TOPIC: PMMA MRI images

I wanted to share some images of my penis after three cycles of PMMA. The MRI shows the fibrotic tissue where the PMMA is located. I thought I'd post these images because I'd be curious to hear from a doctor who specializes in injections if an MRI could be helpful before a procedure to correct irregularities for a smooth finish. Would having a detailed image be helpful in visualizing the areas where to inject as precisely as possible?

I am curious why you had an MRI done of your penis are you having issues or was this an MRI of something else that included your penis just because it was in the same proximity. I would assume an MRI would be a very inefficient and expensive way to determine where to inject PMMA.

I've had several follow-up MRIs in the last year. I had a severe infection after the third round. I still have pain at the base after all this time. According to the doctor, the infection may have caused nerve damage, since the pain is in an area where there is no PMMA. After numerous checks, I was told that the infection has healed and there is no inflammation. There could likely be minimal lymphatic involvement. I was Circumcised during the infection and had more swelling than usual. The cost in Europe for an MRI is around €120, €150 with contrast. If you go to a private clinic, the wait is a maximum of 30 days. If you have time to wait 3 to 6 months, it's free at the hospital. I was curious to see if an MRI would be useful before the injections. I wanted a medical opinion, that's all. If you think it's useless, that's fine. I never thought I'd have all these checks in my life. The reason was complications. If I were to develop any irregularities in the future, I wondered if MRI could be useful in the precise placement of any type of filler.

PMMA works long-term by creating a low-grade inflammatory reaction in response your body lays down in scar tissue or type one collagen, and that’s what creates its bulking effect. My theory is the low-grade chronic inflammation, which is sometimes slightly more than low grade in some people, fires up the nerve endings, causing episodes of pain due to the inflammation. Also, the Removal process can cut nerve endings which overtime regenerate, we hope, but even this process causes nerve endings to be hyper sensitive or hypo sensitive. I personally I am in that boat. I had my filler, Bellafill, eight years ago, and the Removal of most of it seven years ago. I still have a low-grade inflammatory response, which causes some discomfort throughout the day. I hope things slowly get better for you. My suggestion would be massage and stretch.

@Toothman @Zep83
I want to clarify something in this thread. The pain experienced long after injection and/or removal is not due to a "leftover" inflammatory response; it is most likely due to damage to the neurovascular bundle because of too much volume injected too deep. We recently published a case study about this: www.rejuvall.com/pmma-penis-filler-risks-case-study/

While the complications experienced in both of your cases did not result in necrosis, it's extremely likely it is the same issue of "too-deep, too-much" causing the complications you both have been experiencing. Of course we can't make a definitive diagnosis about either of your cases over the Internet without a physical examination, but the symptoms you have both described over the past while are congruent with what we have been seeing more and more of in our repair clinic.

Thanks for the thoughtful response, I would have to respectfully disagree, at least in my case. I had 4 cc and then 8 cc of Bellafill placed 6 mos apart. For me, the discomfort stated once the Bellafill was placed. Inflammation causes pain. Bellafill does cause a low grade inflammatory response. I do think too much to deep and too quickly can add do cause undesired side effects. Again this was just my experience.

@Toothman

Thanks for the thoughtful response, I would have to respectfully disagree, at least in my case. I had 4 cc and then 8 cc of bellafill placed 6 mos apart. For me, the discomfort stated once the bellafill was placed. Inflammation causes pain. Bellafill does cause a low grade inflammatory response. I do think too much to deep and too quickly can add do cause undesired side effects. Again this was just my experience.

You're absolutely right, PMMA/Bellafill *does* create a controlled inflammatory response initially; that is part of how collagen stimulation occurs. But that phase is generally limited to the collagen-building/healing period after placement. Persistent pain or neurologic symptoms many months or years later are usually not explained by an ongoing “active inflammatory response” alone.

