TOPIC: Fusion Thick procedure

If PMMA is injected after the HA layer foundation is set, wouldn’t that leave lumps on the penis once the HA completely dissolves after 1-2 years?

It depends on how the HA was placed. If there was clumping, unevenness, or inflammation with that HA foundation, then yes, the PMMA result would also be "lumpy." But if the HA foundation was placed correctly and smoothly, then no, you wouldn't end up with an uneven appearance after the HA dissolves since it gradually dissipates as the body breaks it down rather than disappearing in "chunks."

This is a confusing explanation. Let me explain. The reason patients don’t feel lumps and nodules when they get HA first and then PMMA is because the HA is concealing the PMMA. Once the HA has dissolved and the Bella fill is exposed the body will react the same to the Belleville as it did without HA. Why would it react any differently to the PMMA with HA versus without HA I believe there are patients that react very strongly to PMMA and there are patients that don’t act very strongly to PMMA and therefore do not develop nodules bumps, and lumps. Is there any clinical literature to back up this claim or is it purely anecdotal through short term observations of less than a few years on patients that may return? I am in no way questioning experience or expertise, but I don’t think this explanation makes much medical sense.
Again I don’t mean any disrespect, just trying to make sense of this explanation

I think the disconnect here is that you're assuming the HA is simply "concealing" the PMMA until the HA disappears. That isn't what Dr. Carney is describing.

The concern with PMMA isn't as simple as, "this person's body reacts strongly to PMMA, therefore it will react exactly the same way regardless of how, where, or in what amount the PMMA is introduced."

Patient-specific immune response absolutely matters. That's one of the reasons Dr. Carney is cautious with permanent filler in the first place. But technique, volume, distribution, tissue plane, local inflammation, and the condition of the tissue receiving the filler also matter.

There is published literature supporting that broader point. PMMA research has found that injection technique and location can affect the development of nodules and adverse inflammatory reactions, even when the material itself is unchanged. Published penile PMMA literature has likewise attributed irregularities and Nodule formation at least in part to injection technique and post-injection factors.

What we are NOT claiming is that there is a published randomized clinical trial of Rejuvall's specific HA-first FusionThick protocol proving that HA somehow changes the chemical composition of PMMA or permanently prevents every possible future inflammatory reaction. There isn't, to my knowledge, a study of that exact protocol, and we shouldn't pretend otherwise.

This protocol comes from Dr. Carney's clinical experience treating both primary enhancement patients and a significant number of patients who come to him with complications from previous filler procedures.

The purpose of the HA foundation is also not to "hide" badly placed PMMA. If PMMA were simply being injected into an irregular pattern and HA were covering those irregularities, I would agree with you that removing the HA from the equation would eventually reveal the underlying problem.

That's not the technique.

The goal is to establish a smooth, controlled tissue contour first and then introduce permanent filler conservatively and strategically rather than attempting to create the entire desired increase with permanent material in untreated tissue all at once.

And there is an important distinction between a **mechanical lump caused by product distribution** and a **delayed inflammatory Nodule or foreign-body granuloma**. Those are not necessarily the same biological event.

In fact, published filler literature repeatedly makes that distinction. Nodules can result from localized filler accumulation, fibrosis, injection technique, or inflammatory/granulomatous reactions. PMMA granulomas can also appear months or even years later, which is exactly why Dr. Carney does not consider permanent filler something that should be approached casually.

So yes, individual immune response is part of the equation. Dr. Carney would agree with you on that point.

Where I disagree is the conclusion that immune response is therefore the *only* meaningful variable and that PMMA must behave identically regardless of how the procedure is staged or performed. The medical literature doesn't support that conclusion either.

Thank you for the explanation.

I asked this question purely from an educational standpoint and curiosity. If Dr. Carney sees so many problems with Bella fill and PMMA filler, why does Rejuvall choose to place it? Is it the desire of patience that outweighs the sound medical judgement for the patients? Why take the risk? Why use a product that is potentially so problematic and irreversible?

If Dr. Carney sees so many problems with Bella fill and PMMA filler, why does Rejuvall choose to place it? Is it the desire of patience that outweighs the sound medical judgement for the patients? Why take the risk? Why use a product that is potentially so problematic and irreversible?

I will let Dr. Carney explain why he performs penile enhancement, including Girth enhancement with Bellafill:
(Don’t worry, he gets to it early on in the video)

That’s a great video, and I think Dr. Carney is doing a great thing. Even after watching the video, I still question why Dr. Carney chooses to use Bella fill for augmentations when one it is permanent and irreversible, and two it has caused problems in a number of men. Why not stick with HA and prevent most of the irreversible and detrimental outcomes?

@Toothman
I think the part you're still missing is why Dr. Carney got involved in male enhancement in the first place.

