Do you also when you run a finger along the Erect shaft feel a surface that is not completely smooth but has a few "bumps"? I think this is normal both in people without PMMA and in people with. The cavernous covers are surrounded by so many elements, from veins to arteries to many other things.
You're right, imperfections exist in men without any work done. Imperfections as a result of a cosmetic procedure will vary in significance both in how pronounced those irregularities are, and how critical the host is of their own body & shaft.
Typically the more noticeable imperfections, especially with fillers, are nodules, lumps, and ridges. These are usually more palpable (to the touch) than they are visual. The ones that are visually obvious deserve the most attention in follow-up appointments. The ones you can feel may smoothen over time, and even if they don't, you might be the only one who notices them. If you feel they need to be addressed, they are usually correctable as well.
Other imperfections include the placement of Dermal Filler, where some areas of the penis may have more dermal product than others. This can be fixed in subsequent appointments by spot-filling to even out the contour.
The penile skin is thin and has no adipose tissue, therefore more susceptible to aesthetic irregularity. This is why having a legit practitioner perform the procedure is crucial because their work will minimize the number of touch-ups you'll need, especially since follow-up appointments are (almost) inevitable. Keep that in mind when pursuing Dermal Filler Girth enhancement.
If you are hyper-critical of even the smallest flaws I wouldn't consider Dermal Filler Girth enhancement. A dermal graft matrix might be better suited for those who prioritize natural aesthetics above-all else (Doctors like Dr. Solomon and Dr. Liu offer Surgimend, a dermal graft matrix implant).
But to clarify: those people who already got permanent fillers like PPMA, would it be possible for them to get a dermal graft matrix implant? I think it would not be possible.
And for me that got dermal fat graft, I assume the same would be true? I started to think if some filler could be added to improve the aesthetic result? I guess it might be fat transfer, but the more I read about fat transfer the more convinced I have become that it is likely to cause imperfections rather than fix them.
I did read a study that dermal graft matrix implant had been inserted in conjunction with fat transfer, in an attempt to improve the result, but it is done at the same time as surgery. Fat transfer is not permanent either, which is not the case with PMMA, so I guess it would be hard to fix if the result was not good if there is both PMMA and a dermal graft matrix.
Getting work performed on a penis that already has a prior enhancement largely depends on the discretion of the Doctor. PMMA is a Dermal Filler injected non-surgically whereas grafts are implanted through de-gloving your penis and placing it around your shaft; these present two different implant zones so in theory, both can be performed on the same host.
The issue is that some Doctors may not be comfortable working on a penis unless they were the ones who had worked on it previously. For example I know Avanti Derma won't perform PMMA on a penis that has had any major surgeries done to it. Some may offer it but might have you sign a disclaimer. It really depends.
Last edit: by Skeptical_One.