This is a common questions amongst individuals looking at phalloplasty and penis enhancement procedures. Please see 2 of our respected doctors answers below! To learn more or join in the conversation, please set up an account and participate in our forum!

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Dr. Solomon:

I perform Surgimend graft surgery (similar to Alloderm & Belladerm). Alloderm and Belladerm (among others) come from human sources. In particular, Alloderm is a donation from someone who has died while Belladerm often comes from remnants of abdominoplasty (tummy tuck) tissue that is removed at surgery. Human dermis is then prepared from these materials. Human dermis varies in thickness depending upon what part of the body it is from and the age of the donor. Human dermis gets thinner with age. As a rule, the thickest human dermis is not more than 2 mm and on average about 1.5 mm. Surgimend comes from fetal calf tissue. This has several advantages. It has never been exposed to bacteria, so it is sterile. Calf dermis is thicker than human dermis. This tissue is cut by machine. So its thickness is uniform and because calf dermis is thicker than human dermis, it is available in thicknesses from 1 to 4 mm.

My average Surgimend graft is 3 mm thick. This seems to be the "sweet spot" between giving a good result while allowing it to revascularize in a reasonable amount of time. I have used 4 mm grafts in some patients, as well as 2 mm grafts in some.

You can have a second wrap, but recovery is long and in several cases, the penis has been almost too thick for comfortable intercourse. I warn patients about these issues before performing additional girth enhancement.

This is a common questions amongst individuals looking at phalloplasty and penis enhancement procedures. Please see 2 of our respected doctors answers below! To learn more or join in the conversation, please set up an account and participate in our forum!

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Dr. Solomon:

Liquid silicone is the injectable form. Its use in medicine for soft tissue augmentation is no longer permitted in the US. It is permitted for some ophthalmic uses. It is prohibited for soft tissue augmentation because the complication rate was unacceptable when it was studied in the past. Liquid silicone was initially thought to be useful when injected in microdroplets into the dermal layer of skin. Injectors of silicone in the penis do not inject silicone into the dermal layer of the penis skin because this layer is quite thin and microdroplet injections in this layer would not provide any significant girth to the penis. In my experience, it has been injected into the Dartos layer of the penis, which has relatively loose tissue and no dermis in which to seat the silicone. Liquid silicone acts by reacting with the body, forming something called a foreign body granuloma. Over time, these granulomas enlarge and become hard nodules. These nodules can be difficult to remove, They can erode through the skin causing ulceration. More importantly, there is only one type of liquid silicone approved for human use in the US. Some patients get injections with non-medical grade silicone that has impurities. The body reacts to these impurities, often causing oozing and ulceration. For these reasons, liquid silicone is not a useful product in the long run for penis enlargement.

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Dr. Shafer:

Juvederm Voluma XC is the longest lasting reversible product. This is Dr. Shafer’s favorite product to inject for patients as it’s the thickest of the injectable gels and lasts the longest.

Dr. Tsay:

At Ageless MD, we use a variety of different filler products to enhance the girth of your penis. The most obvious would be fat tissue; this involves a fat transfer via miniature liposuction from your lower belly. We process the fat to be micronized, and used in a syringe to be injected all along your shaft to increase your girth. I believe fat is the best filler, assuming you have enough to harvest for girth enhancement.

If you don’t have enough fat, there are a lot of other choices such as fillers made of Hyaluronic Acid (HA). There is also another filler called Radiesse that we use and that’s made of Calcium Hydroxyapatite (CaHa). The reason I like this filler in particular, is that CaHa is found in your bones. What better product that is already naturally occurring in your body, that we can use to put into the penis to mimic a firm, hard erection.

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Dr. Wall:

There are no documented reports of HA causing ED I am aware of in the shaft. However, overfilling of the glans can cause a reduction in glans blood flow causing it to be less hard during an erection. It is for this reason I am conservative in filling no more than 3ml per sitting in this area.

This is a common questions amongst individuals looking at phalloplasty and penis enhancement procedures. Please see 2 of our respected doctors answers below! To learn more or join in the conversation, please set up an account and participate in our forum!

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Dr. Wall:

Such a great question, and one I would imagine not many consider prior to adult circumcision if one plans to have filler phalloplasty. I prefer the high and loose cut (not overly loose). This is especially appropriate if one has significant size goals with a plan for 20ml or more. It allows easier expansion of the tissues and a more smooth, symmetrical result.

Dr. Horn:

I’d recommend a low and tight or low and loose circumcision for dermal girth injections. They key aspect being the scar close to the glans.

Dr. Shafer:

You do not need to be circumcised. We treat both circumcised and uncircumcised patients.

Dr. Casavantes:

Circumcision isn’t required but strongly encouraged before injection.

Dr. Carney:

Circumcision isn’t required by strongly encouraged before injection. (re-wording)