TOPIC: Bellafill PMMA in Penis

I think with the recent awareness of Dr. Rupeka in Ohio, there needs to be some things cleared up with Bellafill PMMA. According to Bellafill, this is not a permanent procedure.

The effectiveness and patient satisfaction rates of Bellafill® have been established through 5 years when used to correct nasolabial folds, and 12 months when used to correct acne scars.13 - Bellafill

The collagen in Bellafill® provides immediate volume and lift for results that you can enjoy as soon as you leave the office. Over time, the collagen is reabsorbed while the PMMA microspheres are left behind. They create a supportive base that allows more of your own collagen to develop, resulting in smoother-looking skin in the long term. Bellafill

This is confusing. So, in contrast to Linnea Safe, the collagen will absorb and you'll be left with just the permanent microspheres? I'd hate the idea of having microspheres with no collagen around them. No new collagen will form around the PMMA that's left behind? So that means in order to sustain gains you'll be adding more and more product over product that isn't developing any more collagen?

This is from Dr. Rupeka: The PMMA will convert into collagen over a several month to several year period and last 5-10 years.

First, it doesn't make sense to say the PMMA will "convert into collagen". The PMMA stimulates collagen to form. The microspheres aren't converted into anything. And again, this is a lot different than Linnea Safe which is stable for life.

A user reported paying $5200 for 11 syringes of Bellafill from Dr. Rupeka. We are to assume this is 11cc. Avanti Derma is offering 20-22 cc of Linnea Safe (15-16 at 30%) for less than $4000 (correct me if I'm wrong).

My understanding is that Bellafill is FLAT OUT permanent... as is all medical grade PMMA. Why wouldn't it be given its properties?

The biggest difference between Linnea Safe & Bellafill are its carriers. Linnea Safe uses cellulose-based carriers which absorb much more quickly (less than a week), whereas Bellafill uses a bovine carrier which takes much longer to dissipate (more than a week, possibly weeks). I suppose there also may be some small variation between microspheres, but I can't imagine a lot. From a published article online discussing Linnea Safe it states: "Several factors affect the type and intensity of the inflammatory reaction of the body tissues to the PMMA implantation for the purpose of aesthetic filling; among these, is the size of the polymer microspheres, which should be between 36-43 µm, since this seems to be the ideal size for large dermal injections, preventing phagocytosis and allowing the delivery and stabilization of this material." Suneva's website claims their particles are 30-50µm, so they should in fact behave much the same way as Linnea Safe as far as collagen production is concerned.

Also look at Ellanse. They were telling patients 2-4 years with certain versions, and are seeing the collagen last considerably longer (5+), despite the particles being "designed to dissipate over time." This may have to do with the TYPE of collagen created.

As far as costs: Bellafill has a patent (and therefore no competition in the permanent filler market in the US) and has always been regarded as the priciest filler - the advantage of it is for those who choose not to travel abroad when seeking non-surgical permanent options. Also, traveling abroad is almost always going to provide you lesser expensive options, that's why medical tourism is a huge industry. Heck, if I plan to get any work done on my teeth, I'll go to Mexico.

When you said "This is from Dr. Rupeka: The PMMA will convert into collagen over a several month to several year period and last 5-10 years." I honestly believe that's a layman description probably typed up from their Web Designer using notes from the Doctor. I often see these errors on other sites that also perform fillers. That's why men come to this site, to learn more of the specifics. However, I will point that out to him, because technically it's incorrect.

I think the 5 year claim may be disingenuous on the part of Suneva, as they know most American cosmetic clinics prefer temporary options to that of permanent, for a variety of reasons. Claiming "permanence" may ultimately scare off potential buyers/practitioners. There was a "respected" Dermatologist years ago named Dr. Klein who crusaded against permanent fillers, including PMMA, and I'm certain Suneva is well aware of this sentiment that permeates some attitudes in cosmetic medicine. Otherwise I just can't see how Bellafill PMMA (with claims that its microspheres are even more uniform and correctly sized than International brands) somehow ends up "temporary" at all.

