TOPIC: Infections, Complications, Risks of PMMA?

YES!

Original post was, this is bad, bad, bad news Coolhandluke.

Then, I clicked on the links and I understood that the main scientific reference to the risk of PMMA migration is the famous 2010 Caldellas article, which has been subject of discussion in this forum already.

the physician who made the product versus the physician who has little to gain from not using the product will always have varied opinions, doctors are just like people, we hide behind our titles, that is another way of saying we hide behind the truth. Dr. Gustavo seems to have a very good reputation in South America, i\'d like to know if he has an angle to gain from this, or perhaps maybe he\'s being a good physician/researcher here by sharing his truths with the world.

In order words, I got seriously worried (and posted accordingly) before reading the source behind Dr. April claim.

After having calmed down I\'ve checked one of the sources (a link you provided) and realised that it is nothing new. The strong criticism stems from well known findings by Caldellas on Newplastic injections in the auricle conchal cartilage.

I had to edit my post because my panic had been based on a misunderstanding and I did not want to disorient my fellow forum brothers.

For me, key question stays the same: where is the evidence or well placed doubt that PMMA migrates irrespectively of injection location (as indeed claimed by Dr. Gustavo)?

Well if your question is true, the evidence is when you have the problem. You\'ll know it when you have it & then i\'ll buy you a beer!

Could one of you guys refresh us on the Cadellus stuff? This was in the 180 page thread if I recall. I think we came to conclusion risk 1) Necrosis: not happending \"later\" happens early on due to needle, not just PMMA but injection related2) migration: PMMA biocompatible not going to cause cancer, your system can respond3) absorption: not discussed, not a lot of evidence4) granuloma: down the line, Kenalog shot.Lemperle said straight out biggest risk he sees is assymetry/aesthetics. It would be no suprise to see some people unhappy, including possibly me! Touch up sessions available for this. Changing your unit is a big risk, and once you change it there is no going back.

Question is true? What do you mean my friend?

I am not tolemaically denying what I can\'t possibly know for certain, that is event of PMMA migration after deep injection in the penis; but do we agree that there is no evidence so far that this is indeed possible?

coolhandluke wrote: my tid bit on absorption of PMMA filler, along with nodule formation, and deformities (hardening around the circumference area in my case). The idea of research arose because of the number of patients arriving with complications from the use of PMMA Pedro Ernesto University Hospital, where Castro is a professor. With a team of Amparo and Research Foundation of Rio de Janeiro, the surgeon met 21 patients with cosmetic defects in the ears, who agreed to have the substance injected into the lobe.
This feature facilitates the extraction of material for analysis. Six months later he began the study and analysis found that in all cases there was PMMA absorption by the body. In addition, 20 had infiltration and formation of nodules in 19 of them.
The use of PMMA is so widespread and indiscriminate use in cosmetic procedures so that some scholars describe as \"epidemic.\" The immediate result is fascinating in most cases and, in a small percentage, the initial result has no solution. But what this research confirmed the long-term outcome of polymethylmethacrylate use in cosmetic filler, hardening of the treated area, migration and cyclical and incurable inflammatory process.
The absorbance of the tissues shows that the filling is not permanent and that migration occurs with PMMA is equivalent to that of liquid silicone. While manufacturers say that the complications are caused by poor placement of the substance, the research found that the problems are unique to it. Therefore, the president of the Brazilian Society of Plastic Surgery, Jose Yoshikazu Tariki, recommended to their colleagues in small procedures only use up to 2 or 3 millimeters in parts of the face. In some cases, the PMMA is injected in doses up to 400 mm, such as the buttocks. Therefore, Tariki warned that the use of PMMA should be unique to the doctor and not be used for aesthetic purposes. He further stated that there are some areas of the body where there are more complications such as peri-oral area (near the nose and lips). Writen by Dr. Gustavo April (Argentine Plastic Surgeon) www.misionesonline.net/noticias/23/08/20...n-rellenos-esteticos www.larevistadecirugiaestetica.com/2009/...-infiltraciones.html www.drgustavoabrile.com.ar/ Per this physician\'s clinical/professional opinion, this pmma stuff gets absorbed & is not a permenant filler! The deformities i\'ll share with including photos will be posted in another thread I\'m in the process of working on at a later date, i have other time sensitive obligations to school at the moment, but i want current gents to be aware that some of your bioplasty bros have been busy with obligations to life, but in the mean time have been experiencing unwanted complications with the pmma filler (Newplastic). Everybody has been tooting their horns, fellow friends like EP have voiced concern about the complications associated with this procedure and the reflective practice of it practitioners, and his humble efforts seem to not center everyone. The praises seem to go unnoticed in the fundamentalist crowd of pmma believers, but Coolhand, having always been a friend to everyone here on the forum, hopes to bring some personal transparency to the argument in the coming weeks, centering our fundamentalist friends as it were. We are gents, like-minded men, we wanted some new-age treatment to improve our sex lives and trust me i know what sex feels like with a pmma penis, after procedure 1 it felt \"AWESOME!\" as my spanish sweetheart told me after making love to her the first time:\"Papi eres incre'ble!\"But now, the product & randomly evolving technique that\'s practically experimental for the penile patient are both in question for your\'s truely, SKEPTIC TWO AKA Coolhand. After procedure 1 i had good cosmetic results, but the outcomes of procedure 2 were unnatural and less than desired, and time consuming to say the least. In between my obligations to family and school i\'ve shared personal progress notes with respected friends i\'ve made here on the forum, mod-friends and nonmod-friends alike. i was embarrassed with the outcomes of my 2nd procedure & i hope my respected physician felt/feels the same, it wasn\'t ARTFUL* work, it actually feels like my ego has taken a bullet with the unnatural look of things & the money, and time, and mild pain i\'ve experienced inorder to try recover a decent looking unit. I just want to call attention to TRANSPARENCY, and whatever else i get i\'ll count them as extra fries or onion rings in the bottom of the bag. Cheers old & new friends this is for you, Coolhandluke

