The following are Q&A submissions from Dr. Tsay.
(1a.) How much Girth/circumference can you achieve with Girth enhancement?
Generally speaking, for our fat transfer patients, we can put upwards of 50cc’s of fat at a time, and patients can expect a 15-25% increase in Girth in a single session. For example, if you start with a Flaccid circumference of 4 inches, you could reasonably expect to go to 5 inches in circumferential measurement (which can be visually significant).
For dermal fillers, we don’t want to put too much in at one time. I generally like to cap that out between 10-15cc’s per visit. You’re going to get a mild increase in Girth in one session. When you build upon that over multiple sessions, I find that 50cc’s (in total) is the sweet spot for the average size penis to really see a significant Girth enhancement.
(2a.) How long can filler injections take and what kind of anesthesia is used?
This procedure is all done under local anesthesia. I find that this is generally sufficient enough, and we also offer nitrous oxide (i.e. laughing gas) if you are at all nervous prior to coming in. We can also prescribe sedatives that will give you a calming experience throughout the procedure.
(3a.) Can Girth injections affect the function or sensitivity of the penis? What complications are there to consider?
Some of the common complications are bruising and swelling. This is usually self-limited and lasts 7-10 days. We usually recommend not to use the organ (penis) for at least one week after the procedure. Not only will the penis be sore, but there will be open wounds that need to be completely healed before resuming any sexual activity.
(4a.) How does the newly Girth enhanced penis feel?
We usually follow up with the procedure about 2-3 weeks afterwards, and at that time the swelling is gone, the bruising is gone, and you can really appreciate the final result from either the fat transfer or Dermal Filler placement.
(5a.) Can you gain length from Girth injections?
So the procedures (fat or Dermal Filler) don’t give you an increase in length per se, but more than half my clients who state they appreciate the increase in Girth, also say that their Flaccid length increases as well. So that is a beneficial “side effect” of Girth enhancement.
(6a.) What to expect with a procedure?
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.
(7a.) Can you tell us more about the use of Platelet Rich Plasma (PRP) to aid gains?
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.
(8a.) What is your preference of filler and/or brand?
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.
(9.) Do you have a preference for Renuva or Hyaluronic Acid (HA) for penile Girth enhancement? If not, could you describe the pros & cons of each?
This question is not that simple to answer. If it were for myself personally, I would want to use Renuva. The main reason would be longevity. HA's are safe and have been around for decades. The results are very consistent and predictable (in the right hands). Renuva is still a fairly new product to the market and not that many people are familiar with what it is and what it can do. Ive been using it already for more than 5 years for aesthetic purposes in the face and body. Initially, I would use Renuva in Male Enhancement to "top off" a fat transfer procedure that I had already performed because Renuva causes your body to grow its own fat. Gradually I am using Renuva more and more for Girth augmentation even as an alternative to fat transfer. It is extremely easy to use right out of the box. There is no liposuction needed to harvest ones fat which reduces the downtime and recovery from a mini liposuction procedure. During Covid supply chain issues caused a pause in the sale of Renuva, but in 2022 the inventory has been robust and without any limitations on accessing product. So Renuva game on!
(10.) Do you use a blunt-tip cannula or needle for injections?
95% of time I am doing this procedure I am using a blunt tip cannula. Either a 22 G 50 mm or 22 G 70 mm depending on how long the organ is. When I reassess and have to finalize and even things out, I connect a 27 gauge 1/2 Inch needle that comes with the HA product and inject the remaining with a needle for fine tuning. For glans augmentation I use a small needle and only inject a maximum of 5 ml in 1 session for safety reasons.
(11.) What, if any, are the risks of filler migration?
The penis not a static organ like a chin or or ear. It lengthens, retracts, curves and reaches different directions when being used. With that being said, filler migration is to be expected. For the first month following a Girth enhancement procedure, the product can be manipulated/massaged to even out any irregular distribution. After 2 months the product has almost fully integrated into the tissue so there is less change of moving things around. As long as the product is placed in the proper plane, this should not cause any issues such as migration of filler somewhere else and staying there long term.
(12.) How many sessions can a patient expect to achieve an ideal result?
This all depends on the budget of the patient and how quickly they want to achieve their goals. If they want full correction as quickly as possible, this can happen with a 1-2 fat transfer sessions. With HA fillers or Renuva, this can take several sessions and the goal can be obtained incrementally, which is not a bad thing.
(13.) What makes an ideal candidate?
An ideal candidate is someone who is Circumcised, does not have any preexisting scar tissue, someone who desires mainly Girth enhancement, and has reasonable expectations of reaching their goal. In many instances ones goals may change over time. For example, a patient may initially want to go from 3.5 inches in Flaccid Girth to 4.2 inches. This is 20% and visibly very noticeable. Its not KING KONG size by most standards, but they may enjoy that for a while and later want to go further and try to attain 4.8-5 inches in Girth and be the king of the locker room. As long as one is doing this in a safe manner using safe products, this is the most important factor to consider.
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