TOPIC: PMMA - The Good, The Bad and The Ugly

@Baywoof


Thanks for your positive thoughts - I am convinced that such are what must take us all through our Phalloplasty adventures, understanding that our units are very variable in shape, size and nature, and that they can be impacted in good ways!


For this reason I am taking this incident in stride and looking forward to a more long term satisfaction than the instant gratification I had come to expect from my second PMMA session. It seems that our physiological response to these injections is not only variable from individual to individual, but can also vary between one session and the next. There is also something which Wade told me which we should all consider, I shall paraphrase and apologize in advance if my memory distorts his statement:


\"PMMA collagen formation doesn\'t react the same when it is alone in the shaft, than when it reacts with areas of previously formed PMMA collagen.\"


I don\'t know if an adverse reaction of a new series of injections can be detected at once, after several minutes or hours delay, only the next day, or days thereafter upon post-operative recovery? In any case I got the sense that Wade knew something wasn\'t right when he sent me home, because he was genuinely concerned and conveyed his hope that my very dedicated constant massaging might help spread it out properly.


If this is so, then it might be good if there was a buzz word for \"the shit hitting the fan\" and certain tried and tested post-operative protocols to help patients whose unit isn\'t responding properly. Maybe some form of plalloplasty intensive care? Who wouldn\'t pay for overnight nurses or engage immediately with certain specific and clear to follow massage routines at regular schedules, to reduce the damage?


Had I known that my unit was having an unexpected, unusual and severe reaction to the PMMA - I would have accepted any form of hospitalization or special care right there on the spot. But given that this is experimental surgery and that we are by virtue of that fact volunteer guinea pigs at the same time as lucky beneficiaries of a leading edge procedure, none of this is already set up at this early date.


So my vote would be for various post-op protocols for people who have different reactions to product when injected - granted this is something that can be noted or even guessed at during operation or immediately at the end of an intervention.


My first session allowed for full bandaging for several days, I took it of to take a peek two days later, and then put it on for another day or two. My second session came with the recommendation \"take it off as soon as you can\" and massage it to even out the product. This sounds like very different protocols, but to me they corresponded to exactly the same intervention, so I figured that it had nothing to do with one\'s condition that might be different, but was related to current preferences or the unfolding of practices which might have a slight, but not necessarily significant impact on results.


One thing I\'d like to know from others here who have had several session of PMMA, is what it feels like in Flaccid condition? Is it uniform and constant to the touch, when you squeeze it gently in various places, do you feel clumps and clusters of hard matter. And if so, did this diminish with successive sessions of filler?



Thanks for posting your reactions, opinions, advice or suggestions!


HC

This is why I trust this forum so much- the forumeers are as dedicated in compiling negative/neutral information as they are positive.

Man! May your dreams come true! They do! I\'m Hanging on your every word. Sending positive vibes your way. Hoping the very best!

My post-procedure instructions were to remove the wrap (I actually used a Xleeve) immediately when getting to my destination, either a hotel or my home. Then take the Cialis and massage without any wrapping for the next 12 hours or so, smoothing out any irregular areas.

I think they were recommending longer wrapping periods initially, like a year or so ago. Maybe they just recommend different methods for different volumes of PMMA injected or different penile anatomies. I received 26cc, which is a lot, and my penis was noted to be very empty of structure inside which led them to tell me to take extra care with smoothing out and making sure the PMMA is distributed appropriately during the first 48 hours or so.

Wait, so losing your newly acquired Girth is common?

@boost


Hi boost, thanks for your reply sharing your experience. How many CCs of what percentage concentration did you get in your first session? I see that you also lost enough of your gains to want to go back for another session.


Actually, I can\'t really say that I lost all my initial gains, but only that it was enough loss of Girth to freak me out, reminding me painfully of my original size which was nowhere near as nice! I would say that I lost maybe a bit more than half of the gains from session one. This is sufficient to feel like you have receded way too much and compel you to do something about it.


