TOPIC: Average gain PMMA

@ 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...??

It is true the higher the conc.(i.e. the beads are closer together) is the denser the collagen will be and thats why they use the 40-45% conc. for bony defect reconstruction (e.g. frontal bone) but when you have more beads you will have also more gain in volume even if it was only mild gain.
As far as I remember olafspo had only 20 cc's ?? and not 30 cc's, I am not sure about eastender ??
In my case 30% feels firm and never soft like fat, thats why Dr.Samy said 30% will give you almost the same texture like a real penile tissue.
I just received Dr.Samy's e-mail in regard of the volume I got in each rd :-
I am not in my office, this will occur only January 10, to see the amount I`d implanted in your penis.
For touch-ups I use only the 30% concentration.
Regards

My understanding is that the beads are too large to be phagocytised by individual macrophages (thereby preventing migration), but that the beads are contained by several macrophages (which may end up fusing, creating a so called "giant cell"). There simply is no way a foreign body can remain in contact with your tissue (including collagen) without inducing a continuous response of your immune system, and continually attracting macrophages. If the macrophages were to die, which of course happens all the time, the ongoing immune response attracts new macrophages to contain the now newly exposed bead. Collagen is created by fibroblasts, induced by the immunomodulatory excretions of the macrophages as a matrix to aid in this process, but does not actually have a function in directly containing or encapsulating the beads.

Justabitmore wrote: @ 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?

Yes i dropped I am about .60 gain from .75 right now

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.

@hoddle10,
What you have said it is almost true (( I think 30cc's of 10% would probably give a similar gain as 20cc of 30%, despite there only being half the PMMA beads )).
If you remember I wrote before about the followings :-
1- 30% will give you almost 75% of the initial injected volume e.g. 10 cc's @ 30% after 6 months you will get 7.5 cc's permanent collagen.
2- 10% will give you only 55%.

So in the example you gave 20 cc's @ 30% ---> around 15 cc's permanent collagen. And 30 cc's @ 10% ---> around 16.5 cc's permanent .
N.B. That is only approximately.
I know some doctors wouldn't agree with my points (e.g. Prof. Lemeprle thinks you gain almost 1:1) but I am sure (i.e. only in my experience) about the 30% --> the permanent gain you get will never be = the injected initial volume .

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?

My guess (which is somewhat educated, as I'm a medical doctor) is that the carrier may contribute to initial growth, but that is of little consequence in the long run. Due to tissue remodelling, any excess collagen, i.e. collagen not in the direct vicinity of the macrophages containing the PMMA beads, will eventually be broken down. I'm not sure how long this process wil take, but I think this explains why people tend to lose some Girth after six months. In essence this is also what occurs in any small wound or lesion, scar tissue, which of course is also collagen, will initially be hypertrophic, but tends to diminish over time, up until a point where it is hardly visible most of the time. I'll bet the issue of "diminishing returns" is also caused by tissue remodelling.
In some people, mostly those of African descent, scar tissue actually tends to grow over time (keloidal scars). I'm curious if this can also occur in PMMA bioplasty.

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.

I wonder if stressing the PMMA such as Hanging or a good ADS with significant tension would cause some type of micro tearing of the PMMA and therefore open it up for additional collagen growth as it repaired the micro tearing? I'm no doctor but like to think and this is one of my favorite subjects to think on. I will start Hanging again next month once I know I'm sufficiently healed from the first PMMA procedure.

smartman wrote:
I agree with you (( In theory 10cc 30%, 15cc 20%, 30cc 10% and 60cc 5% all have the same amount of PMMA )) and I have mentioned this before :-

1 cc of 30% has 9 million PMMA beads1 cc of 20% has 6 million PMMA beads1 cc of 10% has 3 million PMMA beadsAnd of course 1 cc of 5% has 1.5 million PMMA beads
So in the volumes you mentioned as an example (10cc 30%, 15cc 20%, 30cc 10% and 60cc 5%) you will have 90 million PMMA beads in each case.

All each example will have 90 million beads, but the 30% will only have 7cc of carrier and the 5% will have 57cc. This is why I think the 30% will be more dense and the 5% will give more overall volume. I think the closer together the beads, the more dense the collagen, but the more spread out the beads are, the more space for growth. This could be complete nonsense, but it would definitley explain the dimishing returns we are seeing. Eastender recently reported a 0.5" gain from 30cc of 30%. Olafspo reported he can hardly notice his gains with the same 30cc at 30%. Yet we've seen guys getting 0.5" from 10%. Guys such as yourself with 30% have described the way 30% feels in a slightly different way to guys at 20%, who in turn seem to think that theirs feels firmer than 10%. So maybe it has to have something to do with how evenly spread out the beads are. Unless I'm missing something, surely 90 million beads in a 60cc solution must be spaced further apart than 90 million in a 10cc solution.

@ smartman Great post. Last time I spoke to Wade he had only had the one round and it was something like 10cc an only in particular areas from what he told me! However he had it done not long before I saw him so I know nothing about what shrinkage he had at the 3 months mark!!

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.