TOPIC: Average gain PMMA

@imbignow,
I agree with you 100% you won't do any harm if you wait but we men want more quick Girth gain .
@hoddle,
It is true what you have mentioned in regard the higher conc. will give you more firmness and more gain (it could be only mild gain??) . Believe me I still trust Dr.C."s work and he is an honest man (lemperle's words) he could easily inject all of us with 30% but in his opinion he wants almost the perfect result in both aesthetic and the gain and never one of them.
I am happy with my gain @ 30% with 2 rounds even that I have not the perfect aesthetic result I need touch-ups with the lowest conc. thats why I want to go for Dr.C. .
IMO Dr. Samy will give you the Girth you want in one or max. in two rounds, but Dr. C. will give you the gain you want but gradually and he is great for touch-ups ( esp. for guys like me living very far from America and they can go max. 2-3 rds only ) .
Few hrs ago I have sent an e-mail to Dr.Samy asking him about the 10% and the 30% conc. and when does he advise for touch-ups ?? That was his reply :-
Dear

---

Thank you for your email
In my opinion, the result of Metacrill implant is directly in proportion with the conc. of micro-spheres. The bigger the concentration, the bigger the result.
The concentrations of 2 or 10% in my opinion are not good, by the smaller proportion of micro-spheres. I always use 30% and I am very satisfied with it.
I always look for doing the procedure in one stage, so I implant the amount necessary to reach the diameter desired by the patient.
My fees actually are US$ 2500 for honorary plus the amount of Metacrill used, US$400 each 10 cc's.
I do not think a small concentration will give a better result.
I agree with you about the touch-ups with 9/12 months, but this is difficult for foreign patients.
Best regards and I am happy with your satisfation
Samy

I think the gains indicated are not only reasonable ... they're fantastic. I had alloderm which provided an immediate gain of about 1". That lasted about 3 years before it slowllllyyyy atrophied. Eight years later it had deterioriated somewhat (Though tolerable) and ended with likely half of that at best. That was a 10k procedure. So, I estimate my yearly cost at about 1200$, with a law of diminishing returns. PMMA appears to have a similiar impact, but much slower in building (.5,.3.,.25) which makes more sense if you think about it. This allows the the new growth time to 'acclimate'. Cost for 3 procedures: 6-7k. Efficacy: good, based on anecdotal results. Permanency: yet to be seen long term (with a few rare anecdotal results, primarily with 30% and previous procedures). If you read the posts and progress, it is easy to see that many members have already pursued other methods and spent 10's of thousands (I'm sure I'll hit 20k) in pursuit of the holy grail of PE. There isn't one. But is this the best one? I personally will be completely satisfied, as I was for several years, with a 5.56Lx5.75-6G Flaccid and a 7Lx6.5G Erect. That is my 'ideal'. length could be a half Inch longer, but Girth I would not to exceed 6.5. I believe these PMMA treatments can provide those kind of results- and if it requires occasional touch-ups, average it out. Would you pay 1500 a year to 'maintain' your ideal result. I'd pay double that, and I'm not mega-loaded... just 'comfortable' (financially). Long term safety seems a moot point. There's millions of gallons of silicone tits out there- They aren't imploding!. We'll survive. Just acknowledge several members have already done allo, bella, prft (sp?), FFT, the elist thing, scaffolds(?), etc... - all at extreme financial and psychological cost- not to mention those super extreme indivuduals whom have injected their own penis and scrotum with disturbing amounts of silicone oil. PMMA presents the least complications for those who have had the most reasonable/modest goals and expectations. Complications seem to manifest when people over do it and have unrealistic goals, even against the doctors recommendations or advice (this was true of allo, FFT, skin graft,etc. as well). Remain reasonable and I think the results will be reasonable. Regards

I'm not disappointed per se, just got used to being 5.75" then down to --> 5.5" and down to --> 5.25" and down to -->?" after 6 months have passed. As some will remember, I broke the rules and gently inserted into my wife (very well lubed of course) 4 or 5 days post Round 1 when I was at 6.125" MSEG and she loved it but I could tell she would enjoy more.

Question: How many Rounds factoring in shrinkage would I need to hit a solid 6.25" - 6.5" MSEG?
Answer: Too damn many! LOL.

