TOPIC: Comparing HA to PMMA

Can anyone who has had both HA (specifically Volux) and then gone on to get PMMA speak to the differences if any in how it feels? Does PMMA feel less like foreign filler and more like thickened skin?

I started with 20cc of HA and then moved onto Rupeka and PMMA. I honestly wish that I had started with PMMA for the fact that 20cc of HA felt squishy. Now, this could be the technique/layer that the PhalloFILL Urologist used that made it seem like that, but personally feel that it's a fairly extreme difference between the two. I went back to Rupeka for a second time in January and he put in 20 more cc of PMMA (I just did 10cc the first time I visited him), with a focus of firming up the HA/squishy areas as well as some even-ing out of specific areas.

I was actually a little disappointed to learn that HA sticks around far longer than advertised because I wanted it gone and just have PMMA because it feels so much more natural and firm, but he did an amazing job of firming things up and doing what he does best.

Hopefully this helps answer your question.

This is great thanks for the info. Anyone else have similar experience ?

I think injection technique and brand of Hyaluronic Acid (HA) which is often cross-linked for different cosmetic applications will play a role in its tangibility. We're our own harshest critics so we tend to forget that the penis (even when erect) has some slight give when pressed. There are people who are quite happy with how their feels and prefer the non-permanence.

The PMMA is not necessarily any less "noticeable" as enhancement, in fact it can feel like your skin has a band of rubber adhered to the underside of the shaft dermis; some guys don't mind this trade-off for permanence.

It's preference, risk aversion, and matters of maintenance. They both (PMMA & HA) by all accounts don't feel 100% natural to when under scrutiny, unless you were getting a very mild enhancement (20 cc's or less, not more than 2 appointments). I should say however, to the unsuspecting or uninitiated (those who aren't looking, much less those who even know male enhancement is possible) are typically not going to notice either, especially if you don't go overboard.

I know PMMA gets discussed here a lot and its associated Clinics, but I will tell you HA aficionados like Dr. Tsay of Orange County, California, the Dallas PhalloFILL Clinic (I can't speak for the urologist Member Shawn9212 spoke of if it was an affiliate office), and the Shafer Clinic (S.W.A.G. Procedure) of New York City have put out stellar work for years and have had repeat business with respect to HA. Heck, even options like Radiesse shouldn't be overlooked (Ellanse-like in that it has temporary microspheres, but HA like in its longevity), which could be combined with the P-Long protocol through an expert in Aesthetic Medicine like Dr. Luis Lee of Northern California.

While it isn't 100% risk or complication-free, HA boasts a strong safety profile because of its lack of permanence (and can be reversed to some extent), as well as the fact that it also naturally occurs in the body (and what's injected is a cross-linked iteration made in a lab), which gives credence to the idea that it induces less of an inflammatory response overall.

I've always wondered why there are so many cases of uncircumcised men getting HA but not PMMA. Is it due to safety concerns or something related to the product characteristics?

I know you're asking for comments from guys who have had the procedure but I hope you don't mind me chiming in. I treat patients with both HA (Volux and Voluma) and PMMA. I would say that its about 50/50 at this point. If I had to say which one feels the most natural overall, I would give a very slight edge to PMMA, but there are a few caveats.
The first caveat is that straight Volux can sometimes have issues with clumping and nodules, and patients should go into it with their eyes wide open that it may have more corrections than Voluma alone. Overall Voluma and Volux can feel and look very natural, especially if you are not going for a huge size increase.
If you are aiming for a modest increase—about a half Inch to an Inch—then it is almost always imperceptible to a partner who does not know that something was done.
However, when you start getting into larger size increases, PMMA tends to look and feel more natural overall. The caveat there is that as larger volumes of PMMA are used, the risk of granuloma does increase. If a granuloma occurs, it can sometimes be visible. It is treatable, but not always 100% fixable.
What I most commonly recommend in my office is a combination approach using HA along with PMMA. In my experience, this combination produces extremely natural results while limiting the risk of side effects, though of course no approach eliminates risk entirely.
There really isn’t a perfect answer as to which option someone should choose. Overall, however, most men are extremely satisfied with either HA or PMMA. I hope you get some more first person accounts!
Dr. S

Dr Sullivan…Do you inject the PMMA and HA in one application and what percentages do you mix HA and PMMA?

Thank yiu

PMMA and HA are injected in the same session. The ratio varies, but typically about one-third HA and two-thirds PMMA. Depending on patient-specific factors, the amount of HA may be slightly higher or lower. Dr. S

Great info… thank you all and I appreciate your input Dr S!

Dr. Sullivan…..thank you for the information. Can you describe how the penis respond or changes once the HA starts . I assume the Girth would decrease however would that take place evenly with the penis so that the penis stays smooth. Also how would the volume be regained?

Thank you.

Over time, Hyaluronic Acid (HA) gradually reabsorbs. This process occurs slowly and uniformly, so any reduction in Girth tends to be mild and even rather than occurring in isolated areas.

PMMA behaves differently. During the first three to six months after treatment, the microspheres stimulate collagen production, which can lead to a modest increase in Girth. Once this collagen has formed, the result becomes stable.

Some patients worry that HA may dissolve unevenly. In clinical practice, this is not something typically observed. HA fillers have been used for many years in areas such as the lips and cheeks, and uneven absorption leading to asymmetry is not a common outcome. Ive never seen it in fact. Dr. S

Dr. S do you use specifically Bellafill or another PMMA brand?

Since I have HA already, would you only inject Bellafill at the time of treatment or would you still mix the HA and PMMA?

Thank you!

Good Morning,

I use Bellafill it is the only FDA approved PMMA filler.
If you already have HA we would just do the Bellafill.

Dr. S