TOPIC: PMMA or Ellanse?

There is no history at all of Ellanse used in high volume. No one knows what the complication rate will be and it\'s highly unlikely to be better than PMMA, which to date seems remarkable. There are loads of members who have had PMMA for over 3 years. There isn\'t a single example of anyone requiring Removal or surgery. Just like in all the studies, serious problems tend to be reported within the first year or most usually within weeks. So Ellanse has no advantage over PMMA. Also there is a school of thought that suggests reactions to fillers are largely the result of dormant infections that take weeks, month or even years to show. If that happens with Ellanse after a year, then you can\'t simply wait for it dissolve. There are no advantages to Ellanse other than if you live in a part of the world which makes flying to get PMMA too difficult.

The main advantage of Ellance is that it seems to give some guys peace of mind built on a totally false premise. We\'ve got 2 forums full of progress reports. NAme me one member who has reported a serious issue that required a serious intervention that occurred over a year after the procedure? If you can\'t, then explain the advantage of having Ellanse if you have a serious issue within the first year? If you can\'t do that, then explain why on earth the advantage of Ellanse is, unless you live near Dr Oates?

I\'m also not going to tell you what option to choose, however if I was in the same position, this wouldn\'t even be a decision for me. I\'d go right to Ellanse. You missed a multitude of PMMA disadvantages and Ellanse advantages. So many to list, and they\'re all covered in any of the Ellanse threads. Good luck regardless of which you choose.

Nobody is going to tell you which option to choose, all I can say is that if I had the option of both, I'd be tempted to go to Italy, but I have less to lose because my previous procedure made my penis irreversibly worse than it was before.

Gg82 wrote:
Hoddle10 had a really good point about this one.
While it is true, and for the long term i would get Ellanse for this specific reason, you have to consider that short term complications for Ellanse and PMMA are basically the same.
Things like granulomas, infections, lumps etc. you can\'t live with for 4 years (or more, because we don\'t actually know if it lasts more than that) so you would have to take the exact same medical measures to solve them, unless you would accept to live with them for years.

Just food for thoughts.

Dr Morganstern claims to be able to remove lumps of any filler that isn't synthetic using a non surgical technique, it's a bold claim but I will soon find out if it's a scam in November, something to think about if your considering Ellanse.

I think I read every single progress report before deciding on PMMA. Lots were several years old. Yet the only two examples I found that required surgical intervention were Darkstaff and Restoration. In both cases their issues started within the first year. DS after about 6 months and Restoration pretty much straightaway. So from that perspective it\'s hard to see the advantage of Ellanse, especially the 3 or 4 year versions.

Also I don\'t think Darkstaff received the correct treatment. He went for surgery way too soon. I don\'t think he got a steroid shot to the area and I don\'t think he had antibiotics.

I agree that in the short term (say 4 years), you are equally fucked should something go wrong. In that regard, I agree with everything @biggy says above, including the fact that reactions are caused by dormant conditons that can show up years later. This is a fact. Hoddle10 made this point, and for this reason he favored PMMA (and actually had it done). I have tremendous respect for him and his opinions and approaches to all things PE related. I can\'t believe he was degloved 3 times. However, this is one area where I tend to disagree. I don\'t think because the short term risks are the same that this is a good reason to just screw it and go with PMMA, which is truly permanent.There are definitely risks with Ellanse, and we currently only have 2 documented cases, and zero long term cases to look at. Formal studies on Ellanse are relatively small. However, it has been used since 2009, and although you can find some complaints on plastic surgery forums with lumps or aesthetics, things like granulomas have been rare. There was one published case I found that said they were the first case reported. Of course, there may be others that were not reported (Dr. Oats had one and I don\'t think he reported it), but I don\'t think it\'s widespread. Furthermore, we\'re talking about PCL, which has been studied going back to the 80s, and is FDA approved for other in-body applications, like drug release devices, and other implants. I read lots of studies that describe it as very biocompatible, non-immunogenic, and having only \"mild adverse reactions\". It\'s being considered for all kinds of tissue engineering applications, and I recently posted one where it was being considered for tunica reconstruction. The science behind its bio-degrading lifetime and properties is well known--if you have the 4 year version, it will degrade in about that time.So yes, in the short term, I consider the risks pretty close to those of PMMA. The two advantages I see with Ellanse have to do with the long term. I am pretty sure someone (I think Smalljay) asked Dr. Gary Alter and another well known doctor about the long term effects of PMMA, and said they were both \"underwhelmed\" regarding possible health risks. However, let me quote Dr. Gary Alter\'s response to Cassavantes PMMA study:

\"No one knows the long-term implications of PMMA micro-spheres in the penis. I hope we won\'t be seeing problems decades from now. As the investigators state, Removal of the PMMA is difficult or impossible.\"

