Seems progressively getting worse. Guessing som form of damage from injections. He uses alot of oil
A small part of my outer quad "died" from a little 1ml injection. First I couldn't flex it hard and then over time it atrophied a little. Nothing felt wrong with injection and I don't even know specifically which injection did it but these things can happen. I rarely do quads either.
There's not much wrong with Ramy's physique. Tight abs. Other than the delts the muscles look pretty fresh and undamaged. The "problem" is that his genetic frame is kinda big, too big. Aesthetically most people think muscle on a small or light frame looks most pleasing. Think a Frank Zane. Another thing which I've never seen anyone else mention is that genetically wide shoulders can be ugly. Think about Yates, Coleman, Wheeler, Priest... all relatively narrow shouldered. Wide shoulders look like a straight coathanger and yo lose the pleasing trap slope - like Ramy in his "relaxed" rear shot.
Look at Ronnie's shoulder girdle. Relatively narrow.