TOPIC: American plastic surgeons' opinions on PMMA - why are they so damn negative?

I just had a consult today for facial filler and the doctor was discussing Restylane and Radiesse with me (Restylane was 650 for 1 cc and Radiesse was going to be 1600 for 2 cc). I brought up the topic of artefill and he flipped out and said he\'d \"never use that - it\'s out of the question.\" I asked why and he said \"It\'s very dangerous - the reactions aren\'t known. You could react today or 10 years from now and I am not interested in doing that to my patients.\" Ok - well... Radiesse hasn\'t been around that much longer than artefill...I thought (but I didn\'t say). What is with the vitriol? I didn\'t want to argue with him over it (and I\'m not trying to get it in my face - I was just trying to see what a reputable plastic surgeon in the USA in a major city would say - and there you have it). Also, I said I mentioned it because if he wanted to augment my cheek area - it made sense to use a bone-like substance rather than Restylane which is more liquid and would look like a blob. PMMA is bone paste in its pure form...so why not even consider it? He said he can make Radiesse look like bone, and don\'t bring up Artefill again - or see another doctor if I want to \"take a risk like that\"...end of discussion.

This is a well respected doc with a big practice and many happy patients / good reviews. He wasn\'t even subtle or mildly discouraging. He was just like - you\'re insane - get out of here if you want that. You\'d think I asked for home depot silicone.

This board has been the first and only glimmer of home I\'ve seen in 3+ years of peyronie\'s disease ruining my penis. To be honest, this is an emotional topic after what I\'ve dealt with.... and then plastic surgeons say this shit to me - I just get so pissed because it\'s totally crushing the possibility without even really explaining anything. At least with one of the posters here, I could read/discuss his bad PMMA experience in great detail and understand it. So, then I leave w/ this nagging feeling - what does he know that I don\'t know? Why am I reading a totally different story on this board?

I\'m seeing a Urologist in a few weeks so I\'ll get that opinion too... though I can predict it already.

Mustang...Thanks for your thoughts....Also to Carl Johnson...and others....Docs get ticked off if you ask them the \"wrong\" questions....which is why I persist in asking.
Good luck guys.

hoddle10 wrote: @xiaflexed, I don\'t have time until the 27th, but when I can I\'ll write something about how you should approach your Urologist in a way that should get him to give a more reasoned response.

That would be really great - thanks for that. I am not always the best communicator. The good part about this doc is that he does research too, and he knows that there are off-label treatments out there that work for some people (Trental, regular Cialis use, and Clomid helped some men...though rather anecdotal - and they didnt help me unfortunately). So, he\'s open minded. He was onboard with the ADS long before it was mainstream. But, he wasn\'t really onboard when I mentioned cosmetic reconstructive approaches. I mentioned resylane long before I ever knew of this board since it just was something I had done cosmetically, and its pretty straighforward. He just said \"you\'ll never have the penis you had before this - you just have to come to terms with that\". Ok, if I still had 5\" Girth - fine... 4\"? Not coming to terms... Btw, as you all know - the poster named Miracle got quite a benefit and he started with PD like me.

Hoddle, if you want to PM me or just post here - I\'ll check back for sure. Thanks again. I\'ll let you all know what he says... I am really going to try to push for a reasoned response - not a knee jerk reaction. He has to just know men have been doing this for 5+ years and they haven\'t all ended up in his OR getting it taken out. He\'s removed too many lumpy fat grafts to be objective, IMO...it\'s hard to crack through that layer of negative experiences.

Hoddle, you touched on another interesting aspect of the american medical system when you said, \"It\'s very rare you\'ll find a Dr who has much or any knowledge of PE surgery.\"

They might not have any knowledge of it, but they would never admit that they are uninformed. Rather they will piece together a response for you based on whatever little knowledge on the subject they do have, leading you to believe they are an expert and their opinion is more valid than someone else\'s. I don\'t think I\'ve ever heard a doc say \'i don\'t know\' except on TV when they can\'t diagnose something on House. They just fake it assuming they must at least know more than the patient so they get away with it.

To be fair, I think American Dr\'s are comparing PMMA to other fillers, rather than PE procedures. It\'s very rare you\'ll find a Dr who has much or any knowledge of PE surgery. They automatically compare implant materials and from that point of view biological materials seem much safer than foreign body implants. Hence they probably would think the idea of injecting PMMA is a bad one. Also the Drs who do do PE surgery can\'t inject PMMA due to price and the carrier used for Artefil.