He is literally saying \"decades.\" Well, it\'s bad enough to have a lingering concern over the next 4 years or so, but I don\'t want that for decades! Time flies, guys... and although 4 years can be a really long time if you\'re fucked, it isn\'t decades. In 4 years or so, the Ellanse will be gone, and just how much of the collagen you still have remains to be seen. But should a future method, better than Ellanse or PMMA come up, you will be in a better place with regard to considering future options. Or just go with Ellanse again for another 4 years if it served you well. It will still be more cost effective than HA, although more risky.

think wrote: See Dr. Alter\'s comment that I referenced. The benefit of Ellanse regarding that particular concern is that it will be gone in 4 years time. I follow your logic with complications arising in the first year, but I don\'t see why you can\'t see the benefit of Ellanse in that regard.

And I read 3 of the 4 papers that you listed on biofilms. That applies to all fillers, and is not a reason to opt for PMMA over Ellanse. Also, it\'s not like you only have the Ellanse clinical studies to go by, as PCL has a 40 year history of safety in biomedical applications and FDA approval. I\'m sure that physicians like Dr. Oats and Dr. Morganstern, who are concerned with safety, took that into account before they started offering it. The credentials from Morganstern\'s practice include a chief Urologist at a leading teaching university. They tend to know how to do medical research.

Dr Alter didn\'t say anything we didn\'t already know or worry about. He wasn\'t revealing anything, just cautioning. I was just saying that in studies done on fillers, the majority of complications are reported in years 1-5 and not beyond. Most complications occur in the first year. That\'s also what we\'ve observed from PhalloBoards over the last 7 years. So the point I was making is that we don\'t actually have any real evidence of late onset complications of PMMA in large volumes, beyond one year. Where this get interesting is that it\'s postulated that fillers are far less likely to react when injected under the dermis, than actually into it, due to far fewer immune cells. This probably explains why we\'e seen so few complications.

The relevance of the biofilm studies isn\'t to compare PMMA and Ellanse directly, but to highlight the school of thought that these late reactions are due to biofilm infections. If you have a biofilm infection they can be impossible to treat. The advantage of HA is that you can dissolve the filler and then treat the infection. You can\'t do that with either Ellanse or PMMA. You can\'t just leave the infection either, so intervention is required, hence the \"advantage\" Ellanse being temporary is negated. Now I totally understand your point that with Ellanse you only have to worry about this for 4 years, but after that time, most people are still likely to want a bigger penis and will have to have it filled again. It\'s hugely unlikely that something that offers the same benefits as PMMA or Ellanse is going to come along in the next 10 years. On top of that, late onset of granulomas reaction from PMMA, in the penis, seems to be totally absent in the literature and from all the cases we have here. In short I don\'t think we\'ve ever encountered an issue with PMMA, that required a dramatic intervention, that came after the life span of Ellanse products.

But I totally understand your point about hoping something better comes along in the future and therefore you like the fact Ellanse lasts only 4 years. Also Reklaw does make the point that for teenagers and younger men, a stop gap option may suit them. But I think there is little chance of anything in the next 10 or so.

Ultimately, if these late onset reactions are caused by biofilms that get in at the time of injection, any non reversible procedure that requires redoing every few years, is probably more risky than a one off permanent procedure (i know people keep going back for more and more but that\'s a choice), unless you only do it once and then decide you don\'t want it again.

biggy wrote: We\'ve got 2 forums full of progress reports. NAme me one member who has reported a serious issue that required a serious intervention that occurred over a year after the procedure? If you can\'t, then explain the advantage of having Ellanse if you have a serious issue within the first year? If you can\'t do that, then explain why on earth the advantage of Ellanse is, unless you live near Dr Oates?

See Dr. Alter\'s comment that I referenced. The benefit of Ellanse regarding that particular concern is that it will be gone in 4 years time. I follow your logic with complications arising in the first year, but I don\'t see why you can\'t see the benefit of Ellanse in that regard.

And I had already read 3 of the 4 papers that you listed on biofilms. That applies to all fillers, and is not a reason to opt for PMMA over Ellanse. Also, it\'s not like you only have the Ellanse clinical studies to go by, as PCL has a 40 year history of safety in biomedical applications and FDA approval. I\'m sure that physicians like Dr. Oats and Dr. Morganstern, who are concerned with safety, took that into account before they started offering it. The credentials from Morganstern\'s practice include a chief Urologist at a leading teaching university. They tend to know how to do medical research.

Gg82 wrote: Well, look where we were 10 years ago.
No good option avaible, literally stone age of PE.

I\'ve no idea what we\'ll have in 5-10 years, but who can really know.

