TOPIC: Planning on PMMA, please advise on latest tech

smalljohnny wrote: I spoke to Mirza in person and he does not provide before and after pictures apparently for privacy concerns, which sounds fishy to me. Either way he uses HA as a filler and it\'s $350 per cc which is too expesive for no to small gains. I am now focused on Dr. C but I am disappointed that he only offers Metacrill. I have heard too many negative opinions on this filller due to it\'s uneven particle sizes. I am really stuck at this point.

What problems have you seen due to uneven particle size? How would you know that is the reason for problems? Look at Artefill, that has more even particle size and there are loads of complaints about lumps and bumps and that is only used is tiny amounts. So it\'s highly unlikely the particle size is the reason behind the issues we\'ve seen with it used in the penis.

In my opinion the issues we\'ve seen are far more likely to be down to the amount and concentration injected. It doesn\'t seem to matter whether it\'s PMMA, fat, HA or any other type of filler, at the volumes being used in the penis, you are going to see issues with lumps etc.

if I were you, I\'d just do nothing. Wait a couple of years and see what\'s going on in the world of PE then. Patience is your best friend in this business.

You are right that there is no way for sure to link uneven particle size to the problems that some have experienced (mainly the granuloma formations). For something that is going to permanent I\'d rather be patient and wait for something more reliable. I guess I\'ll stick to manual PE for now until my patience runs out.

Definitely stick with manual PE.

I posted pics of the PMMA in my tissue that was removed. The particle sizes weren\'t uneven. Also, remember these are 2D images of 3D particles...so some may look slightly smaller, but then the border is usually more fuzzy. In general, the photos looked like the same ones from artefill.

Of course, a few sample slides is not a scientific study...but I was expecting it to be more uneven and perhaps even non-spherical but that was not the case. I developed nodules for an unknown reason.

I also noticed this in the photo of the slide you posted Restoration. The little beads appear to be different sizes. Perhaps this is not the only cause of your complications, but it certainly does not work in your favor. Several years ago when Dr Lemperle was more active he mentioned particle size was critical to prevent an inflammatory reaction and the non-artfill brands had much wider tolerances. He did not mention smoothness but said spheres below a certain size are at risk of triggering a immune response. Also I understand if the spheres are too large they will not stimulate scar tissue growth. Hence the need for the tight tolerance which is expensive to do with the same high standard as artefill.

Bigben wrote: I also noticed this in the photo of the slide you posted Restoration. The little beads appear to be different sizes. Perhaps this is not the only cause of your complications, but it certainly does not work in your favor. Several years ago when Dr Lemperle was more active he mentioned particle size was critical to prevent an inflammatory reaction and the non-artfill brands had much wider tolerances. He did not mention smoothness but said spheres below a certain size are at risk of triggering a immune response. Also I understand if the spheres are too large they will not stimulate scar tissue growth. Hence the need for the tight tolerance which is expensive to do with the same high standard as artefill.

It\'s also tough to tell from a slide whether or not the beads are in fact different sizes. If they are spheres in 2D, some would be sliced through, say, the top (or arctic circle referring to the globe) and others would be sliced through the middle (or equator) thus making the circles different diameters on the slide, even though the 3d spheres from which they were cut were the same size.

Here\'s some more pics. My pathologist said you would need a physical chemist to determine if the sizes are equal or not...since it is 3D and you\'d need it isolated from the tissue. You see a regular h & e stain here... which pathologists use, not chemists.

The best way to make sense of this is to try to find histopathology of artecoll vs. artefill...and compare them to each other and to this.

The other guy who got linnea safe when I did had no issues.

My Dermatologist recently said to me that he thinks I had too much put in, and he\'s had women who get artefill added over and over, and then they start getting lumps. But, I haven\'t seen that on this board at all. My theory is that some kind of network of collagen developed with the existing metacrill implant, and the linnea safe implant 6 months later just couldn\'t stick to it or stay under it. I literally have one normal metacrill implant on my buck\'s fascia and then a bunch of lumps at my injection sites bound to my Dartos fascia...it\'s like the product got squeezed out and formed nodules (rather quickly) at the injection sites - which were still ther 4.5 months later, full size.

I think irregular particule size is more of a trigger for inflammation and granulomas than for nodules...from what I recall.








You wouldn\'t want to see this in your slides (this is Dermalive):



These photos are from the two nodules shown here. They were very firm bundles of collagen, similar to the texture of chewed gum that has been left out. They did not respond to injections (you can see the needle track in one of them actually - but that\'s the best it did...leave a track).





Note that the top one is the one that caused all the problems. The bottom one, though larger, was isolated and the wound closed immediately. The top one created a 2 month mess.