TOPIC: PMMA - The Good, The Bad and The Ugly

Hi HC,

As we know we cannot have a perfect aesthetic results from pmma injection, but there are many criteria which can reduce the unpleasant aesthetic results imo :-

1- The most important the lower the conc. of pmma e.g. 10@ has a better aesthetic result than the 20%, also it could be the mixture of the 30%+10% (imo) does not give you almost evenly distributed 20% pmma beads i.e. there will be some parts of the mixture contains still 10% and other part of the mixture will contain 30% --->i.e. the end result will be different collagen texture between the 10% and the 30% in different parts of the penis ??? I might be wrong.

2- A small volume of pmma injected in each session will give you a better aesthetic result than a large volume e.g:-

SO has a better aesthetic results he had as far as I know in the 1st two rds 10% and in the 3rd rd. @20% but he had small volume of pmma injected in each rd e.g. in the 2nd rd. 11cc.\'s and in the 3rd rd. 13 cc.\'s + 1cc.@10 near to the glans.

3- The technique of the doctor :- It is always advised to continue the smooth flow of pmma during injection in order to avoid depositing the material irregularly. And it should be injected in a threading technique as the cannula withdrawn to get the most even micro-strands and not micro-droplets, of deposited material.

This is the technique advised for Artefill :-

www.asds.net/asdsa/content.aspx?id=1364

That is the same what I feel in my penis like a strands of thick collagen running along the long-axis of my penis and the outer surface of these thick strands feels smooth but the gap (around 0.2-0.3\" in width) between these strands (i.e. the sidewalls of these strands) is rough, so for my touch-ups I need a small volume of pmma (10%??) to fill these gaps, (I wished if Dr.Samy didn\'t space these collagen-strands).

Dr.C. has a great experience with pmma penile bioplasty, and his technique is still being perfected.

4- The site of injection :- PMMA under thin skin will definitely give you nodules and irregularities, so this has to be avoided (e.g. the gap behind the glans) that was one of the reasons Dr.Samy refused to do it at this area and the other reason in his opinion the risk of skin necrosis. Also the anatomy at this area is different from the rest of the shaft; it is too tight and the transition at this area is irregular looks like-finger outgrowth spaces thats why if you get these beads injected at this area the new collagen formed will look finger-like outgrowths.


5- Early post-pmma injection protocole :-

Is very important but still we didn\'t reach the method to help in distributing the pmma beads evenly directly post-injection (massaging +wrapping -/+ the Roller\'s technique??)
In summary :-

If someone is looking for a better aesthetic result (but with less gains with more sessions) is to have only 10% with a small volume injected in each session. Otherwise if anyone who had already received 20% in his previous rd.s (and going for only touch-ups) he should get in his last 2 rd.s small volume @10% (I think by this volume and the lower conc. --> the beads will be less in number and they will settle in these multiple small depressions and roughness so the new collagen will fill these gaps and getting at the end more smoother surface as much as possible more than getting more girth gain).

boost, how Girth did you gain and how much have you since lost? Basically what was your starting Girth, 6 week post op Girth and current Girth?

Man! May your dreams come true! They do! I\'m Hanging on your every word. Sending positive vibes your way. Hoping the very best!

This is why I trust this forum so much- the forumeers are as dedicated in compiling negative/neutral information as they are positive.

@Baywoof


Thanks for your positive thoughts - I am convinced that such are what must take us all through our Phalloplasty adventures, understanding that our units are very variable in shape, size and nature, and that they can be impacted in good ways!


For this reason I am taking this incident in stride and looking forward to a more long term satisfaction than the instant gratification I had come to expect from my second PMMA session. It seems that our physiological response to these injections is not only variable from individual to individual, but can also vary between one session and the next. There is also something which Wade told me which we should all consider, I shall paraphrase and apologize in advance if my memory distorts his statement:


\"PMMA collagen formation doesn\'t react the same when it is alone in the shaft, than when it reacts with areas of previously formed PMMA collagen.\"


I don\'t know if an adverse reaction of a new series of injections can be detected at once, after several minutes or hours delay, only the next day, or days thereafter upon post-operative recovery? In any case I got the sense that Wade knew something wasn\'t right when he sent me home, because he was genuinely concerned and conveyed his hope that my very dedicated constant massaging might help spread it out properly.


