Another one:
1.
Necrosis cannot occur with cannulas since it is impossible to inject it into in artery (which has occurred with PMMAin Brazil several times in the facial artery with nasal
Necrosis).
2. However, foreign body granulomas can occur after
PMMA, especially when injected superficially into the dermis. This is not the case with cannulas ! Granulmas after all injectables occur in about 1:1000 in the face. In buttocks and penis I haven\'t heard or read about one case. As deeper from the skin injectables are deposited, as less they cause granulomas.
3. If inflammation or granulomas should occur, thet treatment of choice are Cortisone (
Kenalog) injections : 2 -5 and they should be gone within 3 - 6 months.
4. Keloids raise from the dermis and have nothing to do with a foreign body reaction around
PMMA microspheres, e.g if the
PMMA or injectable is injected sub-dermally as in a penis. There is no proof or relation published within the last 20 years,
5. This is the best question : The cannula runs normally between the 2 fascia , that\'s where the skin moves over the corpora (and where also an implant is inserted. The early morning erections, however, let the corpora move forwards - and with this movement, the injected
PMMA or whatever becomes automatically attached to the
Dartos fascia, e.g. the skin.
6. I have tested NewPlastic - and it is almost pure , e.g. free of small
PMMA microspheres, which might cause inflammation. The FDA approved ArteFill is absolutely pure and causes no granulomas anymore, however , it will be 10 or 20 times more expensive : 0.8 ml cost $ 450 to the doctor ! And you will need 10 -20 ml! -
7. Since the
PMMA is attached to the skin , its
Removal is rather difficult ! The excision can lead to
Necrosis and skin defects and should be avoided ! Irregularities are in my eyes the only complication you may fear - and that is something you have to discuss with Dr. Casvantes : how often has he seen it - and how did he treat it ? Probably with more
PMMA into the depressions. From all injectables today,
PMMA is the safest (I say this not because I am biased) . There is Macrolane from Sweden on the European and Japanese and Korean market since 2010 , a high viscous
Hyaluronic Acid like
Restylane - however, it last for 1-1,5 years only - and is much more expensive than NewPlastic.
As far as I remember he mentioned before to me :
Low concentration of
PMMA ----> less irregularitiesMore concentration of
PMMA ----> more irregularities