and then he should decide what is the best for him.

I really enjoy having discussion with everyone in this forum, actually I feel we are like brothers helping each other.

Justabitmore wrote: ...do we know how long after her injections her Necrosis started?

within 24 hours re the de Castro paper\"Approximately 24 hours before she had been submitted to a cosmetic treatment on her face, a bioplasty with PMMA, performed by an experienced plastic surgeon. \"

@ eq
thanks eq! sorry hard to read the paper on my black berry yesterday.

Smartman,

I\'m not stating there is 100% proof that the beads are making it to distant organs and that they are causing major problems. I am stating that it is a potential problem that needs more investigation. I think we need to dig further before we conclude that there are no cases. EQ was able to find a study recently regarding migration in humans when many were stating there is no evidence for that happening in humans. Since migration has been shown in both animal and human models now, we really do need to consider the possibility of these beads making their way to organs. I understand your point that no studies that we currently have found show this as a major issue, but will this change when this stuff is in a body for longer than the studies have tracked? Some people may have this stuff for 70 years if they get it while young. I think we need to do more research into the possible consequences of bead migration to organs.

@ all of you

I was with DR C today and told him about this case. He knew it straight away and described it. It was a friend of his a good plastic surgeon who did it and he did use a micro canula. The patient had several face fillers in previously and requested something in an area you don\'t normal go. He simply shoudnt have done it. Dr c said it was all to do with technique and not product in fact hardly any PMMA went in there but the big vessel collapsed and that was it.
Dr showed me how the vessels in the face works and also how to approach the nose. He was with the guy yesterday who is full of regret and admits it was his technique.

He also said you musnt get complacent he approached every surgery with worst case in mind and is very worried about all the new breed of home trained surgeons arriving. He was with a big group from brazil yesterday discussin pmmaand that case came up. Sorry for typos

Justabitmore wrote: ...
I was with DR C today and told him about this case. He knew it straight away and described it. It was a friend of his a good plastic surgeon who did it and he did use a micro canula...

Well hopefully that clears up the statements that the doctor did not use a micro canula.Dr C sounds like a fantastic well grounded doctor. Could you please get a ballpark quote for his procedure using Artefill instead of Newplastic?

@ at eq

I have left now and won\'t be home be back to my pc before wed. Why don\'t you just ping Wade an email he will help you I am sure.

Also DRC mentioned a paper that was done brazil with pmmy over 100000 cases conclusion on almost every case reviewed was due to technique and some using a needle! Even using the needle with the up and down motion is not safe.

He told me some scary stories about especially older women who suddenly are getting qualified to do this stuff. He watch one putting surgical gloves on then taking cup of coffee grabbing some coins from her purse and then back to the patient!

Oh and the good doctor just gained an Inch on his bicep thanks to PMMA!

@justabitmore - Thanks. That is pretty much the same for all procedures (non PE) that we have researched. Operator experience and technique and experience are the most important factor when choosing to have a procedure. Having said that sometimes things go wrong even for the most experienced operator using perfect technique for the simple reason that all our bodies do not react and behave in exactly the same way. As they say in this industry, 'Surgeons are lucky, they often bury their mistakes so no one knows'I'll search on how to get a hold of Wade.Many congratulations on your second successful procedure. I'm sure Mrs. Justabitmore will now say 'just no more'! I would love to gain 1\" on the biceps. I have never been able to get past 15\"

@ eq

Most definitely! The second factor in DR C opionion is the amount of procedures and volume you jack up with. He really is respectful of the material. One guy who he sent away after he felt enough was enough went somewhere else and ended up with 12 session !

Choose the best surgeon ask for his opinion and say you want safety and aesthetics first Girth second.

Stick to that and you give yourself the best chance of a good result.