As far as Metacryl bonding to New Plastic, I don\'t really think that this is how the stuff works? I expect that the microbeads of synthetic material become encased in cellulose, in other words skin tissue growth which wraps them up to maybe isolate them from the rest of your body? In any case this would mean that the new injection, whatever the material, wouldn\'t be in any direct contact with the previous material, but only with the fibrous skin stimulated to grow around the beads?


Regarding issues with 20% Metacryl, I would be interested to know if this is the case, or maybe if so whether this might not be merely because this is what has been routinely used for second sessions, in which there are more issues whatever the material injected? I will be interesting to follow this path of investigation to see how others can better reduce any risks associated with subsequent sessions of PMMA injections.



@jlmb


Was that the post-operative procedure recommended for your first session, or for a later one? I am curious, as my first session with several days in the bandage was last summer. Also, this was the recommendation for my second session, but my unit was so swollen that I don\'t know how one could massage it effectively when so bloated and distorted with fluids that you didn\'t know what you were rubbing or where the shape outline was! I wonder if there isn\'t a much stronger drug which can be used next time to keep me from swelling up so much that I can\'t massage it properly?


26CCs sure is a lot of product for a single session, you must have had a considerable size when arriving before the intervention. I also wonder if you received Metacryl, because normally I had heard that for the first two days you could affect the smooth spread of product.


But in my case within hours after the injections it was stiff, hard and pretty much \"unmovable\", so 24 hours was inconceivable while 48 hours was preposterous. Maybe those time frames have more to do with ensuring that there are no small lumps keeping the surface from being smooth, rather than having to massage it to force lopsided quantities of PMMA from one zone to the next? I would like it if a proper description of how to massage, how softly or gently and in what motion, pattern or intensity, would be made available either by the team or by this forum.



@warpedview


Girth is what PMMA delivers, so you will get that for sure. However, it isn\'t the PMMA alone which brings this, but the tissue formation around the microspheres which thickens enough to give your unit heft, meaning extra weight, increased Flaccid rigidity (no more turttling) and greater circumference.


And yes, any number of former PMMA patients have noticed slight to significant loss of Girth gains, months after their first PMMA session. This is due to any number of factors. One could be that there might be mild forms of tissue swelling which temporarily enhanced your Girth, only for this to recede after that swelling goes away several months down the road.


For example with severe rhinoplasty (nose operations) swelling can take more than a year to go away fully. It is also possible that collagen doesn\'t remain constant and that cells diminish in size or numbers? Who can say, but at least it isn\'t the fault of the PMMA or of the Phalloplasty procedure itself. That is why many of us go back for more interventions.


The higher the concentration, the less Girth loss later on after the procedure, but the higher the risks of granulomas. At least that\'s what I\'ve come to conclude after reading posts in this forum. I hope others who know more than me or who are of a different opinion will chime in?


Cheers,


Hunk Chunk

@Bigben I do agree with your statement :- \" Personally I feel mixing the pmma in house could be much more of a problem due to potential bacteria and incomplete mixing (leading to nodules) \".


And you are right about China they manufacture the pmma microspheres and other pmma injectable products:-

As far as I know injectable the Brazilian\'s pmma products (e.g. Metacrill, NewPlast and the new Linea Safe) are all manufactured in Brazil. But the manufacturer of e.g. the past NewPlast and the new Linea safe in Porto Alegre, Brazil purchased these pmma (beads) in Korea or China. Since PMMA microspheres are mainly produced for paints, and there are no 100% clean microspheres on the market all should be washed and cleaned (sieve analysis)(which is a very complicated). But the crude pmma bone cement is manufactured in Germany.

Also as we know Artecoll which is used in e.g. Europe, Asia and Canada is used to be manufactured in Holland but now it is manufactured in China.


Also interesting in China they manufacture Artefill (1 ml=$112) very cheap :-

www.24meds.org/buying-artefill-steroid-online.php

Also again (I think) in China too they manufacture another pmma product but this time they mix pmma with Hyaluronic Acid ---> Juveni pmma permanent (3ml=$149) so cheap:-

www.components-electronic.com/product-se...z_semipermanent.html

www.juveni.com/wholesale-10-x-juveni-pmm...oplasty-30mg-ml-3ml/

But with this Juveni products you can have complications e.g. infection ??? the possibilities that the hyaluronic acid or the pmma beads are contaminated with bacteria :-

www.realself.com/forum/juveni-confort-juveni-mesolift

So that is true what you have said China is the country :- they manufacture pmma microspheres (to Brazil ??) and some pmma products (Artefill, Artecoll (e.g. Europe,Asia and Canada) and Juveni dermal fillers (Europe and Australia) etc.

