I've ead a couple posts talking about some doctors preferring a base layer of HA before getting PMMA. Why is this?
Here's a section from
this page on our website about adding PMMA to HA
that explains why Dr. Carney will not inject PMMA without a foundation of HA:
Achieving a long-lasting quality enlargement is directly tied to the basic foundation.
When an injectable filler is administered beneath the skin for the first time, the body’s immune system frequently reacts most strongly, causing more edema and granuloma than in subsequent treatments.
We insist that new non-surgical girth enlargement patients begin with at least one layer of hyaluronic acid (H/A) as the starter foundation, even if they are certain from the outset that all they want is a permanent result from PMMA injections. We recommend at least two rounds of H/A to help ensure an even, uniform finish within the penile shaft.
We discovered that beginning augmentation with PMMA almost always results in the formation of nodules or granuloma, which makes for a less than ideal foundation to establish symmetrical penile thickness.
Also, if the penile shaft is uneven from prior H/A injections, it’s essential that we first achieve a smooth even finish with H/A injections. Why is that? The permanent Bellafill injections will gravitate to the uneven areas of H/A filler. Thus, once the hyaluronic acid reabsorbs, that means the remaining permanent PMMA will also be uneven.
I hope that helps answer your question!