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!
Dr. Wall:
We use Emcyte PRP for erection enhancement P-Shots. The feedback I have about this is really remarkable. I hear many of my patients say it takes them back to when they were in their early 20s in regards to strength and longevity of erection. The caveat I will put on PRP results are that not all PRP is created equal. When investigating which clinic to attend for PRP, I suggest looking at the amount of platelets concentrated per ml. Most inferior PRP concentrating systems have 400-600 thousand platelets per ml. Emcyte PRP has 1.2-1.5 million platelets per ml. To explain how it works, Platelet Rich Plasma treatments harness the natural healing and regenerative capabilities of platelets. In normal physiology, these cells are the first to arrive at the scene of an injury. They help in the clotting process, but play a special role in healing, releasing growth and healing factors. The more platelets, the more growth and healing factors. That is why it is important to choose a device with superior concentrating abilities. Most of my patients choose to have both PRP and Filler phalloplasty as a complete downstairs rejuvenation package.
Dr. Tsay:
Many of our patients combine their penile enhancement with PRP. When that happens, the PRP has regenerative properties, so it increases the quality of the erection, the duration of the erection, and the sensation around the glans.
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!
Dr. Wall:
A good candidate is anyone wanting to inject confidence into this area of their lives. They should be above 18, be fit and well medically and have a goal to increase flaccid and erect girth, and increase flaccid length. Men experiencing retraction of the penis during sport/cold weather or just in general, notice a significant improvement in flaccid length after this procedure. They typically go from being a 'grower to a shower'. Men who suffer from premature ejaculation are excellent candidates for glans dermal fillers. This decreases sensation in the head of the penis resulting in significantly longer lasting performance without the need for medications.
Dr. Solomon:
Let me answer the last question first. I turn away almost one third of the men who seek my opinion. Most often, these are men who are either very unrealistic in their goals, or they have a very normal to large penis and I do not think the benefit of surgery outweighs the risks involved. The ideal candidate is a healthy male who wants to make his penis larger in one or more dimensions and has no issues with erectile dysfunction. The reality is that I see men of all types with variation in their health, so I do make exceptions for different medical conditions. I do not do girth procedures on smokers. I have found that smokers in particular have a high complication rate from girth procedures, so I will no longer treat them. The corollary of that is that men who have complications of fillers and are smokers are also at high risk of complications. I ask them to stop smoking for 3 weeks prior to surgery and 3 months after surgery. I have had men who start smoking after surgery and inevitably they need more surgery to get them healed.
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!
Dr. Oates:
I have been using HA for PE (penile enhancement) since 2013. Guys had been asking if there was anything that could be done for the size of their penis without surgery. I found the original Korean papers describing using HA www.sciencedirect.com/science/article/pii/S1743609515333543 plus this Italian article www.ncbi.nlm.nih.gov/pubmed/23388646 . But they were done by Urologists who are not experienced cosmetic injectors. I thought the procedure could benefit with refinement.
My starting point was initially safety. I already had a successful facial plastic surgery practice. One penis dropping off would be bad for business. So certain steps were put in place to make it as safe as possible.
This including using HA rather than a permanent or non dissolvable filler. The great advantage of HA is that it can be 'tuned' with tiny doses of a medication called Hyaluronidase or even totally dissolved with larger doses. In the early days this was very reassuring. Next was to use 'blunt' cannula. Most injections were being done with needles which have a cutting point. Cannula look similar but are blue ended. We need to puncture the skin with a needle first then use the cannula once in. Injecting is the space between the superficial (Dartos) fascia and deep (Buck's) fascia. Inject circumferentially. Circumfrential. Most described techniques were just injecting on the 'top' surface of the penis and looked a bit like a turtles shell. People (still) worried that injecting underneath would put pressure on the urethra - tube that passes urine out - but this is just not the case (not even with stimulatory fillers). Doing as a sterile procedure. In the face skin fillers were just being done as a 'clean' procedure we wanted it to be done sterile like a surgical procedure. Doing the procedure in at least 2 stages, this allows us to get better symmetry as the penis is often variable in size over the day. Getting it numb with topical cream. The idea of needles in the penis is scary enough, best if numb first. The vast majority of guys are surprised how comfortable it is. My belief was if we had a walk in, walk out, no downtime, painless procedure that gave you a penis that looked normal, felt normal, worked normally but was bigger then a lot of guys would be interested. In following threads and post I will fill you in on more of development since.
Comment and questions open on the forum are best. I have answered hundreds of PM's but they dont benefit anyone else. You are probably here anonymously, let everyone benefit from your question if possible.
Dr. Tsay:
At Ageless MD, we offer a variety of different fillers, as well as fat transfer, to enhance the overall girth of your flaccid and erect penis. We also use dermal fillers to enhance and increase the size of the glans.
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!
Dr. Oates:
We use 'blunt' cannula. Most injections were being done with needles which have a cutting point. Cannula look similar but are blue ended. We need to puncture the skin with a needle first then use the cannula once in. Injecting is the space between the superficial (Dartos) fascia and deep (Buck's) fascia. Inject circumferentially.
Dr. Wall:
I prefer the use of a blunt tip cannula. I perform a dorsal nerve block to the base of the penis first to numb it along its whole length. I then use a slightly larger size cannula then most practitioners to avoid the risk of damage to veins and arteries. Smaller gauge cannulas can more easily penetrate the deep fascia, which can lead to scarring of the fascia that can result in permanent deformities to the shaft, along with damage to underlying erectile tissue/nerves and vessels. A needle is used to inject the head of the penis. It is performed in a similar way to lip fillers. 3-5ml into the glans is the usual amount for best results. Rarely, you may need to use a needle in some circumstances such as previous use of collagen stimulating injections such as Ellanse. The collagen stimulating process causes a thickening of the internal architecture between the fascial layers making it hard to pass a cannula. This situation is uncommon.
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!
Dr. Oates:
I have seen granuloma in the face with Ellanse that has lasted 4 years. They were manageable with steroid/5FU injections and not too much of a problem because they sort of gave her the result she wanted. Would not be good in the penis. It is more getting thickening and irregularity that worries me.
Dr. Solomon:
Granulomas are microscopic foreign body reactions that are a normal response to a foreign body injected into any part of the body. For example, liquid silicone often gets injected into the buttocks and hips (especially outside of the US, but illegally in the US as well) and the response is the same as in the penis. It looks good for a while, but over time, granulomas form and get firmer and distort the appearance of the injection site.
Granulomas are balls of scar tissue. They can occur with any of the injectable materials if the material remains in place for a long enough amount of time. You can think of this like a snowball. Once the process of granuloma formation starts, it will continue as the body tries to “wall off” the foreign material. With time, these lumps will get larger.