As I explained, what we are seeing more and more in our repair clinic is a different issue entirely: excessive volume placed too deep into the shaft tissues, particularly near critical neurovascular structures. Over the last several months, a very large percentage of our PMMA-related repair patients have presented with symptoms consistent with this pattern after procedures performed elsewhere.

That does *not* necessarily mean your injector used “too much too fast” in terms of total volume alone. Depth of placement matters tremendously. Even relatively modest volumes can create problems if material is deposited in the wrong tissue plane.

Of course, nobody can make a definitive diagnosis over the Internet, and we are not specifically diagnosing your case here. We are simply speaking from what we are repeatedly seeing clinically in revision and repair patients. Based on the symptoms you described, the concern is much more consistent with structural/tissue-plane injury than with a chronic Bellafill inflammatory phase continuing indefinitely.

In any event, I sincerely hope you are able to find relief soon. No one should have to experience residual discomfort or pain after a procedure meant to enhance and improve their life.

Thanks for your reply. In my case, I received a total of 69cc of PMMA in three rounds. I don't know if this is an excessive amount of PMMA. There are users who have had more without any problems. I think it's an average amount after three rounds. I've never had any pain after the injections, and healing has always been quick and painless. Unfortunately, two weeks after the third round, I had a serious infection. During my hospital stay, I began to feel pain, especially at the base. I thought it was due to swelling of the lymphatic fluid (my doctor measured my circumference at 18cm while I was sedated in the hospital bed). I believe this pressure compressed some nerves, and despite a year and a half having passed, I've seen little improvement. I don't know if the injections were given too deeply, but I had no problems during the first two weeks of healing. The pain began during the infection and was mainly on the sides of the base of the penis, where no PMMA was injected. The Urologist following my case immediately told me that surgical Removal of 69cc of PMMA would be devastating from every perspective. He would only proceed with surgical Removal if the infection didn't resolve with antibiotics. I underwent 16 days of combined intravenous antibiotics to avoid the risk of biofilm. The cause of the pain is still unclear. The Urologist advised me to live with as little thought as possible about my penis, given that I have no infection or inflammation. He also suggested that the pain might improve over time or become part of my new normal, training the receptors in my brain to not perceive this pain as a danger signal. The only positive thing is that I don't experience any discomfort during sex, but it starts after 2-3 hours. There's no logic to all this.

Rejuvall wrote: @Toothman @Zep83
I want to clarify something in this thread. The pain experienced long after injection and/or removal is not due to a "leftover" inflammatory response; it is most likely due to damage to the neurovascular bundle because of too much volume injected too deep. We recently published a case study about this: www.rejuvall.com/pmma-penis-filler-risks-case-study/

While the complications experienced in both of your cases did not result in necrosis, it's extremely likely it is the same issue of "too-deep, too-much" causing the complications you both have been experiencing. Of course we can't make a definitive diagnosis about either of your cases over the Internet without a physical examination, but the symptoms you have both described over the past while are congruent with what we have been seeing more and more of in our repair clinic.

Hi Dr. Carney, I don’t want to hijack this thread, but I recently came in for a consultation with you regarding a focal PMMA/Bellafill lump. Although I mentioned there was occasional discomfort, at the time my concern was mostly cosmetic 

However over the last couple weeks, the discomfort has become MUCH more consistent. I’m now getting a very uncomfortable dull / throbbing ache localized to the side where the lump is, sometimes lingering for hours after masturbation and it even occurs while flaccid.

Reading your comments here, especially the case study you linked, honestly has me a bit worried that this could represent something more than just a cosmetic nodule. I realize my situation is obviously not as severe as the case you described, but some of the symptom overlap has definitely increased my anxiety about it.


Given your comments in this thread about providers injecting into deeper planes and causing injury, I was wondering whether this symptom pattern is something concerning in your experience, or whether it can still occur with a more localized fibrotic nodule. I’m also wondering if this changes your thoughts on excision/revision in cases like this.

Thank you I always appreciate any insight, I truly wish I had gone to you initially to begin with.

@PmmaResearch Please DM me so I can get you in touch with the right person. Thanks!