If this is so, then it might be good if there was a buzz word for \"the shit hitting the fan\" and certain tried and tested post-operative protocols to help patients whose unit isn\'t responding properly. Maybe some form of plalloplasty intensive care? Who wouldn\'t pay for overnight nurses or engage immediately with certain specific and clear to follow massage routines at regular schedules, to reduce the damage?


Had I known that my unit was having an unexpected, unusual and severe reaction to the PMMA - I would have accepted any form of hospitalization or special care right there on the spot. But given that this is experimental surgery and that we are by virtue of that fact volunteer guinea pigs at the same time as lucky beneficiaries of a leading edge procedure, none of this is already set up at this early date.


So my vote would be for various post-op protocols for people who have different reactions to product when injected - granted this is something that can be noted or even guessed at during operation or immediately at the end of an intervention.


My first session allowed for full bandaging for several days, I took it of to take a peek two days later, and then put it on for another day or two. My second session came with the recommendation \"take it off as soon as you can\" and massage it to even out the product. This sounds like very different protocols, but to me they corresponded to exactly the same intervention, so I figured that it had nothing to do with one\'s condition that might be different, but was related to current preferences or the unfolding of practices which might have a slight, but not necessarily significant impact on results.


One thing I\'d like to know from others here who have had several session of PMMA, is what it feels like in Flaccid condition? Is it uniform and constant to the touch, when you squeeze it gently in various places, do you feel clumps and clusters of hard matter. And if so, did this diminish with successive sessions of filler?



Thanks for posting your reactions, opinions, advice or suggestions!


HC

What baywoof said goes for me too. Hoping that things go well for you and that you get the end result you want.

I have a feeling that DMSO would be very effective on PMMA lumps. But I\'m not sure it\'s a good idea at all. It\'s dangerous enough using DMSO at the best of times, so is too risky to used when you have a foreign body.

I don\'t want to tease people by hyping something that I don\'t think is safe, but I\'d put money on DMSO being twice as useful as Kenalog.

@HC

I\'ve had 3 procedures and as of now my penis is soft & pliable in the Flaccid, and uniform & stiff in the Erect state. I do have a few small nodules behind the glans, but overall shaft aesthetics is mostly natural. This goes to show that there is indeed a variance from patient to patient (penis to penis), and quite possibly, from round to round.

Thanks for reporting!

@PMMA someday soon


Hi, good to meet you, and I like your forum name! I didn\'t post this thread to scare people away from PMMA, which I think is today probably the best bet we all have to gain greater manhood, or at least a far more pleasurable unit for the ladies! Quite to the contrary, I hope my situation contributes not just to fixing my own issues but to helping the entire Phalloplasty community better address the challenges that these new techniques bring with their benefits.


I did get benefits, which I am not about to complain about. Daily I get multiple phone calls from woman who are inconsolable without my attentions - and this is something I never had before despite being something of a Casanova with relentless sex lasting many hours on end. I grant full credit to Dr C and Wade, for delivering such improvements which for me were really life changing. And if I am upset, it isn\'t because I\'ve lost anything respective to my original condition, but because once you make both Girth and aesthetic gains in a most natural way, you don\'t want to lose an iota of those benefits.


If you\'ve never had PMMA before, you can see with the team in Tijuana what they think will deliver the best results for your configuration with the least results of complictions. I cannot vouch for this, but I haven\'t heard of such issues as my recent ones in a very first session. I figure one must become far more cautious and conservative after that initial series. Best of luck and hope you appreciate what it brings!