Men are going to seek permanent girth enhancement whether Rejuvall offers it or not. That isn't theoretical; Dr. Carney has spent decades seeing what happens when these procedures are performed poorly, because a significant part of his work involves repairing complications from enhancement procedures performed elsewhere.

His conclusion wasn't, “Men shouldn't be allowed to have permanent enhancement.”

It was, essentially, “If men are going to do this, someone with the appropriate medical and surgical expertise needs to figure out how to do it as safely and responsibly as possible.”

And Dr. Carney's background matters here.

He isn't someone who took a filler course and decided to start injecting penises. He is a physician, pharmacist, board-certified urologist and surgeon, a Fellow of the American College of Surgeons, and a reconstructive urologist who has spent decades working with male anatomy, surgery, complications and reconstruction. He founded a genitourinary reconstructive surgery fellowship and served as Chief of Urology at Grady (one of the nation's only Level I trauma centers) for more than 20 years.

There are only a handful of physicians anywhere in the world with that particular combination of pharmacology, urology, surgery and reconstructive experience.

So when Dr. Carney sees complications from PMMA, his response isn't, “PMMA has complications, therefore nobody should ever use it.”

His response is to look at why those complications occurred: how much was injected, where it was placed, whether permanent filler was used as the first step, whether the patient was an appropriate candidate, how the tissue responded, and how the procedure could have been approached differently.

That's also why Rejuvall does not approach Bellafill as simply “inject PMMA until the patient reaches his desired size.”

Dr. Carney developed a much more conservative staged protocol specifically because PMMA is permanent. HA is used first to establish the foundation and allow the anatomy and result to be evaluated before permanent material is introduced. PMMA is then used strategically rather than relying on large-volume PMMA as the entire augmentation.

And yes, permanence creates additional risk. Nobody at Rejuvall is denying that.

That's precisely why HA remains an option and why some patients should choose HA instead.

But there are also men who specifically want a permanent result and who will pursue one regardless of whether Dr. Carney offers it. The practical question then becomes: Would you rather those men receive permanent penile filler from a provider whose primary experience is cosmetic injections, or from a reconstructive urologic surgeon who understands the anatomy, has treated the complications, and has spent years refining a more conservative way of performing the procedure?

That is really the philosophy behind Dr. Carney offering Bellafill.

It isn't patient demand overriding medical judgment.

It's recognizing that the demand already exists and applying medical judgment, surgical expertise, and lessons learned from repair cases to try to make an inherently higher-risk permanent procedure safer.

If someone's personal risk tolerance is, “I would never put anything permanent in my penis,” that's completely reasonable. HA exists for exactly that reason.

But that's a different argument from saying that because a permanent procedure carries risk, a highly trained physician shouldn't offer it at all.

I have been trying to contact you guys for several weeks. Can you DM me when possible please. Thank you. ( Don't mean to hijack the thread )

Jut DMed you @jon11

For some reason it is not showing in my private messages. Any ideas ?

No, that would be a question for @Skeptical_One . You’re welcome to DM us.

jon11 wrote: For some reason it is not showing in my private messages. Any ideas ?

I responded to your PM earlier today (maybe a couple hours ago), if you've received it, please reply back. I'm not having issues receiving PMs from others, including messages I got after yours from last week. I see nothing on the backend that should affect your PM inbox, and my only suspicion is that this could be a momentary inconvenience while some major upgrades are underway (which I doubt is the reason, but I have to investigate all possibilities). If you did NOT get my PM from earlier, please email me at This email address is being protected from spambots. You need JavaScript enabled to view it. rather than posting your response here.

As a broader Community Note: the PhalloBoards is undergoing its most extensive renovations & updates since 2020, and given the multi-functionality of the site, glitches may surface where we least expect them (as usual for anyone who's ever worked in IT). Phase 1 is already underway and we will see some updates to the Forum (modernizing functionality) among others that will continue to roll out in the coming weeks & months (exciting times ahead).

I write this all to say that despite the rigorous stress-testing, there may be some brief or inconvenient interruptions nonetheless. It would be most appreciated if anyone reading this please notify me of on any error/bug/glitch (regardless of whether you post here at all or not), or any suggestions on things you'd like to see added or modified for a better user experience.

To make it easier for me to separate & organize topics related to site-related problems, please send your messages to This email address is being protected from spambots. You need JavaScript enabled to view it. with the subject line "PB2026 [Name of Issue]". For example, if @jon11 did not see my PM from earlier today, he could send me an email with a subject heading like:
PB2026 PMs not working

I sincerely hope I don't get too many of these (and don't anticipate to either, but some hiccups come with the territory); also, as a polite reminder, use the email to reach out to me on the aforementioned matters so that we don't inadvertently derail the discussion. I think I've shared enough lol, I ask we resume the topic at hand, thanks