{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T19:03:43Z","timestamp":1786993423748,"version":"build-2736575974"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2016,9,1]],"date-time":"2016-09-01T00:00:00Z","timestamp":1472688000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"},{"start":{"date-parts":[[2016,9,1]],"date-time":"2016-09-01T00:00:00Z","timestamp":1472688000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"}],"content-domain":{"domain":["jsm.jsexmed.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2016,9,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>An unknown percentage of men will take every risk to develop a larger penis. Thus far, most injectables have caused serious problems. Polymethylmethacrylate (PMMA) microspheres have been injected as a wrinkle filler and volumizer with increasing safety since 1989.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To report on a safe and permanently effective method to enhance penile girth and length with an approved dermal filler (ie, PMMA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Since 2007, the senior author has performed penile augmentation in 752 men mainly with Metacrill, a suspension of PMMA microspheres in carboxymethyl-cellulose.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measures<\/jats:title>\n                    <jats:p>The data of 729 patients and 203 completed questionnaires were evaluated statistically.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The overall satisfaction rate was 8.7 on a scale of 1 to 10. After one to three injection sessions, average girth increased by 3.5 cm, or 134% (10.2 to 13.7 cm = 134.31%). Penile length also increased by weight and stretching force of the implant from an average of 9.8 to 10.5 cm. Approximately half the patients perceived some irregularities of the implant, which caused no problems. Complications occurred in 0.4%, when PMMA nodules had to be surgically removed in three of the 24% of patients who had a non-circumcised penis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>After 5 years of development, penile augmentation with PMMA microspheres appears to be a natural, safe, and permanently effective method. The only complication of nodule formation and other irregularities can be overcome by an improved injection technique and better postimplantation care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.jsxm.2016.06.008","type":"journal-article","created":{"date-parts":[[2016,7,26]],"date-time":"2016-07-26T13:11:18Z","timestamp":1469538678000},"page":"1414-1422","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":48,"title":["Penile Girth Enhancement with Polymethylmethacrylate-Based Soft Tissue Fillers"],"prefix":"10.1093","volume":"13","author":[{"given":"Luis","family":"Casavantes","sequence":"first","affiliation":[{"name":"Avanti Derma , Tijuana, BC , Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gottfried","family":"Lemperle","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery \u00a0 , San Diego, CA , USA"},{"name":"University of California\u2013San Diego \u00a0 , San Diego, CA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Palmira","family":"Morales","sequence":"additional","affiliation":[{"name":"Avanti Derma , Tijuana, BC , Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2016,9,1]]},"reference":[{"key":"2024032602350171100_bib1","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1111\/j.1743-6109.2012.02725.x","article-title":"Position paper: management of men complaining of a small penis despite an actually normal size","volume":"10","author":"Ghanem","year":"2013","journal-title":"J Sex Med"},{"key":"2024032602350171100_bib2","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1007\/s11934-012-0260-2","article-title":"Impact of penile size on male sexual function and role of penile augmentation surgery","volume":"13","author":"Shaeer","year":"2012","journal-title":"Curr Urol Rep"},{"key":"2024032602350171100_bib3","doi-asserted-by":"crossref","first-page":"978","DOI":"10.1111\/bju.13010","article-title":"Am I normal? 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