@Hoddle10


Thanks for your response and especially for offering your help regarding what might assist in reducing one\'s lumps, which are especially daunting when they are hard and rigid, resisting to the touch like stiff rubber. I noticed that my recent prescription for numbing cream to use before dermotological facial fractioned CO2 Laser was actually 5% Lidocaine / Prilocaine.


For the past few days I have been applying Hydrocortizone cream to the raised vertically thin ridge of PMMA circling the left side of my glans. It helped soften the edge of it a bit, and in general made it a touch less stiff. However, it was still a hard mass, vertically sticking out from the upper side of my shaft. It isn\'t large, only it is clearly not of any natural origin, calling into question the admittedly phony legitimacy of my entire unit. I guess I am trying to deceive women that my manhood isn\'t courtesy of Dr C in Tijuana, so all that I have lost is my ability to lie about my virility?


For one day I have since applied the Lidocaine / Prilocaine cream to that ridge and it seems to have softened its edges more considerably, and I feel that maybe I am on track for some forms of simple patient intervention, post surgery, which might help others in the future. I shall continue despite the fact that, if it perchance spreads over the glans, it might temporarily numb your unit LOL. It sure did mine, making it feel like it was sedated!


I very much appreciate your suggesting to use DMSO. I tried for months last year to buy some in Europe, but websites selling it are blocked, even eBay pages are censored in France. So when I was in the States I brought back several bottles and even a pot of DMOS cream. I can use it in any of these forms, and even agree that it might help because of what a pharmicist in Yuma Arizona told me: \"Morgues use this to disintegrate the dead tissues of corpses!\" which scared me at the time, but now sounds pretty much like what I\'d like to do to the worst of the lump formations...


I will keep you posted, and if you have any suggestions regarding liquid or cream form, let me know!


Cheers,


Hunk Chunk

Skeptical One wrote: @HC

I\'ve had 3 procedures and as of now my penis is soft & pliable in the Flaccid, and uniform & stiff in the Erect state. I do have a few small nodules behind the glans, but overall shaft aesthetics is mostly natural. This goes to show that there is indeed a variance from patient to patient (penis to penis), and quite possibly, from round to round.

Thanks for reporting!

Thanks for sharing that with me, SO, it helps to know of others\' experience. I guess that I am at the outside of the Gaussian curve when it comes to second series PMMA injections. I think it has to do with one\'s unit\'s reaction, which is something which nobody can predict in advance, and I am hopeful that my experience will help establish some routine protocols to ensure that issues can be addressed properly and negative effects countered effectively.


I even wonder if a general softening up of the clumps and clusters won\'t help make them easier to absorb unnoticeably in a future injection of PMMA surrounding and connecting with them? If so then one could hope to attain optimal results, similar to those of patients who encounter no problems, despite having a session which reacts strangely and clusters up with lumps!


Cheers,


Hunk Chunk

do you think it might have been something to with the second round being Metracil? I had my round 1 finished back in January. I slowly been losing gains and almost back to my original Girth. I\'ve been contemplating another round but worried about how the Metracil will bond with the New Plastic.

I also remember reading people mentioning something about complications with 20% Metracil. I was about to contact Dr. C to schedule my next appointment. Hmm.. Going to have to do some more research..

My post-procedure instructions were to remove the wrap (I actually used a Xleeve) immediately when getting to my destination, either a hotel or my home. Then take the Cialis and massage without any wrapping for the next 12 hours or so, smoothing out any irregular areas.

I think they were recommending longer wrapping periods initially, like a year or so ago. Maybe they just recommend different methods for different volumes of PMMA injected or different penile anatomies. I received 26cc, which is a lot, and my penis was noted to be very empty of structure inside which led them to tell me to take extra care with smoothing out and making sure the PMMA is distributed appropriately during the first 48 hours or so.

Wait, so losing your newly acquired Girth is common?

@boost


Hi boost, thanks for your reply sharing your experience. How many CCs of what percentage concentration did you get in your first session? I see that you also lost enough of your gains to want to go back for another session.