There\'s actually no improvements for the past 10 or even more years on this field. Things like PMMA for PE already were existing in early 00\'s in Brazil (and keep in mind that at the present time PMMA exists for 30 years). Also, I\'ve somewhere read about using of HA for penile glans enhancement like 15 years ago. If you want more (not only about fillers procedure): the ligament cutting procedure were first performed for cosmetic reasons by Chinese surgeon (forgot his name) in 1990, moreover, first mention of this procedure (not for cosmetic reasons) was in early 1970\'s.Now you see that there\'s not so much changes for the last 10-20 years?

chester wrote: Biggy, your information regarding Ellanse is quite far from factual. A \"fact\" isn\'t a fact because you say it is. It\'s a fact because science says it is, and multiple scientific, peer-reviewed papers unequivocally demonstrate much better biocompatibility and safer incorporation for Ellanse than PMMA. No offense here, but I won\'t even go into your medically unsupported theories, spoken with the confidence of an experienced physician. It\'s a good topic question and it deserves comprehensive research, which involves actually reviewing medical papers, case studies, patient reports and scientific data from manufacturers and independent entities alike, which is what I have done in arriving at my decision.
For you, or other members, who would like to become *properly* educated on Ellanse, please do a thorough search on Google. The data is available, and I share two detailed papers in the \"Ellanse\" thread on this forum. If not, then good luck either way.

What information? I\'ve pointed out the total absence of information on Ellanse as a high volume filler. What information do you have to contradict that?

They aren\'t my medically unsupported theories, I merely posted the theories of medical professionals. If it was spoken with the confidence of an experienced physician, it\'s because I learned it reading the work of experienced physicians. I did comprehensive research and reviewed actual medical papers before getting my procedure. Hence I was aware of this and am sharing it with the forum.

Here are some quotes regarding biofilms infections and reactions to fillers from a few studies:

\"biofilms form when bacteria is introduced during filler injections or are seeded in the filler during bacteriaemic episodes.14 Once present, they remain dormant for months or years on the surface of the filler and become a target of a delayed immune response, resulting in granuloma formulation.\"


\"Based on their clinical course and response to treatment, most reported hypersensitivity reactions are likely due to an infectious process\"


\"Delayed reactions associated with dermal fillers have often been attributed to hypersensitivity reactions; however, the evolving literature suggests that biofilms may represent an underrecognized cause and a difficult diagnosis to establish\"

\"The biofilm can either be dormant or active depending upon the external triggering factor. When the cell metabolism shuts down, it becomes dormant (persister). Thus it gets out of reach for antibiotics and also becomes difficult to culture in vitro.\"

aestheticsjournal.com/feature/granuloma-management

www.ncbi.nlm.nih.gov/pmc/articles/PMC2890130/

www.ncbi.nlm.nih.gov/pubmed/25207761

www.ncbi.nlm.nih.gov/pubmed/21246453

Herbert West wrote:
I\'m afraid that there\'s a strong chance that this will not happen nor in 5 nor 10 years.Do you have any reliable information or at least your own assumption of what it could be? Like some new or some old improved injectable filler? Are you talking about this area?

Well, look where we were 10 years ago.
No good option avaible, literally stone age of PE.

I\'ve no idea what we\'ll have in 5-10 years, but who can really know.

mediatps wrote: I guess one more advantage of Ellanse is that if there are some amazing developments in the world of Phalloplasty over the next 5-10 years you may still be able to make the most of them. Committing to PMMA now may reduce your chance of being suitable for other more effective methods in the future? Just playing devil\'s advocate but really trying to understand and make an informed decision.

I\'m afraid that there\'s a strong chance that this will not happen nor in 5 nor 10 years.Do you have any reliable information or at least your own assumption of what it could be? Like some new or some old improved injectable filler? Are you talking about this area?

Biggy, your information regarding Ellanse is quite far from factual. A \"fact\" isn\'t a fact because you say it is. It\'s a fact because science says it is, and multiple scientific, peer-reviewed papers unequivocally demonstrate much better biocompatibility and safer incorporation for Ellanse than PMMA. No offense here, but I won\'t even go into your medically unsupported theories, spoken with the confidence of an experienced physician. It\'s a good topic question and it deserves comprehensive research, which involves actually reviewing medical papers, case studies, patient reports and scientific data from manufacturers and independent entities alike, which is what I have done in arriving at my decision.
For you, or other members, who would like to become *properly* educated on Ellanse, please do a thorough search on Google. The data is available, and I share two detailed papers in the \"Ellanse\" thread on this forum. If not, then good luck either way.

It's definitely worth taking into consideration that PMMA would prevent you from having anything in the future, some guys on here are in their teens, if I were in that boat I'd be tempted by Ellanse.

Well said think. Totally agree with you.