Since Dr. Casavantes refuses to use 30%, I will try to talk him into a higher volume... say 30cc's. If not, I don't mind flying to Brazil again. The women are indescribably beautiful and I could get 30cc's of 30% and use Dr. Casavantes for touch up and additional Girth and STILL save money. Making 5 or 6 trips to Tijuana isn't in my future; I've got a family of five to think about. They need me home more than they need the money. That's a lot of plane tickets and time missed from the family and at Dr. C's new pricing... well, it makes more sense to head to Rio de Janeiro. IMHO

There is definitely a trend of dimishing return with PMMA, which suggests there is a limit to the amount of collagen that can be produced, or that the beads have to be evenly spaced apart. For example, lets say each bead becomes surrounded by a 1mm (i know that is way too much, but an easy number to use) thick layer of collagen, then unless each bead is over 1mm away from the next, then many beads are going to share than same collagen layer. This is why I think the higher the concentration the denser the tissue, but this doesn't mean much or any greater volume. Hence we've seen a guy get over 0.5" with 15cc of 10% and a guy get 0.5" from 30cc of 30%.

Basically I think higher concentration usually provides slightly more volume, but is more solid and thus more likely to cause aesthetic issues. So is it worth the extra risk? It seems that second treatments often yield very small gains, so are they worth the risk? I think your starting size (smaller the better) and distribution of the beads in the PMMA you get (down to pot luck) are the greatest determinants of gains.

I think we need to look at this procedure as an enhancement, not an enlargement. We can't simply decide that the answer to penis size issue's has been found, because we've found a filler with a decent track record. I think to set goals and keep having the stuff injected until we reach them is dangerous. Lemperle has said the risk increases with both the amount and concentration of PMMA. Maybe it would be better if we were all just greatful an enhancement is available, rather than feel dissapointed it can't give us all what we want. This time last year, if you wanted a similar gains to what you'd get from a more sensible approach to PMMA, you had to pay $10,000 for Belloderm, and got through all the risks of surgery and then months of recovery. A year ago guys wanting 1"+ gains didn't really have any sensible options and I'm not sure that has changed. Obviously there will be PMMA success stories with guys gaining over an Inch, but given we don't know how this stuff is going to pan out longer term in the penis, should we be risking injecting so much for the limited gains one gets due to severely diminishing returns? We could well find that due to the amount of extra product needed and higher concentrations, that the risks involved with gaining an Inch are 4 or 5 times those involved with gaining 0.5".

hello people i was the 2nd one on the original forum to get this done. And EP was there same day. He went in after me. I would say so far the gains are still here i would say after about 5 months you will see a drop to real size. so your gains could be from .25-50 in my opinion.

We have mentioned before about an article which prove that the gain of pmma will be present for a long time (e.g. 15 yrs) :-
www.ncbi.nlm.nih.gov/pmc/articles/PMC2872008/
Check fig. 6 & 7 after 15 years for the same lady :-
www.ncbi.nlm.nih.gov/pmc/articles/PMC287...2872008/figure/Fig7/
But in regard how much of the gain will be permanent I think :-
1- 30% conc. ---> 75% permanent gain volume from the initial injected volume.2- 20% conc. ---> 65% permanent gain volume from the initial injected volume. 3- 10% conc. ---> 55% permanent gain volume from the initial injected volume.

Now the thing I am thinking about in regard of the 20% conc. :-
Is it really exactly 20% (the mixture is done in the clinic and not in the medical lab. I think) ?? Or it could be less than that and not accurate (and thats what I think I could be wrong) and not everyone is getting the same conc. in regard of the 20% i.e. some will get e.g. around 15% and some will get around 20%. Is the mixture between 30% and 10% 1:1 ratio ?? or what I think they mix more volume of the 10% than the 30% ( because as we know Dr. C. prefers the 10% and never the 30% so he will try to increase the conc. a bit but not too much than the 10% conc. and he doesn't want to be close to the 30%).
Is the gain in the 10% almost the same for each patient with the same volume, EL and EG, but in regard the 20% (??) is the gain the same with the same conditions or is it different ??

I think you need to remove the "0". Those gains are sad!
I believe you are correct though.
Round 1 = 1/2" or .5"Round 2 = 1/3" or .3"Round 3 = 1/4" or .25"

Dr.Casavantes is right handed (from the video I saw) so if he is going to enter the cannula near to the glans he has to be on the Rt. side of the patient and if he is going to enter the cannula at the base he has to change his position and to be on the Lt. side of the patient .
So for those who has the asymmetry on the Lt. side where were your entry points (i.e. glans or base or both) ??

