TOPIC: Granuloma Complication linked to Chronic Kidney Disease

Has anybody that had PMMA injections ended up with Chronic Kidney Disease?

I had PMMA injected in my penis, buttocks, pecs and arms over the course of several years in the early 2010s.

I've been suffering from Chronic Kidney Disease (first diagnosed in 2016) and I'm now reaching end-stage kidney failure with a need to start dialysis.

My kidney doctor told me today that there's a link between PMMA injections and kidney disease, and after doing a Google search I found this article www.ncbi.nlm.nih.gov/pmc/articles/PMC8257287/

I'm in total shock. I can't believe something I did years ago for the sake of vanity could have ended up causing so much damage and impacting my life in this way. I don't have any family history of kidney disease so it's been a mystery for years as to what might have caused it for me. I'm curious to see if other people who've had PMMA injected are also now suffering from kidney disease?

I think the first obvious question is can you verify that it was legitimate PMMA used in all of your procedures.

The math starts getting quite expensive when used in very high volumes in buttocks etc. So... was it legit

Secondly, PMMA just forms collagen and locks itself in place. There's no real migration risk or even contact except with the collagen it's formed. So that's why I'm asking is it legit and was it injected properly.

A astonishing number of people get 'PMMA injections' and it turns out to be just something else. Usually silicone or some injerior product.

I'm confident it was legit. I had all my procedures done at Avanti Derma which I'm sure is one of (if not the) most reputable place for PMMA. I've emailed them to get volumes and dates injected as I never kept a record for myself.

I am confident PMMA is the cause, as I also have the hig calcium levels which is what was shown in the research. Plus I have no family history of kidney disease or other medical reason doctors could find to explain it.

There is a lot to unpack here and I think this discussion warrants an examination of all angles, including overall risk assessment. I've had PMMA in me for a decade, PLUS I operate a forum that discusses this filler extensively, so I take this topic seriously.

I'm terribly sorry to hear about your ordeal. If what the studies say (including other material I read before typing this) have any validity, then it is plausible hypercalcemia (excess calcium) may have occurred through a granulomatous condition stemming from high-volume injections, cascading into kidney issues. That said, I remain reluctant to agree with the PMMA-link conclusion without a 2nd or 3rd opinion, since even that study you cited had only two cases represented. Not saying you are wrong, but rather, this is the first extraordinary claim of its kind since the inception of the forum, and so it deserves extraordinary evidence.

You see, reports of foreign body granulomas are exceedingly rare, and side effects (like hypercalcemia) other than a localized immune response are even rarer, so much so that this is the first time I've actually heard about it. Having read a lot of literature on the subject over the years and not seeing this suggested link tells me that this is in-fact very rare. The study you mentioned even says: "Foreign body granulomas associated with cosmetic injections may occur in up to 1% of the cases and uncommonly may trigger calcitriol-mediated hypercalcemia, even when adequately used."

Let's examine the study and its two patients. A few notable similarities:

• Both patients were 65 or older.
• Both patients were women.
• The patients had PMMA injected into their buttocks and arms respectively, which are areas of the body that do involve relatively higher volumes of filler. *These are also performed through intramuscular injections.
• The study cites the kidney symptoms being a result of granulomatous reaction due to the PMMA implants but without elaborating on how/why.

Using these observations I'd like to compare them with your background @pr2005

(1) If you are comfortable, could you describe your age (you can provide a range if you are not comfortable giving exact year)?
(2) Were the Doctors able to determine whether or not a foreign body granuloma was present? (I'm curious to know if those are easier or harder to detect in the muscles?).
(2) Once you obtain your medical records detailing your injection volumes, could you provide them to us?
(3) Although I assume this to be the case, can you confirm with Avanti Derma that you received these intramuscularly?

From my initial review of the information, I'm initially shocked at how such a major complication went under the radar, however this must be an indication of how exceedingly rare it is. You are the first to report the suggestion of a link that I've ever heard, and that's from both patients and Doctors alike (including Doctors who repair filler-penises that have no interest in defending PMMA).

And pr2005, this is a support group and you have our ears, eyes, and empathy. I hope we learn the root cause of your condition to better help educate others down the road. I personally hope to hear about effective treatments that may alleviate your condition and possibly improve it (e.g. granuloma treatment/removal). Please keep us updated, and if you can provide the answers to the questions I listed above, it would be most appreciated. It will help bring forward others who may be experiencing similar issues, or at the very least, bring awareness to lesser known complications.