@xiaflexed, I don\'t have time until the 27th, but when I can I\'ll write something about how you should approach your Urologist in a way that should get him to give a more reasoned response.

I had paid hundreds and hundrdes of thousadns of US dollars as a tax payer, now that I am a one man business, I can\'t afford health insurance, it is over $900 a MONTH for the LOWEST plan....IF I need simple anti biotics, here is my cost:

$160 Dr visit
$150 lab test (results are not sent to me, but to the Dr to force me to go back to him)
$160 Dr visit for results check and prescrption
$25-$30 for generic Anti biotics

---

$500 or so.

My cost for buying anti biotics overseas by simply going to a \"Pharmacy\" Cost: $3.50!!!!!

(BTW, I hate the name \"Drug Store\" in the US, it should be called \"Pharmacy\" like everywhere else)

We are being programmed to think with in the box and our freedom is going away.....

For cosmetic surgery look oustside the US with proper research, of course.

My trust in the American medical system was absolutely rocked when researching Phalloplasty options. I was so gung ho and such a believer in the AMA and the FDA that I wouldn\'t even consider A procedure in another country. I was literally driving myself insane, because here was a certified US doctor, touting a procedure as permanent and successful, and again and again I was reading horror stories from guys who had had it done. There was exactly one success story for many many disfigurements, and even still, my faith in the system was winning. I had booked my procedure, paid my deposit, and then it happened. On a plane back home from vacation, I started reading about a procedure outside the US. There were dozens and dozens of success stories, from guys who had been posting for many years on other sites about other options, who had finally settled on going outside the country, and they weren\'t ending up severely disfigured. That\'s when I finally cracked. The American medical system and the FDA are complete bullshit. They do not care about patient safety, they care about money. They are on the take, corrupt to the core, and their ethics are shady at best, outright criminal in some cases. This has had a profound effect on my political views, how I view my own profession in medicine, and especially how I view elective plastic surgery in the US. We are not leaders anymore. We lead the world in cost, not outcomes, and there is a big rea$on.

Agreed Mustang. When I was in Asia I came down with a cold or flu or something. The over the counter meds had me good to go way faster than the US counterparts. I know this isn\'t scientific by any means. I also bought some sleeping pills for the flight home and have never felt such a strong sleeping pill. And you\'re spot on with the prescriptions. I don\'t go to the Dr often, but if I do it is for antibiotics 90% of the time. I know that\'s what I need and the doc knows that\'s what I need. But I can\'t get it unless I waste an hour at the doc to get a prescription. What a waste of time/resources/money.

While the US medical system is OK, it has prevented many great medicines to be approved and hence denied the public such benefits while approving some other medicines that killed US citizens. Sure, mistakes happen by the FDA and other establishments, but overall I am not impressed by the FDA.

Some of the medicines that are made overseas, under the same brand and licensed, are a lot more effective if bought in, for example, Asia, Africa or even the Middle East. I know, I have been there and bought some. For example, I think OTC Tylenol in the US is junk and it never works for me. I bought the same pills in Asia for cold and headache and it worked fantastic! it was made there. Also, many \"prescription meds\" can be bought OTC (over the counter) without a Dr\'s prescription. I am responsible enough to buy what ever I want, I do not need the government to tell me what is good for me.

If one does some research, one will find that the US medical system (while excellent in many ways) is not the \"only good\" system out there. Asian hospitals and some of their Dr\'s are the best in the world also. So one needs to be selective and not blindly trusting in the US system nor any system!

Hey everyone - thanks so much for the replies. I posted that right when I got home & was pretty frustrated with his answers - so it\'s good to hear your agreement that I had a reason to be frustrated. I think he definitely has some of the doctor/god complex going on. And, thanks for posting that Radiesse link - there are totally a lot of negative reports on that stuff too - even on RealSelf. But PMMA - god forbid. Like you said, I would\'ve at least appreciated a discussion / explanation from his side of this issue...Otherwise, what\'s the point? Why be so negative? He was also very busy (already 45 min late) and the office was full of people. So, maybe he was just like \"shut up and move on\" because he was busy...but I don\'t think it\'s necessary to act that way just because your office is full. It wasn\'t really a good experience overall (I waited an hour just to get the price of the other stuff and ask one more question - despite his staff of 10 running around). I\'d love to talk to a totally independent biochemist about metacrill to understand the absolute scientific basics of it with as much objectivity possible. I did this with xiaflex (it took a while to find someone - but I was able to do so through some PhD friends of mine) - and the information I got was beyond anything that I ever imagined.