I believe Dr. Rupeka is simply citing what the manufacturer states to be quite frank, with a generous 10-year upward bound. He's Suneva's #1 Injector of Bellafill and so I would imagine he's made privy to all their studies and trials. I will be chatting with him this week to get some clarification for the board - but as far as I know, and with all the empirical evidence over the years, PMMA is most certainly permanent, or at the least, very very long-term (I've had it for 12 years with no apparent loss in size).

So if it was in-fact temporary, maybe it's lifespan is 15+ years and we just don't know it yet. However, I doubt this because I would have at least seen SOME loss in size over those 12 years, whereas nothing has changed. If 12 years doesn't shave even 0.1" of Girth off, and it was still somehow temporary, that would make its lifespan effectively permanent.

Like I said in a previous paragraph, I will be getting in touch with them again this week and will flesh out those details, and he will likely be submitting a Q&A like some of our other Sponsors do.

After your explanation on the fat transfers as well as this clarification this is seeming to be the option I might be looking into. After the other progress posted for Doctor Rupeka I feel like I might take the jump and see how I feel about the results. Now the person who had Bellafill did say there was some length gains, what accounts for these in Girth procedures? Is it just the tissue expansion or traction devices? I see it mentioned in posts but never really discussed or I’m just missing the right posts.

Grievence wrote: After your explanation on the fat transfers as well as this clarification this is seeming to be the option I might be looking into. After the other progress posted for Doctor Rupeka I feel like I might take the jump and see how I feel about the results. Now the person who had Bellafill did say there was some length gains, what accounts for these in Girth procedures? Is it just the tissue expansion or traction devices? I see it mentioned in posts but never really discussed or I’m just missing the right posts.

It should be noted that Girth procedures on paper do not provide length gains or losses, however there are circumstances where it may appear as such. For example, some men report improved Flaccid length; however, some men have reported marginal length loss, most common with guys that have a lot of product at the base, which probably plays a role in the appearance of lost length. Whether gained or lost, it's usually negligible in my opinion, almost an illusion since no ACTUAL shaft length is gained or lost.

Grievence wrote: After your explanation on the fat transfers as well as this clarification this is seeming to be the option I might be looking into. After the other progress posted for Doctor Rupeka I feel like I might take the jump and see how I feel about the results. Now the person who had Bellafill did say there was some length gains, what accounts for these in Girth procedures? Is it just the tissue expansion or traction devices? I see it mentioned in posts but never really discussed or I’m just missing the right posts.

I believe your talking about my posts - I attribute my Erect length gains to using a Penimaster Pro - and I attribute my Flaccid gains to the filler making my penis heavier and hang more pulling on the suspensory ligament . I only started taking pictures of my Erect length being measured after some success - I didn't start off with before pictures because I didn't think It would work - thankfully that is the reason I have such a well documented experience with fillers because that procedure was done after I started stretching - I learned my lesson and and take pictures of me measuring everything . I haven't talked about it too much because this is a Phalloplasty board and Penimaster is a device not a procedure

Thanks for the clarification. Though it generally seems device usage is part of any success of length procedures so it somewhat fits.

Here are some interesting words from Dr. Casavantes regarding Bellafill and Linnea Safe:

The most common PMMA-based soft tissue fillers are in chronological order: Bellafill (20% PMMA + Bovine Collagen), Metacrill (PMMA 2, 10 & 30% + Carboxymethylcellulose), and Linnea Safe (PMMA 2, 10 & 30% + Carboxymethylcellulose).

Bellafill is the direct descendant of Artecoll, the first soft tissue filler containing PMMA (20% suspended in a gel of bovine collagen), developed by Prof. Gottlieb Lemperle from Frankfurt, manufactured by Suneva in San Diego, CA., and approved by the US FDA.

