PhoenixNow wrote:
Androfill wrote: 15:00 - Ellanse lasting a lot longer than expected, Dr. Oates has not seen it ever go away (even after 6 years). Yes, this is what we are seeing too.
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Apologies if I'm hijacking the thread (can move it if so), but Androfill Clinic, do you know why it is that the Canadian Androfill clinic doesn't want to use Ellanse ? It's a bit disappointing than CAN folks have to go out of country to get any get of permanent Girth enhancement filler procedure....
That benefit that
Ellanse would eventually clear from the body now seems to be in question at two major clinics,
Androfill and
Calibre (with Dr
Oates saying it is lasting more than 6 years), and perhaps
Avanti Derma are seeing the same durability of the product. If
Ellanse in the penis is turning out to be a more permanent solution like
PMMA, then the risk profile is higher than we once thought.
The risks that a doctor must consider when using
Ellanse and the risks that an individual must consider are obviously very different.
From one angle, the patient takes a gamble which will likely pay off (the gamble of getting a good result and avoiding complications), but for the doctor when there is eventually a complication (and statistically this is certain), they will have to face it. So in short by choosing to use
Ellanse we know we are going to eventually, with certainty, face a problem, but a patient can be pretty confident that they won't face a problem. There is asymmetric risk, although obviously the materiality of the problem is higher for the patient.
When we consider
HA, from our perspective (considering our interests), there is very little risk that we will damage a patient, be sued, or have medical licenses come under scrutiny should an issue occur. In regard to
Ellanse, the risks are higher in all three categories (causing damage, being sued, and having a regulator question the wisdom of injecting
PCL into the penis for a cosmetic procedure).
If we consider
Androfill uses Hyalase in approximately 1 in 20
HA patients (to correct minor to moderate issues) (5%), it means in approximately 50 patients per year in London (5%) we have this magic substance to bail us out called Hyalase, which is not available to us for
Ellanse patients. We could not operate a medical business with 50 complications per year and no antidote.
To make
Ellanse a viable solution in a litigation-friendly nation such as the UK, or in USA or Canada, that % of issues that we see with
HA needs to come down much lower for
Ellanse, considering we have no 'antidote'. The price of the procedure also needs to be much higher (to additionally 'self-insure' or build up a fund for dealing with complications (complications that are moderate but not severe enough to use negligence insurance for).
At present in the UK we do not adequately account for these risks in the pricing of
Ellanse in my view (
Ellanse should be much more expensive than it is). That calculation may be different in a different jurisdiction.
Androfill Canada is run by Dr. Jack Chang and Pollock Clinics / Gentle Procedures. They would have to consider that the risks involved in offering a product like
Ellanse outweigh the benefits. They have a large group of companies offering low-risk, 'gentle' procedures, I can guess that would not want to risk their wider business by offering
Ellanse - but by all means, reach out to them and ask.
Dr. Jack Chang was trained by both Ingrid Tall (
Androfill Australia), and Dr. Gary
Horn in person in London over 2 days (seeing 16 live procedures including the treatment of complications). Dr. Chang is an experienced
Urologist, so in Canada there really is an excellent option for
HA. If Dr Chang doesn't want to use
Ellanse we support that decision.
Referring back to the podcast, at one point Dr.
Oates was discussing a new permanent PAM filler Aquamid that he is experimenting with (around 1:03:00 timestamp).
I wonder why he is experimenting with this PAM filler when
Ellanse is lasting so long, 6 years+ in his clinic (and possibly longer). Dr
Horn and I do email him from time to time so I might ask the question directly, unless he replies here.
Dr. C in the Podcast briefly touched on the differences between
Ellanse and
PMMA, but seemed to focus on the packaging and superficial differences.
I think a question that needs to be answered, and probably Dr. C. is in the best place to answer it (considering he uses both
PMMA and
Ellanse), "if
Ellanse seems to be lasting for so long, and seems not to have the benefit of eventually biodegrading away, then is there any benefit of using
Ellanse over
PMMA" or conversely, is there any benefit of using
PMMA over
Ellanse.