This suggestion of using Chinese made stuff is very very serious. I was told by Dr C\'s office that the New Plastic they used on me (three sessions and I asekd every single time to be sure) was the original stuff, I do hope that we will find out for sure what was being used in the case of Metacrill or NP...

Dr C has a good reputation on this site and he has a lot to gain/loose, so I do hope that one way or another the facts come out to the surface now matter what they are...

Hi Bigben, I do understand your point of view (in regard of the 20% conc. risk of contamination as I have mentioned it before) but I am sorry I have to disagree with you in regard of Dr.C.\'s honesty , imo there is a big difference between these two doctors (Dr.C.+Dr.L.):-

Btw Dr.C. was not my treating Dr. and I have never met him in my life but what I have heard about him (honest and has great skills and experiernce in PMMA bioplasty) from the inventor of PMMA prof. Lemperle ( also he mentioned about Dr.Samy Passy +Dr. Marcio Serra in Rio.) these 3 doctors have great experience in PMMA injections (i.e. in the whole body not only in regard of the penis) also what we have read positive things about him from the members here . The other important thing which makes me trust this guy more:- if he was not honest; why did he bother to choose the mixture 20% ??, he could do that also with the 10% or the 30% if he was intending to cheat. Imo Dr.C. (by this mixture) is trying to find the best aesthetic result from PMMA penile bioplasty, I am sure he tried the 30% (he mentioned that) but he didn\'t like it\'s result, so he wanted to reduce the conc. of 30% just to reduce the risk of PMMA beads clustering together (lumps formation) (btw Dr.Samy disagree with him), the long-term continuity of his business, patient\'s satisfaction and his reputation are more important for him than a quick profit .

In the other hand Dr.L.\'s mixture is unknown mixing different fillers with different minerals e.g. we have Irishfan (>85cc.s =0 gain , and the strange thing Dr.L. said he is doing it for 1 year and still didn\'t find the right mixture to give him a gain of at least 0.1\") I am sure if one of these brazilian PMMA\'s products were FDA approved he will be the 1st one to use it instead of using his mixture.

Btw if somebody is interested to know who has a great experience (around 10 years) in PMMA injection in California actually he was the 1st one to use PMMA as far as I remember in this state (of course not in the penis) Dr. Douglas Hamilton in Beverly Hills

boost,
I have mentioned this before but I feel it is worth repeating. There is no 20% metacril. It does not exist. It is something that Dr Casavantes invented. There are several things he could be labeling as 20% metacril:

1. 30% and 10% metacril mixed in his office. (#1 = expensive and time consuming)
2. 30% metacril mixed with a filler in his office. We will never know what the filler is.. Saline solution ? tequila ? Dr loria\'s secret sauce ? (#2 = cheap and time consuming)
3. PMMA purchased from China. Many after market PMMA products are manufactured in the far east. In fact the brazilian makers likely have plants there. (#3 = cheap and quick)

I think 3 is the most likely as it would be the cheapest and least amount of work, but your guess is as good as mine.

Someone posted a long time ago requesting to see the PMMA packaging and Casavantes quickly changed the subject. So I think that gives us all the information we really need. Questions the PE doctors shy away from, are the ones you need to have answered. I have no intention of getting PMMA, but throw this out there for the sake of others health.

Bottom line, likely we never will know what Loria and Casavantes are injecting. And they use their patients as guinea pigs to trial new formulations.

I went to Dr N and she had a box of 10% on the counter. When i asked are we using that she said 30% was better? She also only uses one entry point at the base and a pretty large needle. when she distrubutes the metacril she uses her hands and shapes the product.

I think smartmans point 5 is the most important. My 1st round i was a bit naive to think it will just sort itself out i was in work the next day and then travelled to work away for the week. no post op care at all. but i only got 10ccs so the effect of this were limited.