Bellafill is an excellent product for small deficits in the face, and it's authorized for frown lines by the US FDA. However, when used in large volume, the vehicle (bovine collagen) remains in the tissues like a gel which prevents the microspheres from being quickly surrounded by the host's collagen fibers. Other PMMA based fillers use a gel of carboxymethylcellulose as a vehicle that is quickly absorbed, leaving the microspheres free in the tissues, and ready to be surrounded by the host's collagen fibers.

So, if the PMMA microspheres remain free, without being locked up by the host's collagen fibers, they will move freely (hypothetical) and will settle months later, when the body slowly reabsorbs the collagen gel.
Last but not least, the presence of bovine collagen increases the price of the product substantially. If the same volume is used, expect a possible tenfold in the cost of a procedure performed with Bellafil when compared with PMMA/Carboxymethylcellulose products like Linnea Safe and Metacrill. The mix of bovine collagen and PMMA makes total sense because it gives an immediate result which slowly turns into a permanent one. The presence of PMMA in the tissues is permanent, but the reason why they say it lasts five years is that the effect of it goes away in a progressively aging face.

Bellafill is a lot more expensive and is only 20% PMMA compared to 30% with Linnea Safe where most candidates get roughly 13-16 ccs of 30% and 4-8 ccs of 10%. Or any combination you want to a certain limit. Also, Dr. C is shedding some light on where Bellafill is getting their timescale from. I believe Dr. Casavantes is saying that the small amount put in the face is done so to correct your skins current state. When you lost elasticity, lose collagen, and develop more wrinkles as you age, you need more product. So I guess Bellafill is basing the longevity of it's product's effects on this notion. Not on whether or not the PMMA is still present because it does seem clear it's permanent.

More from Dr. C:

Bellafill is a great product for correction of fine lines in the face, but it doesn't offer any advantages over the PMMA/Carboxymethylcellullose products when used for Phalloplasty. I believe that the last ones are better for that specific indication.
I used Bellafill for the face many years ago, when it was called Artecol, but it was eventually removed from the Mexican market mainly because of its high cost.
I wouldn't spend my money in Bellafill if I had access to Linnea (speaking about Phalloplasty here).


We made a microscopic comparison of 4 products almost 20 years ago when it was customary to compound PMMA in Brazil. We studied Artecoll (now Bellafill), New Plastic (now Linnea Safe), Metacrill, and one product compounded by Brascher Pharmacy in Rio de Janeiro.

The compounded product showed the most inferior quality (mixed-size microspheres ranging from 10 to 100 microns, other particles that were not spheric, etc.).
Metacrill was good, but Linnea and Artecoll were great: almost only 40-micron, smooth microspheres, with virtually no "trash".

To my knowledge, there is no evidence that Bellafill can last more than Linnea (or any other). Bellafill contains only 20% of PMMA, and its collagen vehicle goes away through the normal metabolic process. Linnea Safe includes 2, 10 or 30%, and since PMMA is not biodegraded or absorbed, I cannot understand a non-absorbable filler lasting more than another one.

If the clinics in the US that you mention base their comments on an article published by a doctor that worked for Suneva (the manufacturer), I will not consider it as a real source of unbiased information.
I'd love to see the data where they are supporting their statements.

This may answer what is on Bellafill's website. About the collagen being reabsorbed and you being left with just the PMMA particles. After reading what Dr. C said, I think Bellafill is referring to the bovine collagen gel being reabsorbed, not the collagen grown via the PMMA particles. I believe Dr. C is saying early on after the procedure, it's easier for collagen to surround PMMA when there's less gel/vehicle to get in the way. This is in line with the effects of Ellanse. You gain more collagen as the gel dissipates and the results are nearly consistent after day 1 of the procedure. Where as with Linnea Safe, users don't experience as much of a sustained or immediate lift with the gel. They experience a bigger dip in gains as the gel dissipates more quickly. But at the same time, they then see a much quicker ramping up of collagen growth because there is little gel to get in the way. Which process is better for collagen growth in the end would be an interesting study. I'm wondering if there's some benefit to allowing your body to surround the PMMA earlier on instead of slowly throughout the course of 3-4 months.

