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 And it should be injected in a threading technique as the cannula withdrawn to get the most even micro-strands and not micro-droplets, of deposited material.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).