The need to bring to light the real risks inherent in this procedure (and all elective medical procedures) is paramount to the discussion! Good to see you back CHL, and I truly appreciate you enlightening us on this matter, in specific: migration and non-permanency.
I personally am of the camp that believes that penile bioplasty is still relatively experimental, both in that it lacks extensive long-term research (penis-specific), as well as the need by Dr. C\'s office (the practitioner most often cited here) to refine the technique over time. With that being said, I\'m also of the camp that believes it can provide effective results, but not without risk. I haven\'t been told of any major complications (i.e. that comparable to the damage reported from alternative methods), but minor complications (and please, when I say minor, I\'m in no way trying to lessen its significance, only trying to differentiate between a small nodule and total tissue necrosis) have been reported.
This is also why I tend to recommend this to only a select type of male, and often discourage many other members (usually via PM) from entertaining the idea unless they\'ve made a sound, healthy, and informed decision.
Now as for the links you\'ve provided us, as well as the claims made, the only question/problem I have with them are the glaring lack of some of the most essential information. While I\'m not doubting the reports legitimacy, it has been contended by practitioners and members alike, that there are a multitude of factors that can play a role in things like migration. Cannula size/type, size of PMMA beads, where it is injected, etc, are vital pieces of information, and without it, we are at the mercy of speculation. If any of these specifics were cited at all, please bring it to my attention and I apologize in advance for overlooking them.
What we do know now is that according to one study, PMMA has been observed to migrate and not remain permanent. This is in stark contrast to the information provided by Dr. C\'s office, who may have a different approach(different cannulas, brand of PMMA, etc) in methodology than the above cited study. This is also in light of the fact that Dr. C has been doing this for many years, and would certainly have noticed re-absorption over time and/or migration (Dr. C & Wade both have PMMA in themselves).
What we know for sure is that we need to continue the discussion, analysis, and research on this very topic (risks & complications arising from penile bioplasty). Furthermore, there should be no doubt that this procedure is not a walk-in-the-park all of the time. Many have had short-term success, others have had mixed reviews, and there are even some with not-so-satisfied outcomes.