I\'m going to ask my Urologist at the end of the month, and I know he\'s going to be negative - but I am going to push him for why. Part of the problem with urologists is that they see the guys who are messed up & who they have to fix. They don\'t see the people who are fine. So, obviously there\'s going to be a bias there. Also, I think in the USA there is a much greater fear of being sued than in Mexico or Europe - so even the 1-5% chance you can have an adverse reaction, they are going to just immediately jump to \"it\'s unsafe, you can\'t do it\" as long as their PEERS agree. Once the medical establishment is okay with something, then doctors can do it without fear of being sued. Facial fillers have come a very long way in the last 10 years, mostly off-label in areas like the undereyes or chin and jawline (never FDA approved for those). But, it took a while for a few adventurous patients and surgeons to try it - and then to publish it / present it at conferences...etc... and now you can get the same \"forbidden\" filler techniques at med spas in malls 10 years later.

There are lots of pioneers here...and it\'s given me a lot of hope to fix this.

There is an \"unspoken yet agreed upon mutual plan\" by the Dr\'s, the medicine companies, the medical insurance companies, the AMA and so on to stick together and promote their financial benefits and to insure the security of their jobs.

They keep thinking \"in the box\" to protect their own interest, they do not want us the patients to question their judgement. Of course they DO help us and provide some good services, but anytime one questions their judgement, MOST dr\'s will get butt hurt, they think they are gods...Most, not all. Every time I questioned a Dr about something he said or did (and I knew the answers to my questions, I wanted to check his ethical manners) he failed the test and got angry when I confronted him.

So, I take my Dr opinions with caution and I do my own research as much as possible. I Do not trust them totally, I trust them only after I know the answers and they confirm them....

No studies beyond 3 years and reports of nodules forming. Doesn\'t sound any better than the worse PMMA reports.

www.radiesse.com/RADIESSE_Wrinkle_Filler...ructions_for_Use.pdf

my guess is ... HE DOESN\'T KNOW lol....why so defensive without any insight as to why

this dude prob has no clue about it and hasn\'t done any homework on it and wants to just sound like he does because he is a \"reputable\" doctor in your area....well to me reputation means taking into consideration your patients emotional feelings and never turning away a question with no facts to back up your opinion of something

a good doctor would have explained WHY and given you statistics and experiences of other doctors he might have known or heard of

sounds like you got the \"just because i say so and i am boss\" answer and to me that\'s non sense and i would not ever take that as a intelligent or educated opinion of any doctor

sounds like he got offended not at the fact that you asked him about artefill but rather at the idea that you might know more then him about it lol

Seems a little over the top! Most reputable doctors would explain their view. To go off on you like you asked for something illegal , does not give me much confidence in his opinion!! Thanks for sharing and I really don\'t think your hopes are gone, only based on one opinion , and one that did not explain himself !

The Urologist I saw today wasn\'t as bad as the plastic surgeon at all. He said he has never had to take PMMA out and didn\'t even know what it was. He said he did a lot of fat removals and he said there\'s some tribal practice where men put some sort of oil in their penis - and he\'s removed that & said it has had very bad consequences - but he\'s never heard of PMMA or dealt with it in a negative situation.

So, overall - he was a lot nicer about all of this. Since my Girth now ranges from 4.0\" to 4.3\" (Erect postTrimix injection in the office - might be different out of the office - I hate measuring it) - he was pretty understanding about why I\'d want to do it. I have lost about 1\" Girth and 1\"-1.5 length. He was against alloderm, fat, or the Elist implant...and he never heard of surgiderm or PMMA. Basically, he just said he can\'t advocate it but it\'s my body... so he understands where I\'m coming from. This is also a highly respected Urologist who sees patients from all over the country. I can understand that he can never advocate PMMA given it is not approved or anything he\'s trained with - but he mostly said it would be a problem if it bound to the tunica or caused inflammation (which it sounds like it does not)

Like the poster Miracle, I need to have the Peyronie\'s resolved first since he can\'t operate through the PMMA...so I\'d obviously need to wait a while anyway (plus healing can take a while). But, I am glad he wasn\'t like \"i see 20 guys a year with that crap\" or something negative like the plastic surgeon.

There is no surgery that will restore me to my pre-Peyronie\'s state. The drug xiaflex will also be a huge gamble because it has not worked for many patients and the costs are very very high - and the side effects can be awful (that\'s actually how I found the board - I googled something about it - and oddly made my username xiaflexed when I don\'t even think I\'ll ever get that drug).