What is better and safer for penile enlargement: PMMA or fat transfer?

Please, if you learn only 1 thing from this website that it be this: Do not put PMMA in your penis. You are asking for a disaster.

We recommend a more permanent non-surgical penis enlargement solution called the Prometheus by Dr Malik. Our highly specialized medical team is solely dedicated to providing permanent penis enlargement results that exceed patient expectations. The penis girth enlargement procedure involves microinjections of our proprietary filler just under the skin—no general anesthesia, scalpels, or stitches. In your penile shaft, this filler stimulates your body to produce more collagen, resulting in an impressive size increase.
There are many risks for pmma and fat transfer including: Uneven penile shape after injectionUneven absorption of the permanent floating gel with asymmetriesDetachment of the injected materialDisproportional spreading of the injected contentUnpredictable areas of absorption causing deformed and disproportionate penile shapeBuildup of lumps and bumpsAcute infection from the foreign materialInternal scarringSevere fibrosisDamage to veins and arteries

I have written a few papers about penis enlargement and evidence-based outcomes.Remember, safety first! Go to an experienced provider.
Penis enlargement surgery can offer modest improvements in both length and girth, but there are risks and limitations that should be carefully considered.
Lengthening Surgery: The most common method involves cutting the suspensory ligament that attaches the penis to the pubic bone, which can result in an increase of about 1 inch in flaccid length. However, this may not significantly affect erect length. Additionally, some men experience a "drooping" effect where the penis no longer rises in erection, but instead points downward.
Girth Enhancement: This can be achieved through fat grafting (using the patient’s own fat) or the insertion of dermal fillers or collagen-based materials. These techniques can add circumference, though fat grafts may have issues with uneven absorption, and synthetic fillers can lead to complications like infection, ulceration, or extrusion. The use of Alloderm (a type of cadaveric tissue) has been controversial due to risks of tissue reabsorption or complications.
Minimally Invasive Alternatives: Non-surgical treatments, like platelet-rich plasma (PRP) injections or fillers, are also options for improving penis girth and overall appearance. These methods generally have shorter recovery times and lower complication risks compared to surgery.
While surgery can lead to some visible improvements, the results may not meet all expectations, and the risks of complications are significant. For those seeking a modest increase in size, non-surgical options may offer safer alternatives. Consulting with an experienced surgeon is essential to determine the best course of action.
Krishna Vyas, MD, PhD, MHSHarvard, Hopkins, & Mayo Clinic Trained Aesthetic Plastic SurgeonNew York, New York

For fat transfer, it is necessary to get the fat from your body by a small liposuction, whereas, PMMA is available in a vial. PMMA is permanent. About 50% of the fat injected will be absorbed. The rest will stay permanently, although sometimes they do disappear with time. Much more fat can be safely injected at one time. Fat has more of a tendency to become lumpy. Sometimes some of the fat become liquefied and can cause cysts. The fat comes from your own body, and so there is no chance of allergic reaction or rejection. Although rare, there is a chance of allergic reaction with PMMA, and that is why it needs to have a skin test before using it. Generally, if a large amount is required, I prefer using fat. For smaller amounts, it is easier to use PMMA.
Best wishes.

Victor Liu, MD

Fat filler is safer. Because it can be autologous, non-allergic, reproducible and permanent. Also, the risk of complications is very low.

In my opinion, fat transfer is more natural and uses you own body cells to enhance the penis. I personally use PRP for most patients. I don't know how much you are looking to get out of either PMMA or fat transfer in terms of increase in penis size.