It's also my responsibility to help bring perspective to those who may have genuine concerns reading this that may already have PMMA in their penis. In no way am I downplaying pr2005's dilemma, but given the significance of the claims, it's important for men who've strictly received PMMA to their penis not jump to any conclusions or anxieties about their own current situation, at least from where things currently stand; let's take a look:

1. The cases being discussed in this topic pertain to large volumes injected intramuscularly. Penises are relatively low volume, injected intradermally. Furthermore, patients with muscular PMMA enhancement tend to have hundreds of (as high as 500+) cc's of filler which would make the granuloma condition more systemic, and could explain hypercalcemia. When you have THAT MUCH filler, you are going see your risk factors scale much the same way. Penile PMMA enhancement however, have 30-60cc's of filler, and a granuloma would be local, small, and treatable, in the rare event they occurred.
2. No instance of renal function associated with penile PMMA has been adequately established, let alone claimed.
3. The material I've reviewed prior to writing this suggests that a foreign body granuloma would be the culprit in hypercalcemia, not merely the presence of PMMA in it of itself. And even if you had the rare misfortune of an FBG, that still doesn't automatically condemn you to life-long kidney issues.

It should also be noted that virtually most fillers can experience the rare complication of a foreign body granuloma - tens of thousands are done all over the world every day in small volumes intradermally (like in the face and the penis) and it doesn't appear that FBGs are a commonly reported, much less significant complications that stem from FBGs. Every search I've done since the inception on this topic (especially medical sites/journals) regarding the concerns of hypercalcemia from FBGs always seemed to involve areas that require large volumes like the buttocks and breast, and also happened to vary in filler type. None of these sources seemed to indicate that the issue was widespread. Which again leads me to believe that the penile application is relatively safe.

You obviously can't rule out anything 100%, even common medications have bizarre 1% side effects, but I'm inclined to believe those with low-volume application of PMMA to the penile skin are at considerably lower risk given what I've presented.

I do not know about PMMA being linked to chronic kidney disease, and I have not read in-depth about PMMA, but often when I see it mentioned by doctors it is considered to be high-risk compared to other fillers.

PMMA is produced from petroleum, which sounds kind of scary, and compared to other fillers it has not been used very long, or studied extensively for a long period of time. Fat transfer however has been performed very long, and hyaluronic acid is the most common filler now.

Dr. Jason Oates wrote this on Phalloboards 2.0: "Free fat transfer can give good results. But I have also seen infections, resorption, unevenness. PMMA/Megafil/Silicone/Articol etc are too great a risk."

www.phalloboards.info/general-forum/phal...oates-australia.html

When it comes to something as severe as chronic kidney disease, it is probably very rare, like the extremely unusual side effects of pills. I do not think anyone should panic, but it seems also not good as a principle if it were a habit to firsthand recommend PMMA over other fillers that are considered safer.

Board sponsors Androfill and Calibre state that least risky is HA, then Ellanse (higher risk), and even higher risk is fat transfer and PMMA. Usually fat transfer is said to be safe, but Calibre list it on the same risk level as PMMA. I had dermal fat graft and Calibre also list it on the same risk level.

PMMA has the difference to other fillers that it is permanent (or semi-permanent as stated by Calibre). Dermal graft is considered permanent too, and Calibre state it as being permanent, but it does not seem unusual that many people had to remove them.

On the plus side, it seems easier to remove than PMMA, but degloving the penis both to insert the dermal graft and then if necessary removing it, does of course have risks (nerve damage). It is scary to think about it that one day I might have to remove the dermal fat graft, and there is a risk associated with it.

But to summarize for those reading this and considering which procedure to have: is it not more reassuring to have something reversible like HA? It is what I would have chosen now instead of dermal fat graft.

Hi @skeptical_one

In answer to your questions:

(1) If you are comfortable, could you describe your age (you can provide a range if you are not comfortable giving exact year)?
I'm in my 40s with no other health complications other than my kidney disease and high blood calcium. There's no history of either of these in my family, and I have not been taking any medications for long periods of time or any that are believed could have contributed. I hadn't mentioned my PMMA to my doctor as I didn't think it was relevant, but he saw it in a CT scan so asked me what it was.

(2) Were the Doctors able to determine whether or not a foreign body granuloma was present? (I'm curious to know if those are easier or harder to detect in the muscles?).
I am being referred for a PEP_CT scan which I think is meant to show inflammation/granuloma

(2) Once you obtain your medical records detailing your injection volumes, could you provide them to us?
I'm waiting on them but will share volumes and dates once received

(3) Although I assume this to be the case, can you confirm with Avanti Derma that you received these intramuscularly?
I'm pretty sure my buttocks were intramuscular and subcutaneous, my pecs were subcut and my biceps were intramuscle

When I know more I will share.