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PMMA Injections for Penile Enlargement

NOTE: The Male Enhancement Centers and Dr. Elist do not perform polymethylmethacrylate (PMMA) Penile Enlargement Procedures. The following material is solely for informational purposes. Complications reported in this section are based on phalloplasty revision surgeries performed at our facility due to previous PMMA procedures and associated complications.


PMMA Injections History:

Polymethylmethacrylate (PMMA) – For more than half a century, plastic and reconstructive surgeons and dermatologist have been using medical grade PMMA mainly to fill up small wrinkles in the face (cosmetic soft tissue augmentation).

Artefill, one of the best known names in PMMA technology, has been approved by the FDA for facial rejuvenation. Since its beginning, PMMA products have undergone many improvements and refinement to become one of the most widely used dermal fillers.

What Is PMMA And How Does It Work?

PMMA (polymethyl-methacrylate) fillers usually consist of about 20% tiny PMMA microspheres (microscopic synthetic polymer beads) suspended in 80% of purified bovine (cow) collagen gel. Injections are usually offered is 1cc syringes in order to maintain a well-controlled dosing and prevent over injections with several serious side effects. Due to the limited amount to be injected at once, multiple injections are usually required to achieve a volume effect.

The principle of PMMA injections- When injected inside the wrinkles and underneath the skin, the PMMA microspheres (micron sized plastic beads) are delivered into the tissue alongside with the collagen gel. After a few months, the collagen gel is broken down and absorbed and body’s newly formed collagen replaces its place by surrounding and encapsulating the PMMA microspheres.

While mostly claimed to be permanent, the world of plastic surgery only refers to PMMA fillers as being semi-permanent and only effective to use for the treatment of medium-to-deep wrinkles, folds and furrows, particularly nasolabial folds. It can also be used to fill out pitted scars and to augment thin lips.

Besides the traditional PMMA injections using collagen gel as carrier, a new generation of PMMA is told to be developed in Latin America which is reported to use a water-based carrier. This product has been developed in Brazil and mostly available in South American countries.

PMMA injections were developed based on the same principle as free fat transfer (FFT) in order to fill tissue gaps and defects with longer lasting results. As with fat injections which needs a solid surrounding supportive tissue in order to revascularize and fill out a gap, PMMA injections require a solid collagen and soft tissue surrounding structure in order to a) stay put where injected and b) for the injected collagen/ water-based solution to be absorbed and replaced by the body’s natural collagen.

What Does The Scientific Literature Say About PMMA Injections?

Adverse results with PMMA fillers.

Aesthetic Plast Surg. 2012 Aug;36(4):955-63. doi: 10.1007/s00266-012-9871-8. Epub 2012 Mar 22.

Various alloplastic materials have been used for filling depressions and for body contouring. Among them, polymethylmethacrylate (PMMA) has provoked many clinical compilations in both the acute and chronic phases. This study shows the correlation between the clinical application of PMMA and the physiopathology of the acute and late complications.

Conclusion: The injection of PMMA within the tissues can cause severe complications and side effects in both acute and chronic phases. Initially, the complications are related to vascular compromise, but at the late phase they are a consequence of capsular contracture that involves particles of PMMA. The contracture causes local tissue hardening and clinical nodulation of the implanted areas, ending with extrusion of the filler material.

Complications After PMMA Injections: Report of 32 cases.

Aesthetic Plast Surg. 2012 Aug;36(4):955-63. doi: 10.1007/s00266-012-9871-8. Epub 2012 Mar 22.

Various alloplastic materials have been used for filling depressions and for body contouring. Among them, polymethylmethacrylate (PMMA) has provoked many clinical compilations in both the acute and chronic phases. This study shows the correlation between the clinical application of PMMA and the physiopathology of the acute and late complications.

Conclusion: The injection of PMMA within the tissues can cause severe complications and side effects in both acute and chronic phases. Initially, the complications are related to vascular compromise, but at the late phase they are a consequence of capsular contracture that involves particles of PMMA. The contracture causes local tissue hardening and clinical nodulation of the implanted areas, ending with extrusion of the filler material.

PMMA Penile Augmentation Procedures Side Effects

As with all types of surgical procedures, PMMA Penile Augmentation procedures can also be associated with general complications such as swelling, bleeding, pain, hematoma, and infection. Risks and complications specifically reported with PMMA Penile Augmentation procedures are based on two general pathophysiological mechanisms:

A) Injection of a free gel inside a pocket between the penile shaft and shaft skin

Specific risks and complications:

  • Uneven and non-homogenous penile shape after injection
  • Dislocation of the injected with disproportional spreading of the content
  • Uneven absorption rate of the freely injected gel with asymmetries
  • Unpredictable amount and areas of absorption resulting in disproportionate penile shape and deformity

B) Injection of an army of micro-beads inside the same pocket

Specific risks and complications:

  • Detachment of the injected material and permanent floating gel
  • Multiple micro and macro granulomas surrounding the injected foreign material
  • Buildup of multiple lumps and bumps
  • Severe fibrosis and internal scarring
  • Acute, severe infection as a reaction to foreign material
  • Chronic inflammatory reaction to micro-beads
  • Damage to arteries and veins due to granulomas and capsule formation resulting in severe damages to the penile shaft and penile skin
  • Severe granuloma formation with necrotic damage to the penile skin with acute and chronic skin scarring, necrosis, and skin loss
  • Multiple capsule formation with soft tissue retraction and penile deformity
  • Internal invasive granuloma formation with severe damages to the penile erectile tissue resulting in curvature and erectile dysfunction
  • Severe internal dermal damages resulting in a thickening and leathering of the penile skin

What We See in Patients with PMMA Penile Enlargement Procedures?

The extent of damages caused by PMMA Penile enhancement procedures can be best described by the following case which were presented to our facility for revisional surgery:

Case#1: Patient from Brazil with severe penile deformity

PMMA Injections
PMMA Injections

Case#2: Patient with Scrotum PMMA injections

PMMA Injections
PMMA Injections
PMMA Injections
PMMA Injections

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