Most newer
PMMA is too large (30-50um) [RBC is about 7um] to be phagosized by macrophages and is essentially chemically inert to cause an immune reaction in most people(reason why it is used widely in medical implant devices like contact lenses); what essentially the body does is form collagen capsules around these foreign objects over time, and wall the particles (or these microbeads) off from the rest of the body; this makes the particles stay or stick to the areas it is implanted . Therefore it is extremely unlikely these particles or beads are going anywhere. Now the problems with
Bellafill is the collagen additive or carrier agent, this is where people can be sensitized to the product and why testing before getting the product is strongly advised.It is bovine based and has antigens that people can be allergic too and can cause swelling and lymph nodes to swell etc. of course infection can do this too. Overall,
PMMA is extremely difficult to remove once it has been placed and the collagen reaction has occurred , requiring skin and tissues underneath to be cut out causing greater deformity. Silica dust is much smaller .2 to 5 um size and is readily cleared by the macrophages and the lymph system(eventually being collected in reactive lymph nodes) and due to this factor can lead to immune responses and cause issues such as silicosis and other inflammatory processes. Silicon is made innate when it is encapsulated or combines with other agents, or made into oils, to increase its size and change its irritated properties making the immune system less likely to react to this modified silica, such as breast implants and the like.
My advise is to leave the
PMMA alone except if the nodules are a cm or more in size, they are very mobile and superficial they can be expressed or sc
d from a small linear incision over the
Nodule leaving a barely noticeable scar. If deep would leave alone or if bothersome try steroid injection or other dissolution techniques mentioned by others posting on this blog.
Just FYI most of problems with
Nodule formation with
PMMA and other dermal fillers are the result of two main problems, improper dilution and poor application technique or combination of both. The thicker the filler (higher concentration or increased viscosity) the deeper it must go- into the larger subcutaneous space- and the more manipulation(think like stirring a thick soup- a bigger pot also makes the stirring easier) it needs before it sets in or sets up. Migration of the filler is dependent on the thickness of the filler and in which tissue layer the substance goes into, in the penile tissues it needs to go as close to bucks fascia(the collagen fibrous capsule over the erectile tissues) as possible; most issues(nodules, the accordion effect in the non-
Circumcised, bunching, blanching, etc) develop when it (thick filler) is injected into the dermal layers or left in the dermal layers on entry or exiting of the needle or cannula. When placed in the dermis, the filler has to be quite thin, however this makes it more mobile and less likely to stay where it is placed if it gets into the subcutaneous spaces and has to be confined by bandages or rubber bands as in Dr. Loria\'s and other procedures.