@ EP Yep that area has for now shrunk back to almost what it was before and this is after round thee. basically the circ scar measurement remains around the 6-6.125 measurement and has done so since round round one. unfortunately for me its the left side only so it does create some asymmetry however it is not unsightly or obvious . three round have given me 1.25 estimated and I would say 0.25 stayed from FFT. That's a crude guess. Others have gained more and some a lot less. in my opinion it all depends what you start with. if your penis is 3 inches in circumference you could probably gain 1 Inch plus in one round. if you start with 6 you might only gain 0.4 in round one.

@ M7 yeah I see your point. You know I just realized I only would have gained 0.25 in my round three and that was 22-23 cc of 20%? and I could still shrink...??

I would agree with Bighat. As a physician who does cosmetic surgery in the US, I can tell you that the general consensus is "permanent filler= bad, temporary filler = great!" Part of this is because as you age, at least in the face, there are changes that occur around the filler such that you may not want something permanent lodged against something that is changing. It may not look as good in 15-20 years as it does when the face is much fuller and more elastic. Also, if the patient doesn't like the filler, it'll go away in 6-18 months depending on the filler used.

For some general plastic surgeons, temporary fillers and botox have become the bread and butter of the practice. I'm not a general plastic surgeon but I've had ladies come in a spend $3-4000 every 6 months on their botox and filler indefinitely. And that takes 20-30 minutes. They leave happy and can be playing tennis in a few days feeling great.

My point in telling you this is, in medicine whatever way a certain physician does something is always the best way and he/she will have a million reasons to sway you against something he doesn't do or doesn't agree with. Do you own research, ask questions and don't just trust that one way is necessarily the only way. If the people you're talking to don't use PMMA for FDA approval or preference reasons, they're going to tell you not to do PMMA.

In the US, we don't really use PMMA much. If you ask the average doc in the US, he's going to want you to do juviderm, Restylane, Radiesse, etc and come back in 6 months and do it again.

PMMA is mentioned as permanent in some articles and semi-perm in other articles. Given the fact that its basically an acrylic and its also used in orthopedics to cement bone, I would venture to say its at the very least semi-permanent but on the order of decades vs a few years or permanent. Again, I don't use it at all so this is just my opinion based on knowledge of the physiology and characteristics/chemical makeup of the PMMA.

But its good that you're going into any procedure with reserve and questions. The procedure will be available whether you do it now or 2 years from now.

EP: I've called and have discussed with many plastic surgeons regarding PMMA, and the general consensus is that it is not permanent, but rather 'semi-permanent,' meaning that loss in Girth is guaranteed. Most insisted that PMMA results will suffer after 5 months, ultimately losing most of it in 1-2 years. I'm going to stick around here for a while, and if gains are still had, I'll pull the trigger. This is not permanent, at least according to the many surgeons I've talked with.
Now, I did talk to two who said that at least some added Girth will remain, but the question is how much, if they're right?
I think it's just best to keep up with people who actually have had it, and decide if it's worth it or not. Hopefully members will keep updating.

@ Jason Good to hear from you! You say gains are still there. I seem to remember you gained 0.75? did you drop any of that?

Hi Skatezy,

Good question! What I've found when researching PMMA used as a filler is lots of descriptions of foreign body granulomas but not much mention of the actual incidence. I found one mention in one article that in one small study, the incidence was 0.01%. The rest of the articles merely state that the incidence is "very rare" or something similar.

I'm encouraged by the idea that most of the granulomas respond well to serial Kenalog injections. There was one mention of one patient whose granulomas subsided after treatment with allopurinol, which is an oral medication. It seems that surgical exision is also a rare necessity.

So given the ideas that there are risks to any procedure, PMMA is being widely used outside the US, the incidence of granulomas seems very low, the treatment seems uncomplicated and the response to treatment is good for the most part, I'm confident in my decision to proceed with the procedure. I'm not advocated for or against because we all have to determine what level of risk we are comfortable with when it comes to our bodies, I'm just stating that given what I've seen of the procedure, including the risks, and the positive outcomes I've seen so far, I personally am comfortable going forward and having it done.

Can shrink all the way up to 6 months post op from what I've read ... (medical literature and patient PR's). I've found the advice and knowledge of smartman a valuable asset and a voice of experience to rely on in such unfamiliar territory.