TOPIC: Infections, Complications, Risks of PMMA?

@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.

ndbig1 wrote: 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.

Some one mentioned that Dr C may be mixing his own % of PMMA to make custom concentrations, if this is the case, then it will be tons of work and almost impossible to keep track of it?

I take what CHL says at face value. HE\'s the one that tipped me off on liquid bandage, which I think is very helpful in the healing process. A couple things: 1) I understand that CHL is busy, but it is a bit much to come on the board in a lengthy way with cyptic dissapointment and then say \"dudes no time to tell you about it, later\". I have grad degree from a top school (sure many years ago) and I can tell you, you need breaks from even the most arduous work and this sort of board qualifies. 2) After a succesful round 1, CHL seems most concerned at the moment about aesthetic OUTCOMES, and seems to only now retrofit that to the science/technique risks (vs. round 1 when all was good on his end). Now Looking at CHL\'s starting stats (!) I personally wonder why he wanted PMMA. Not judging or hating, but it makes me leap to the idea that CHL is a perfectionist (nothing wrong with that). But if you have 4.5\" Girth attached to a small lengh, relative assymetry or less than ideal aesthetics may not be that big a deal to you. For CHL having an above average penis to start was NOT good enough, so if his penis post PMMA is not good enough. There are many cosmetic surgery patients who are \"unhappy\" with outcomes, PMMA will be no different. The hardness issue has to be considered over course of time---if it stays hard that is a problem. I just want to add my two cents in because I would personally feel sorry for guys with real units (a true small unit, not a CHL starting unit) to bypass this procedure based on the outcomes of one. So far I am doing well, even though I see this is far from perfect e.g., my faccid unit is not as comfortable as after round 1 .

@mustang, why would Dr.C mix his own? I mean 10% comes out of a 10% container and same for 20% correct? So why any mixing need be performed?
However in the event that he did that anyway. We still should be able to see the batches and dates of the groups he mixed. I mean lets say he put 2-5% together to make 10% its not impossible to say which two he used. Also I would believe its to his benefit to track it based on a possible complication from a bad batch which would need to be traced to pinpoint the culprit. So there may be more questions that may arise from this practice if it is confirmed. I know Wade reads the boards so maybe they will address this and present a bit of re-assurance.

QUOTE: So far I am doing well, even though I see this is far from perfect e.g., my faccid unit is not as comfortable as after round 1 .

@bighat what do you mean ?

ndbig1 wrote: I know Wade reads the boards so maybe they will address this and present a bit of re-assurance.

Are you sure about that? Wade may skim these boards from time-to-time but he gets most of his info directly from the patients themselves (email & phone), and has told me he barely has enough time to actually review the information on this forum on a consistent basis. He\'s also mentioned that he\'s not computer savvy and tends not to know how to navigate this site when he does visit (however often that is??).
If I\'m not mistaken, Christian will usually pull up the site and Wade & Dr. C may review it per request of a patient or prospective patient.
While bringing this up may appear off-topic, I addressed it to bring to everyone\'s attention that everything you post may not necessarily be read by Wade or Dr. C, so it\'s always smart to ask everything when consulting with them - including risks & complications.