Actually, I can\'t really say that I lost all my initial gains, but only that it was enough loss of Girth to freak me out, reminding me painfully of my original size which was nowhere near as nice! I would say that I lost maybe a bit more than half of the gains from session one. This is sufficient to feel like you have receded way too much and compel you to do something about it.


As far as Metacryl bonding to New Plastic, I don\'t really think that this is how the stuff works? I expect that the microbeads of synthetic material become encased in cellulose, in other words skin tissue growth which wraps them up to maybe isolate them from the rest of your body? In any case this would mean that the new injection, whatever the material, wouldn\'t be in any direct contact with the previous material, but only with the fibrous skin stimulated to grow around the beads?


Regarding issues with 20% Metacryl, I would be interested to know if this is the case, or maybe if so whether this might not be merely because this is what has been routinely used for second sessions, in which there are more issues whatever the material injected? I will be interesting to follow this path of investigation to see how others can better reduce any risks associated with subsequent sessions of PMMA injections.



@jlmb


Was that the post-operative procedure recommended for your first session, or for a later one? I am curious, as my first session with several days in the bandage was last summer. Also, this was the recommendation for my second session, but my unit was so swollen that I don\'t know how one could massage it effectively when so bloated and distorted with fluids that you didn\'t know what you were rubbing or where the shape outline was! I wonder if there isn\'t a much stronger drug which can be used next time to keep me from swelling up so much that I can\'t massage it properly?


26CCs sure is a lot of product for a single session, you must have had a considerable size when arriving before the intervention. I also wonder if you received Metacryl, because normally I had heard that for the first two days you could affect the smooth spread of product.


But in my case within hours after the injections it was stiff, hard and pretty much \"unmovable\", so 24 hours was inconceivable while 48 hours was preposterous. Maybe those time frames have more to do with ensuring that there are no small lumps keeping the surface from being smooth, rather than having to massage it to force lopsided quantities of PMMA from one zone to the next? I would like it if a proper description of how to massage, how softly or gently and in what motion, pattern or intensity, would be made available either by the team or by this forum.



@warpedview


Girth is what PMMA delivers, so you will get that for sure. However, it isn\'t the PMMA alone which brings this, but the tissue formation around the microspheres which thickens enough to give your unit heft, meaning extra weight, increased Flaccid rigidity (no more turttling) and greater circumference.


And yes, any number of former PMMA patients have noticed slight to significant loss of Girth gains, months after their first PMMA session. This is due to any number of factors. One could be that there might be mild forms of tissue swelling which temporarily enhanced your Girth, only for this to recede after that swelling goes away several months down the road.


For example with severe rhinoplasty (nose operations) swelling can take more than a year to go away fully. It is also possible that collagen doesn\'t remain constant and that cells diminish in size or numbers? Who can say, but at least it isn\'t the fault of the PMMA or of the Phalloplasty procedure itself. That is why many of us go back for more interventions.


The higher the concentration, the less Girth loss later on after the procedure, but the higher the risks of granulomas. At least that\'s what I\'ve come to conclude after reading posts in this forum. I hope others who know more than me or who are of a different opinion will chime in?


Cheers,


Hunk Chunk

I received 10% New Plastic. I believe around 19-21CCs. Forget exact amount. I do remember Dr. C and Wade being surprised I was able to fit so much in considering my starting size.

I\'ve been wanting to schedule a new appointment but I was worried about clumping the PMMA underneath the surface of my fat pad. Dr. C recommended getting Lipo and waiting. I never ended up getting the Lipo so I never got my 2nd session of PMMA. Assuming the Metracil works well for everyone, I wanted to go back and get 20%. Thats what I originally wanted with New Plastic but Dr. C recommended getting the 10% first to get a good base to apply the 20%. It took a few months before my penis looked nomal and the ring to dissapear. Just sucks losing Girth with it.

Thanks for keeping up on the updates.