Dr C. and Wade claim they have PMMA in themselves. Has anyone asked for proof?

Dr C and Wade have on many occasions mentioned to their customers that they have had PMMA in the face, abs, legs and penis. No proof was offered but there signs of it when you look at them and they have been straight and honest with their services to us.

One thing I would like to see is a date and batch # of the PMMA on the receipt one is given after the session..

mustang2020 wrote: they have been straight and honest with their services to us.

I had a discussion with E.P. on the idea that Dr. C\'s work & practice could very well be one of the most scrutinized on the web. Even on sites like makemeheal(dot)com, I\'m not sure there is so much information and analysis being exchanged about one doctor like there is on this site. With that being said, it would be rather reckless & idiotic on Dr. C\'s part to lie to us in any way, shape, or form. Wade expressed the realization that virtually everything their office does with respect to penile bioplasty will inevitably make it to the forum. To my knowledge, they\'ve been pretty open & transparent with their work... they\'ve also been pretty conservative with their approach to reduce the number of irregularities. I\'ve personally found their practice to be more forthcoming than any other PE doc\'s, and have never doubted their honesty.

@CHL
I\'m also curious to know if you\'ve experienced any of the things claimed by the study to be of issue: migration and absorption/non-permanency ? If you have indeed experienced these complications, how were you able to determine this to be the case?
Otherwise it is apparent from your recent post that you have indeed experienced an unsatisfactory outcome and would hope to hear more about it when you have time (I know the Finals are around the corner, good luck!!).
Also, I\'m not sure what you mean by \"fundamentalist crowd of PMMA believers\" and I\'m not sure who, if any, this could pertain to. In my mind, there are really two crowds in PMMA, those who share, and those who don\'t. But as far as a \"fundamentalist crowd,\" is concerned, I have a feeling it may mis-characterize those who have enjoyed short term success. Even the guys with legendary success here at PB aren\'t suggesting this procedure is without risk. I myself have been the first to remind members the need to re-assess their ambitions and goals with PE before pursuing PMMA (or any other method) and have always been keen on reminding the forum on the realities of risks & complications.
As a matter of fact, per Astroman\'s request, I will sticky this thread to highlight this very reality. But in fairness to the topic (of complications, etc), it would be important that we get the whole story/background when it pertains to reported complications.

I mentioned to Dr.C. and Wade about showing the date and batch but they didn\'t really act interested. That actually concerned me and made me a little nervous although everything else was relativity flawless. I have a feeling that they don\'t want to do that and if so there must be a reason.

Perhaps the reason the clinic doesn\'t want to provide batch #\'s and such is the obvious one: more (paper) work. I work with such things in a completely unrelated field and I\'m sure we all realize documentation/confirmation/etc. is an additional time and money expenditure. Regarding all of these recent posts regarding complications: Is there anyone willing to categorize and document these events? (this may inadvertently drive home my previously mentioned point above). Are they of major concern relative to the absurdly horrendous results of some of these other procedures? It has been pointed out time and again that PMMA has been used for over 50 years in various procedures. When the concentration % and volume are considered- aren\'t these reasonably safe parameters? CHL- Have you published your adverse results with PMMA? You seem to be the strongest... detractor? You appear to imply other \'veteran\' members concurr with your long term prognosis. I mean no offense, but am,.. well, alarmed. Transparency would be appreciated if this indeed a road of dispair- a road I\'m on that appears \'safe\' at the moment. Your suggestions and implications are of great concern... if they are not alarmist. I\'m quite sure I saw an episode of Oprah (wayyyy back in the day) with a panel of women claiming that silicone breast implants led to extreme cases of lupus and other maladies. I hear nothing of that now, and believe it was dismissed as \'alarmist\'. Please take my non-medical and unscientific questioning as a means of teasing out the \'truth\': Are these inherent risks and side effects reasonable and acceptable for a person willing to augment their penis? clearly anyone considering it has already crossed a line of risk management. I would greatly appreciate any and all \'veterans\' to chime in on this subject. Anecdotes welcome- I personally feel they have more value. And thanks to those with pics- clearly worth a thousand words and very brave indeed. Just puttin it out there guys.. .because these threads have always given me pause. I will hesitate on a second procedure without additional feedback and resolution. Regards

