We recently completed a major update to our penile enlargement repair page because the complications we are seeing today are increasingly complex, especially complications involving injectable fillers.
One issue that deserves more attention is prolonged pain after PMMA.
There is a tendency to explain this by saying that some men simply have a stronger inflammatory response than others.
Individual immune responses do vary. But that explanation can be incomplete when the procedure itself involved
PMMA as the first filler, high volume, deep placement, or some combination of the three.
PMMA creates girth partly through the body’s foreign-body response around permanent microspheres. So inflammation is expected to some degree.
But the amount of material placed and where it is placed directly affect what happens when that response occurs.
A large amount of PMMA placed deeply does not become safer simply because it is farther from the skin. It places permanent material (and the swelling, collagen formation, fibrosis, and bulk that can develop around it) closer to important penile structures.
The penis also has a limited amount of space. There is no empty deep compartment designed to accommodate unlimited filler. Deeper are structures responsible for blood flow, sensation, erectile function, and the urethra.
Some soreness during the first several days after injection can be expected, but significant pain continuing beyond roughly a week is not something we consider a routine part of recovery. Persistent or worsening pain should be evaluated rather than automatically attributed to a prolonged inflammatory response.
Depending on the individual case, pain may be associated with inflammation, excessive tissue pressure, fibrosis, granulomatous change, nerve irritation, vascular compromise, infection, or material placed in an inappropriate plane.
One of the most serious PMMA cases Dr. Carney has treated involved a patient who received multiple high-volume injections elsewhere. His complications progressed to vascular compromise, tissue necrosis, and permanent loss of part of the glans. Dr. Carney’s assessment was that the pattern was consistent with excessive PMMA placed too deeply and in too much bulk.
That is an extreme example, but it illustrates why
a biological reaction and a technical complication are not the same thing.
Dose, depth, anatomy, technique, and the choice to introduce permanent PMMA into untreated tissue all matter.
That is exactly why we expanded our repair information; to explain not just
what complications can occur, but the different mechanisms behind them and why identifying the actual cause matters when deciding what can be done about it.
Updated Penile Enlargement Repair Guide:
www.rejuvall.com/penis-enlargement-repair/ 