I tip my stetson black eagle to bighat, of course i don\'t wear that around SoCal, but it\'s likeable to my texas kin. At any rate here\'s a study break entry from B.Chem; there\'s too many issues to address i wish we had a skype conference, but here it goes...Mustang addressed a very (very) important issue concerning mixing & titration of the PMMA product. Last friday was the final biochem lecture of the semester & i couldn\'t concentrate since i had this revelation during that time, here\'s what i wrote in my notes instead of paying attention; \"In principle a 3-way valve works for soluble liquids. But to properly mix insoluble solutions of different solute concentrations a 3-way valve, is an inaccurate & artfully not the best choice for titrating a reactive insoluble Dermal Filler like PMMA, because, the molar weight (including reactive size) of the concentrations has them unevenly dispersed throughout the syringe. Based upon the polarity of the microspheres, the result has lead to clumping/Nodule formation after its been applied to the skin as a Dermal Filler. The outcome would include undesired irregularities after the PMMA filler settles. This leaves the 6% (not assumed 5%, per my 2nd procedure conversation with the treating physician) & 20% concentration in question, presumed unprofessionally (improperly) titrated & mixed for modest appilcation. Leaving the 10% & 30% concentrations as the only viable options due to tested quality control reports & proper mixing techniques for distribution accuracy per the manufacturers laboratory. A cheap 3-way valve used in clinical nursing can not replace, the invaluable time labored titration & mixing technique done in biomedical labratories\" [end note] That is my amateur opinion; the science man in me must also suggest inorder to accurately conclude that this is true, we would need to cut up my Dick, take photos, cise out PMMA clumps & nodules and send them to the lab for further analysis. Then we would need to run an experiment, timely experiment, we would need to have an FDA or SSA approved Lab facility or University, then determine if mainly the 20% in question causes unfixed irregularities using a 3-way valve for mixing or if the lab titrated version of 20% provides the best results. I\'m tired of human experimentation with this product, i would then use swine as test subjects because their unit can typically be twice the size of ours, i would add a second variable & compare the absorbtion rate in old swine versus the younger test subjects. I would make this a short 2 year study and publish since a lack of funding probably wouldn\'t take me close to a10 year study. My friend Bighat, please do not use the Walgreen\'s liquid bandage, it may or may not have added to the Nodule(s) formation around my circumference line. As the story goes of which i\'ll go into detail later in the Drudge Report, I called 2 days post round 2, asking Christian to see if i could speak with Dr.Casavantes or Wade about a continuous bleeding concern(not plasma) that was occuring at the entry points. I waited on the phone, he came back and said, Wade wants to know your concern. i told him i would like to ask if Liquid bandage is a contraindication in the healing process or use in this PMMA procedure. I basically wanted the ok. Christian said both Wade and the Doctor were busy and Wade said it was ok, I asked if he was sure & he said Yes. I\'m not certain, but i believe liquid bandage may have affected the healing too well maybe having a indirect link to the Nodule formation. Ironically we applied the liquid bandage in question on touch-up procedure round 2.5 as it were with the doctors visual approval on the nodules that he tried to caterize with an electrode, of which i felt (PAIN) since the lidocaine wore off, the caterization stopped the bleeding, but those details are for my later report. Now the loyal sewing circle could gossip to the doctors staff. Now listen i have what i have i grab him everytime i urinate, i bear partial responsibility since i paid for the damb procedure, but i had a 6inch Dick, with a 5 & 1/8 Inch Girth & i wanted a little more. I\'m only 5\'6.5 in height, i\'m no Audie Murphy i\'m just a nerd, and i wanted a little extra to add to my genetic insufficiencies in this 1 meager life, & so what its the year 2011, i spent close to $4000 on this PMMA investment i believe i\'m entitled to a good outcome. Some personal hardships have rattled my cage this year like death taking a goodwoman, but i\'m a man of science, fluff doesn\'t get me anywhere. Every testimonial is subjective and long patience should not be reserved for a witch hunt. I want to help whoever needs help by joing this group with what time i have. Until this stupid week is over, i\'ll be able to address photos & personal PM\'s in the weeks to come. Cheers, Coolhandluke

CHL, I would kindly ask you to clarify your points in either this thread or in your other report. I do feel that you are addressing important topics but I can hardly follow not just your reasoning but what indeed you are talking about.

Regrettably, my field of study is not in the medical sciences. I think you are assuming too much (even at terminology level) from people who are trained in other disciplines. Just to give you a feeling: what if I told you that each sigma-bounded Baire set is the union of a countable disjoint union of bounded Baire sets? Or if I stated that a locally compact group has a sigma-compact subgroup which is both open and closed?Back to your points: among others, are you actually saying that you think that Dr C. is amateurishly mixing various concentrations of PMMA?

Thanks a lot EP.

Great table and very informative.

At the same time, my uneducated guess is that CHL refers to something else: his use of the verb \"titrating\" would seem to refer to manufacturing of ad-hoc percentage product from mixing official products with different concentrations. Unless of course I\'ve plain misunderstood his post, which is quite possible as I have hinted in my previous post.

I am trying to figure out why CHL has an unsatisfactory outcome after the 2nd round and not after the 1st round :-
In the 1st rd :- 10% conc. , entry holes at the base, blunt micro-cannula and no bleeding post-injection.
In the 2nd rd :- 20% conc. (its sterility??), entry hole at the Circumcision area, sharp large gauge needle ( blood vessel injury ), bleeding , cautery (could it also affect the beads at this localised area ?? the heat ???) and the Walgreen\'s Liquid Bandage .
So it could be one or more of these issues in the 2nd rd which gave CHL an unsatisfactory result, so we are now learning more about PMMA penile injection and its complication esp. the early ones .
So any one who is going to get PMMA penile injection in the near future (either 10% or 20% NewPlastic or even 30% Metacrill) should insist on :- no entry hole in the Circumcision line , no sharp needle ( only blunt micro-cannula) and no cautery.
@CHL
I hope that you will be fine and you get over with this issues as fast as possible. I would like to know, please :-
For how many days did you have this bleeding-like issue ? Is there any possibility that water came in contact to this entry hole during this secretion ? As far as I know you didn\'t have any Phalloplasty before, correct?

I think Dr C uses a sharp needle to make a perforation in the skin to allow the big or small Canullas to enter the penile skin. I know in my case some times he had to do a couple of punctures in the same place with the sharp needle for the Canulla to enter for PMMA dispersion.

I also had one entry point near the glans that did not close up for a few days. I used lots of Triple ointment solution to keep it clean. Eventually it did close up and now it is healed.

I think at this point and with what we know and I hope with what Dr C realized that entry near the glans had caused some issues.