Thats a really good question- I could just barely move my Bellafill after 1 day . It wasn't squishy and didn't migrate at all . It felt like it stayed put right where Dr Rupeka put it . I plan on sticking around a while and I'm going In for another round so mabye I can make a video of the playability over time . I'll give it a shot anyway

@Hyperbol

Thanks for posting that. But let's be honest here:

Dr C must surely still have a commercial interest in Avanti even though he's retired. Now with Bellafill at a higher price, and many US based docs offering that, using it would his margins (as he uses products the US docs simply won't use, as they are not approved), and he would need to up his prices.

So if he came out and said "Yeah, Bellafill is fantastic, and superior" only then would would his protege's technique be the reason anyone would go there at all. That or they would take the 'inferior' product for a better price.

That would be my read on it, albeit a skeptical one.

My two cents on it-

1) The FDA approval has to count for something. That process is not cheap, and it has been commercially tested heavily, way more than the other two products.

2) 20% PMMA doesn't sound bad at all. It seems in the case of Ellanse, that the 30% level is what is leading to lumps, and if that's a 'happy medium' that alleviates this issue then great.

Now personally, if there was a 20% Ellanse, that was FDA approved, I would jump on that in a flash. PMMA and it's permeance for me, is worrying. Who knows if guys down the line will literally lose their dicks. No idea. It's a massive risk.

Two interesting, non phalloplasty viewpoints given here:

practicaldermatology.com/articles/2016-a...or-permanent-fillers

Dr C must surely still have a commercial interest in Avanti even though he's retired.

Yes, he pretty much owns the place. But he wrote all that in 2019.

many US based docs offering that

Many? Do you know who else is doing it other than Dr. Rupeka?

So if he came out and said "Yeah, Bellafill is fantastic, and superior" only then would would his protege's technique be the reason anyone would go there at all.

I disagree. Many would still go there to get Ellanse. And Bellafill would still be cheaper there. When Ellanse was FDA approved, it was still far more expensive to get the procedure done by Dr. Carney. When Dr. C wrote that in 2019, I'm unaware of any well respected doctor performing Bellafill injections into the penis. Let's be honest here...it's not hard to believe Dr. C would want the best products for penis enlargement in his office. When he says there's no reason to pay higher prices for Bellafill, I tend to believe the man and in no way do I think it's because him saying otherwise would some how hurt his bottom line.

The FDA approval has to count for something.

You're right. If the FDA approves something, that means it's FDA approved. But that doesn't mean what isn't approved isn't safe. It takes a long time for things to get approved. It's costly as you said. Companies lobby the FDA. There's a long list of things waiting to get approved. Do you know why Ellanse was taken off their approved list? No one really knows why. I never heard an explanation. I think you're biased into thinking that if it isn't approved in the US it must not be as safe but we know that not to be true. And I never was alluding to Bellafill being any more safe or unsafe than any other product.

20% PMMA doesn't sound bad at all.

You're right. It's not bad. You just won't gain as much.

It seems in the case of Ellanse, that the 30% level is what is leading to lumps

And PMMA? I really don't see a difference between 30% Linnea Safe and 30% Ellanse in terms of potential irregularities. Also, you could work the percentages and amount of Linnea Safe you get to equal what you would get with an 11cc 20% round of Bellafill and it would still be cheaper. Regardless, it's not the 30% which leads to irregularities, it's how much you put in.

Now personally, if there was a 20% Ellanse, that was FDA approved, I would jump on that in a flash.

I wouldn't. I wouldn't want to pay more money for less product.

Two interesting, non Phalloplasty viewpoints given here:

practicaldermatology.com/articles/2016-a...or-permanent-fillers

This link takes me to a list of articles. I'm not sure which ones have to do with Phalloplasty. Can you link the specific articles?