@boost,

As far as I remember e.g. Mikehok received 17cc.@10% around 10 months ago and his gain in EG is still 0.4\", but in your case you received around 19-21 cc.s @10% and losing Girth?? ( either the reason is your body\'s collagen i.e. every person his body reacts differently than the other or you have a bigger stats (length+Girth) )

Hi HC,

As we know we cannot have a perfect aesthetic results from pmma injection, but there are many criteria which can reduce the unpleasant aesthetic results imo :-

1- The most important the lower the conc. of pmma e.g. 10@ has a better aesthetic result than the 20%, also it could be the mixture of the 30%+10% (imo) does not give you almost evenly distributed 20% pmma beads i.e. there will be some parts of the mixture contains still 10% and other part of the mixture will contain 30% --->i.e. the end result will be different collagen texture between the 10% and the 30% in different parts of the penis ??? I might be wrong.

2- A small volume of pmma injected in each session will give you a better aesthetic result than a large volume e.g:-

SO has a better aesthetic results he had as far as I know in the 1st two rds 10% and in the 3rd rd. @20% but he had small volume of pmma injected in each rd e.g. in the 2nd rd. 11cc.\'s and in the 3rd rd. 13 cc.\'s + 1cc.@10 near to the glans.

3- The technique of the doctor :- It is always advised to continue the smooth flow of pmma during injection in order to avoid depositing the material irregularly. And it should be injected in a threading technique as the cannula withdrawn to get the most even micro-strands and not micro-droplets, of deposited material.

This is the technique advised for Artefill :-

www.asds.net/asdsa/content.aspx?id=1364

That is the same what I feel in my penis like a strands of thick collagen running along the long-axis of my penis and the outer surface of these thick strands feels smooth but the gap (around 0.2-0.3\" in width) between these strands (i.e. the sidewalls of these strands) is rough, so for my touch-ups I need a small volume of pmma (10%??) to fill these gaps, (I wished if Dr.Samy didn\'t space these collagen-strands).

Dr.C. has a great experience with pmma penile bioplasty, and his technique is still being perfected.

4- The site of injection :- PMMA under thin skin will definitely give you nodules and irregularities, so this has to be avoided (e.g. the gap behind the glans) that was one of the reasons Dr.Samy refused to do it at this area and the other reason in his opinion the risk of skin necrosis. Also the anatomy at this area is different from the rest of the shaft; it is too tight and the transition at this area is irregular looks like-finger outgrowth spaces thats why if you get these beads injected at this area the new collagen formed will look finger-like outgrowths.


5- Early post-pmma injection protocole :-

Is very important but still we didn\'t reach the method to help in distributing the pmma beads evenly directly post-injection (massaging +wrapping -/+ the Roller\'s technique??)
In summary :-

If someone is looking for a better aesthetic result (but with less gains with more sessions) is to have only 10% with a small volume injected in each session. Otherwise if anyone who had already received 20% in his previous rd.s (and going for only touch-ups) he should get in his last 2 rd.s small volume @10% (I think by this volume and the lower conc. --> the beads will be less in number and they will settle in these multiple small depressions and roughness so the new collagen will fill these gaps and getting at the end more smoother surface as much as possible more than getting more girth gain).

boost, how Girth did you gain and how much have you since lost? Basically what was your starting Girth, 6 week post op Girth and current Girth?

I received 10% New Plastic. I believe around 19-21CCs. Forget exact amount. I do remember Dr. C and Wade being surprised I was able to fit so much in considering my starting size.

I\'ve been wanting to schedule a new appointment but I was worried about clumping the PMMA underneath the surface of my fat pad. Dr. C recommended getting Lipo and waiting. I never ended up getting the Lipo so I never got my 2nd session of PMMA. Assuming the Metracil works well for everyone, I wanted to go back and get 20%. Thats what I originally wanted with New Plastic but Dr. C recommended getting the 10% first to get a good base to apply the 20%. It took a few months before my penis looked nomal and the ring to dissapear. Just sucks losing Girth with it.

Thanks for keeping up on the updates.