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Gosh, I feel the PMMA, Doc!

“I can grab it from the top -by the glans- and know exactly how thick it is; I can feel it at the base as well…”

This headline is a variation of a comment from many patients who have had one or more sessions of nonsurgical phalloplasty with soft tissue fillers.

So for all of you wondering if this can happen to you after a soft tissue filler phalloplasty, our comment is about it.

Before answering that question, we would like to state that the thickness and consistency of the implant of any soft tissue filler in the penis have infinite variations, so what may be a miracle for some may offer an unwanted result for others.

Looking for a balance between a meaty enlargement and an implant that goes unnoticed is a near-impossible task. It is the primary challenge of nonsurgical phalloplasty.

Well, rather than feeling the PMMA itself, the patient feels the living tissue that comes from the new collagen created around the PMMA microspheres.

A widespread story among those who have had PMMA for GE is that their skin had thickened and is no longer thin or movable over deeper tissues; this type of results are more likely if the patient is not circumcised. In the circumcised patient, the skin is way firmer and less mobile, making the soft tissue filler implant less obvious, more so if used sparingly.

IMPORTANT – There is always a trade-off between increased girth and some unavoidable consequences:

  1. Thickening of the skin
  2. Camouflage of the superficial veins
  3. Palpable implant

If the patient receives a high volume of soft tissue filler, especially over multiple sessions, the implant will be noticeable even to the inexpert eye. Deformities such as “accordion effect” and “pig blanket” are extreme cases where it is pretty evident that the patient got an implant.

The patient must understand that an implant under the thin skin of the penis shows easily because -unlike the face or other areas of the body- the skin of the penis lacks subcutaneous fat tissue that helps camouflage the presence of soft tissue filler and its imperfections.

Avanti Derma’s patient selection criteria clarify that perfectionist, doubtful or dysmorphophobic patients are not good candidates for permanent fillers (PMMA). They should opt for temporary options such as hyaluronic acid or polycaprolactone, or non at all.

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