@coolhandluke,
I am sorry to hear that you have experienced an unsatisfactory outcome and I wish you the best man .
1) In regard of this person in:-
www.penisdoctor.com/photo5b2.htm
I know this guy very well, he had Alloderm and then PMMA injection the entry hole near to the glans was oozing for few days and his old alloderm graft was exposed through this particular hole, the mistake he did water came in contact with this entry hole ---> severe penile infection of the whole thing ----> I.V. antibiotics and multiple needle aspirations after few weeks he met Dr. Elist who removed the whole infected tissues (including alloderm, pmma and the connective tissues) but the biggest mistake Dr. E. did he inserted his Implant at the same time ---> again severe infection, extrusion of the implant, major skin necrosis and loss, temporary peyronie and permanent dorsal numbness. Thats why I have always mentioned before anyone who had a graft before should take an antibiotic and avoid water to be in contact with the entry holes.
2) In regard of migration esp. of the small pmma beads :-
a) Lemperle answered this Q. to me before :-
\" A 10 micron cell, which eats a 40 micron bead - cannot migrate !
It is a difference whether a 10 micron cell eats a 2 micron bead: then it can still migrate !
But what is so bad about migration ?? What do they fear ? A smoker stimulates every day millions of macrophages to move all the tar to the periphery of the lungs - and Kupffer cells in the liver all filled with all kinds of non-resorbable particles in elder patients, without doing any harm.
So the body takes care of soo many particles (think of the tar from cigarettes or the silicone particles from implants ..., and look at the Kupffer\' cells in the liver of old people : full of junk ! - So, these \"few\" small PMMA microspheres don\'t do any harm at all - if they were found in lymph nodes, liver or lung.... \"
b) In the 2nd Bioplasty congress in Mexico \"PMMA for facial and buttock\" in Dec. 2010 :-
Dr Suzana Barreto from Sao Paulo, Brazil did MRI on her patients before she injects them with PMMA and a few months later to see how the implant behaves in people. She showed great slides on MRI results of the face and buttocks. She also compared MRIs done in patients that have had silicone injected to show how silicone migrates and shifts in tissue.
She said PMMA did not migrate in her patients.
That is her e-mail if anyone would like to ask her :-
This email address is being protected from spambots. You need JavaScript enabled to view it.
3) In regard that PMMA is absorbable and not a permanent filler :-
PMMA is known to be a non-absorbable filler and FDA has approved that ( and not only the inventor of PMMA) :-
google2.fda.gov/search?q=Is+ARTEFILL+a+n...e=FDAgov&btnG=Search
Also a paper which shows PMMA injection successfully lasting for 15 years :-
www.ncbi.nlm.nih.gov/pubmed?term=19787393

4) In regard of the study of injecting PMMA around the auricular cartilage :-
An implant can cause pressure necrosis on its bed e.g. Silicon Chin Implant can cause bony absorption and in some cases erosion of the bone.

5) In regard of hardening around some area ---> could it be the formation of scar tissues around the beads esp. you had 20% in the 2nd rd which will take around 6 months for scar tissues to soften .
I would like to know more about your unsatisfactory result CHL, plz esp. in regard of deformities that you have mentioned above ??? Are they only aesthetic issues or an inflammatory complication ?
You had (as far as I remember) in the 1st rd 10% and the injections were near to the base only and you had great result but in the 2nd rd you had 20% with a good volume and the injection site in this time were near to Glans, so are the nodules and the deformities you have mentioned above present only near to the Glans or the whole shaft ??

IMO the things which I could be mostly concerned about are :-
1- Foreign Body Granulomas usually it happen between 6 months-5 years triggered by systemic infection ( esp. it can happen if the pmma injected superficially and not deep) and they can be treated by Kenalog injection.
2- Aesthetic results (nodules, lumps and asymmetry) kenalog and the lowest conc. pmma to fill any irregularities .

I think the worst case scenario is if some PMMA spheres some how go into the blood stream and that is when major issues can occur.