We are all just sharing our experience here - I'm not sure why my decision to go with Bellafill makes you angry . You've made several posts here and in my results thread calling into question my results. You have a bunch of words and opinions , I have a bunch of pictures of a successful procedure . There is nothing to clear up - I posted my actual results with pictures . Instead of tearing down my decision or steering others away from it we can all root for each other regardless of what filler or clinic was chosen . I don't care what DR. or clinic people choose and I'm not sure why you do .

Consider for a moment that traveling to Mexico and staying there costs money and if someone can drive to an American clinic they may spend less money total. Further more cost was not a factor in my decision . Not everyone is ok with leaving the country or spending days in Mexico .

@Hyperbol There are more doctors besides Rupetka offering Bellafill with great success and gains. You're either misinformed or trying to stir up controversy were none should exist.

Truckerguy wrote: Thats a really good question- I could just barely move my Bellafill after 1 day . It wasn't squishy and didn't migrate at all . It felt like it stayed put right where Dr Rupeka put it . I plan on sticking around a while and I'm going In for another round so mabye I can make a video of the playability over time . I'll give it a shot anyway

@Truckerguy Try using heat next time: Like with a microwaved hot rag. that should get you a tad bit of pliability. And for people other than yourself whom may be more scared of the product setting up too fast: I have always been a proponent of constant rolling and shaping over the first few days.

I would love read how your next round goes.

Texas wrote:

Truckerguy wrote: Thats a really good question- I could just barely move my Bellafill after 1 day . It wasn't squishy and didn't migrate at all . It felt like it stayed put right where Dr Rupeka put it . I plan on sticking around a while and I'm going In for another round so mabye I can make a video of the playability over time . I'll give it a shot anyway

@Truckerguy Try using heat next time: Like with a microwaved hot rag. that should get you a tad bit of pliability. And for people other than yourself whom may be more scared of the product setting up too fast: I have always been a proponent of constant rolling and shaping over the first few days.

I would love read how your next round goes.

Good advice if it needs to be molded , I was actually happy it stayed put tho lol . Mine was even and stayed that way . I will do a whole new thread after my round 2 .

I'm not sure why my decision to go with Bellafill makes you angry

I'm not sure where you derived this from. You getting Bellafill def doesn't make me angry, lol, you sound like the one who is getting angry. I was merely sharing what Dr. C said. I was comparing Linnea Safe and Bellafill. I'm not sure why that upset you. This forum exists to provide information. There were comments supporting Bellafill in the US as the most cost effective. This is false. Misinformation on this forum or anywhere is bad. You bought tickets to get the Penuma implant so you know all about misinformation.

You've made several posts here and in my results thread calling into question my results.

Again, assuming you're replying to my posts, at no time did I question your results. That's a false assertion. I was merely comparing Linnea Safe and Bellafill directly form the leading doctor in the world who performed these procedures. I was calling into question how Dr. Rupeka and Bellafill advertised the product which we determined to be inaccurate.

You have a bunch of words and opinions

From Dr. Casavantes

I have a bunch of pictures of a successful procedure

I never questioned your results. It was clear to anyone reading my posts that I was merely comparing which product had better value.

Instead of tearing down my decision or steering others away from it

Again, this forum doesn't exist to promote one product over another. We are here to simply provide and compare information. If someone wants to pay $2,000 dollars more for less PMMA in Ohio that's their decision.

I don't care what DR. or clinic people choose and I'm not sure why you do .

It only makes sense to care about this. That's why this forum exists. Because guys couldn't find the right doctor. Here you are wondering why I care about finding the right doctor when you booked a flight to get the Penuma implant. Huh, how ironic.

Consider for a moment that traveling to Mexico and staying there costs money

FYI It's cheaper to stay in Mexico

Further more cost was not a factor in my decision . Not everyone is ok with leaving the country or spending days in Mexico .

I totally respect that. But Dr. Rupeka isn't known to be better than Dr. Morales and Avanti Derma. So it seems your decision was based solely on not leaving the country. I'm merely pointing out that Bellafill is NOT the best value if one doesn't mind traveling to Tijuana.