TOPIC: Action plan if PMMA goes wrong

Hi all,
So having recently done the procedure I have been having some anxiety over who to contact if things begin to take a turn for the worse.Most physicians/specialists I have read on here have limited experience with PMMA.I found a physicians database on the forums although this is now locked for replies.

Is there a way to make a list of potential problems and the doctor to contact,I know there are Singh and Gelman,but like I said they seem to have little experience with this filler.Dr C would be an obvious one to contact first,but if things get more serious FBG,Necrosis,cancer I\'d like a better idea of who to go to.

I still think the go to guy has to be Gary Alter. I\'ve read some people don\'t like his attitude, but from what I\'ve seen, he does great work, which is much more important. I\'ve not been in the least bit impressed with any other reconstructive surgery, other than surprisingly a case of Comacho-Melo.

It\'s interesting you started this thread as the other day I thinking about starting to one to discuss how we don\'t hold reconstructive surgeons to the same standard as we do the PE Dr\'s. We act as if they are doing us a favour (which to some degree is true), but this shouldn\'t stop us criticizing their work and after care etc. Sometimes I feel as if they think the patient should grateful and must accept the outcome of the reconstructive surgery, as it was they who got themselves into the mess in the first place. I actually think the standard of reconstructive work is usually as poor as the original PE surgery.

Hans wrote: I found a physicians database on the forums although this is now locked for replies.

Only the Guidelines thread is locked. The Physician Database sub-forum itself is still wide open for all other threads & replies.

An action plan should be in place in conjunction with a plan to undergo the procedure in the first place. In other words, when you are saving/acquiring the funds to pay for a procedure (in this case, PMMA), you should also have just as much money obtained for emergency purposes (e.g. flying back to Mexico, seeking 2nd or 3rd opinions, possible costs of Revision or reconstruction should your Health Insurance not cover it, and other unforeseen expenses). Not having done so makes any Phalloplasty an incredibly risky endeavor.

I think, the first and foremost place to go to is back to the practitioner. If we\'re referring to Dr. C specifically, he\'s arguably one of the most qualified professionals to give an opinion on how best to resolve a problem. After him, I\'d consider urologists and dermatologists, and it\'s necessary that they are familiar with PMMA. It also would be advisable to send an email to Professor Lemperle and hope he responds with any of his insight.

I should also note, any issues that arise with Phalloplasty, and PMMA in this instance, should be resolved step-by-step. Total Removal of PMMA (i.e. de-gloving) really ought to be a last resort option since there is good reason to believe most issues arising from PMMA can be treated by other means (e.g. time, Kenalog, etc). First start with the practitioner, then if necessary, get a 2nd or 3rd qualified opinion, then undergo the most sensible treatment option.

And I should also note, any doctor who is unfamiliar with PMMA should be completely disqualified as having a legitimate professional opinion on PMMA complications. My 2cents.

Hi Hans,


Yours is a great initiative, because it is really difficult to find anyone to go to with one\'s problems, much less a competent phalloplastician who can offer various forms of remedy. One thing I am at issue with, is the generally widespread prejudice of urologists, plastic surgeons and even phalloplasticians against PMMA.


We all know that PMMA presented some serious issues when used in the face or other parts of the body. However, there have been few if any severe problems with its application in Phalloplasty, and even now there is new hope for glans enhancement using a Korean form of PMMA called Lipen-P. Nonetheless, it is widely considered by reputed phalloplasticians to be \"lousy\".


I will give two examples. Dr Abecassis who is France\'s most renowned phalloplastician told me to stay away from it and to never inject anything which would not resorb. He believed that PMMA was dangerous. If you went to him with issues about it, he\'d possibly recommend degloving when there are other remedies which you may prefer to consider.


My second example is Dr Bachtiyarov, who is a top flight plastic surgeon and phalloplastician. He used to reconstruct from scratch the penises of soldiers which had been blown off, using their shoulder muscles as material. Needless to say, this is one top flight specialist. When he examined my unit, he tossed it to the side with disdain, saying \"silicone\"? I replied PMMA and he said something to the effect of \"same stuff\" if I got the gist, and he seemed to think it was a way stupid thing to have had done. If I had complications I assume he\'d suggest degloving also.


Those were only my two small experiences with surgeons who know their stuff like nobody else, but who don\'t really know nearly as much as we patients at PhalloBoards about PMMA and its potential issues and drawbacks. So maybe, in addition to recommendations of competent doctors, we must create a list of suggestions of what we might wish to do in various worst case scenarios. Sort of a troubleshooting guide to getting your unit back up and running in perfect health?

Suggestion # 1 might be:


Wait one week after a PMMA before freaking out - many times it is just excessive swelling and at worst a minor infection.

This happened to me after session 3. Another point could be:


If you are very upset at the aesthetics of your unit after PMMA or have defects which shouldn\'t be there, do not despair, it can be usually fixed - PERFECTLY.

This was my case after session 2 and it got fixed fabulously by Dr C. Thanks god I didn\'t go and get it all removed ! ! !

We could also have a section with many photos gathered from various postings and progress reports so that guys can see whether their problem looks like one another forum member had before them. They they could just search out their threads and see what they posted as the outcome of the problem. Just a few ideas.
In any case, congratulations for this much needed initiative.


Cheers,


Hunk Chunk

Definitely keep a list of any issue you are having for your doctor.

You all make extremely important points which emphasise do not risk jumping into this procedure lightly or with no financial backing!

HunkChunk, yes agreed very important to wait a week after your round before freaking out ( I should have taken that advice)

The Dr. in Paris, seems to be a good one for having experience dealing with FBG\'s and PMMA.

I\'m just having a read of your issues now and wish you all the best in getting this sorted!!

Surely,seeing as so many people are having this procedure done, one day there will be a \'safer\' way of having PMMA removed, without so much unknown risk!

Thanks Hans,

Actually my situation isn\'t as bad as it might seem at first glans... uh, I mean glance LOL. In fact my Flaccid is only like that half of the time, when seriously retracting. In a less stressed out or less exhausted state, it has a far more normal form. Meanwhile the semi Flaccid is quite honorable and Erect it looks way better.

I do thank you for your support, and I will keep you and others posted in my wacky Ninja Turtle thread. I have already started applying DMSO to soften the outer collagen in addition to aggressive stretching. At the beginning of June I will see Dr C and would be willing to take bets that he\'ll come up with a positive solution. All bets are on!


REGARDING THIS THREAD TOPIC

We might want to start a Reference List of known issues with PMMA along with a recommended Go / No Go flow chart of what might be going on and potential solutions in each case? An estimated timeline for various issues and their resolution might also be helpful to reassure members encountering similar problems to those already surmounted or survived by earlier Phalloplasty pioneers.


Cheers,

Hunk Chunk

hahaha glans..glance.oh glad it doesn\'t happen all the time!I will be following your tmnt thread closely.

Yes thats a great idea..if we could come up with some sort of timeline of events after PMMA injection and issues that may arise..along with a solution and/or potential doctors to see.Oh and I see now there is an option for listing doctors in one of the sub-forums.I think this timeline initiative would really help ease peoples worries,and worrying is not good for penis health!

Hopefully these creams that you have been using and also the one that Olafspo has been using for his issues are a less invasive solution also!

I\'m going to go and update my thread and also send you a PM over some of my issues haha