TOPIC: Rejuvall Appointment-What should I expect?

So basically the title.

I just made an appointment with Rejuvall for the HA/Bellafill procedure for Girth.

From anybody that has had it done, what should I expect?

Also I'm curious do they inject under the Circumcision scar? I asked the guy I spoke to but he said that'd be up to the doctor.

Any info would be great.

Thanks.

I would just get all Bellafill.

Why?

The Doctor there seems to think it reduces the chances of getting nodules.

While mine was not done together or in tandem, I have had HA added to my PMMA and to be frank... I love the feel of it. It's very smooth and consistent. So I can kind of believe Rejuvall's claims when it comes to the benefits of incorporating some HA. It sounds to me like they also also use the HA to help create space and see if guys are happy with filler in general prior to adding something permanent.

Yes, this is basically the jist of what they told me. I happen to already have HA and have lost some size from when I was at my max.

Like everyone else here, I'm very keen on avoiding nodules or worse. If the Doc sees HA reduces the chances of them then I'm all about it.

Functionally wouldn't all this do is dilute the PMMA concentration?
To give an analog, if you look at the uses Avanti has for the 10% PMMA vs the 30% PMMA, the former is going to be a smoother results at the expense of size.
Which makes sense,
-20ml of 10% PMMA gives you ~2ml of PMMA microspheres
-20ml of 20% PMMA (like Bellafill) gives you ~4ml of PMMA microspheres
-20ml of 30% PMMA gives you ~6ml of PMMA microspheres

so now when you look at a blend of say, equal parts HA and PMMA
-20ml of a blend (10ml Bellfaill + 10ml HA) gives you 2ml of PMMA microspheres - the same total PMMA as if you'd used 20ml of a 10% PMMA solution

All other things being equal if you get 20ml of SOMETHING containing PMMA, the lower the concentration the better the aesthetic resuit, at the expense of permanent increase per total injected mL of product.
I say this not to advocate one way or another, rather to give my layman's understanding of what you accomplish with a blend. Lower concentration makes for less chance of "clumping" microspheres on top of each other, greater uniformity and more ven distribution.

I wonder if there's other functional benefits to the HA too - for example, is it going to act as a sort of lubricant for the PMMA microspheres to help them slide over each other and flatten out for a nice even uniform layer?

Either way I can see why it would yield a seemingly more natural aesthetic result and why they would like doing it. My semi-educated guesses could be garbage nonsense, I am open to that as well.

Great question! Yes, it will be up to Dr. Carney how he works around your circ scar once he sees you in person and can see your specific physiology. However, I think you'll be very happy with your results and the specialized technique he uses.

In terms of the HA/PMMA, Dr. Carney likes to have an even base layer of HA already down before adding the PMMA, because when you start out with PMMA alone, it does cause granuloma because of how the substance interacts with the tissue if you go straight to PMMA without the HA "buffer" there.

For guys new to filler, we do start out with HA to get the basic look and feel you want while having the most options available to do something else later on, such as making your new girth permanent by later adding PMMA. This is what we call our FusionThick procedure.

We have an entire web page that explains all of this in much better detail than I can quickly share in this forum, if anyone is interested in knowing more about how we do HA/PMMA and why we do what we do. https://www.rejuvall.com/permanent-girth-injections/

Thanks for your excellent question, @7indream ! We're looking forward to seeing you and are available if you have anymore questions or concerns before we see you in-office.

Functionally wouldn't all this do is dilute the PMMA concentration?
To give an analog, if you look at the uses Avanti has for the 10% PMMA vs the 30% PMMA, the former is going to be a smoother results at the expense of size.
Which makes sense,
-20ml of 10% PMMA gives you ~2ml of PMMA microspheres
-20ml of 20% PMMA (like Bellafill) gives you ~4ml of PMMA microspheres
-20ml of 30% PMMA gives you ~6ml of PMMA microspheres

so now when you look at a blend of say, equal parts HA and PMMA
-20ml of a blend (10ml Bellfaill + 10ml HA) gives you 2ml of PMMA microspheres - the same total PMMA as if you'd used 20ml of a 10% PMMA solution

All other things being equal if you get 20ml of SOMETHING containing PMMA, the lower the concentration the better the aesthetic resuit, at the expense of permanent increase per total injected mL of product.
I say this not to advocate one way or another, rather to give my layman's understanding of what you accomplish with a blend. Lower concentration makes for less chance of "clumping" microspheres on top of each other, greater uniformity and more ven distribution.

I wonder if there's other functional benefits to the HA too - for example, is it going to act as a sort of lubricant for the PMMA microspheres to help them slide over each other and flatten out for a nice even uniform layer?

Either way I can see why it would yield a seemingly more natural aesthetic result and why they would like doing it. My semi-educated guesses could be garbage nonsense, I am open to that as well.

I can see where you're coming from, but we don't mix the 2 substances together and then inject them. Dr. Carney has a special technique he developed where he lays down a foundational layer of HA, then once the patient is happy with his results, Dr. Carney goes back in and adds the PMMA to essentially make the HA permanent. You can read more about it here if you're interested: https://www.rejuvall.com/permanent-girth-injections/

It does reduce the chance. I just would rather have more permanency and not have to go back for touch ups as much. HA doesn't force your body to create as much collagen as PMMA. It's expensive for how long it lasts in my opinion. Again, even if money isn't an issue, I'm of the belief the more you get poked, especially at an older age, the more problems you'll have. Nodules are much less common during the first two visits and with the proper amounts. Issues start arising when guys put in too much at one time or too much in general. As well as poor after care.

I would consider some HA when I know I'm near max with PMMA and 5 ml more would be too much/a high risk of Nodule formation. A little HA would be cool for smoothing everything out.

Rejuvall wrote: I can see where you're coming from, but we don't mix the 2 substances together and then inject them. Dr. Carney has a special technique he developed where he lays down a foundational layer of HA, then once the patient is happy with his results, Dr. Carney goes back in and adds the PMMA to essentially make the HA permanent. You can read more about it here if you're interested: https://www.rejuvall.com/permanent-girth-injections/

Thanks for the info! That does clarify - you aren't using a blend in one session, you're injecting HA in one session, letting it settle, maybe injecting again to manage any unevenness or irregularity, and THEN injecting PMMA after that's all settled in a separate/final session. Until your post I read this as a blend of two fillers into one syringe, during the same session.

Without trying to get into anything too proprietary, does laying a layer of PMMA beneath the HA cause both layers to be encapsulated within collagen and somehow prevent the breakdown of the HA by the body's own natural hyaluronidase so that the HA itself contributes to the total permanent volume? I think that's what I'm reading from what you've written and that link. If it's too long-winded and/or something a random plebe can't really totally grasp (or a trade secret), all good! I was the "how does this thing work" kid that took apart everything in the garage.

Without trying to get into anything too proprietary, does laying a layer of PMMA beneath the HA cause both layers to be encapsulated within collagen and somehow prevent the breakdown of the HA by the body's own natural hyaluronidase so that the HA itself contributes to the total permanent volume? I think that's what I'm reading from what you've written and that link. If it's too long-winded and/or something a random plebe can't really totally grasp (or a trade secret), all good! I was the "how does this thing work" kid that took apart everything in the garage.

I'm happy to help however I can! Tbh, I'm not 100% on how much I can share about that, but I'll get with Dr. Carney when he's back in the office next week and see if I can get an answer to that for you. And I totally get it; I was the same way and still am. Never stop learning!

Lol there's no way to prevent the breakdown of HA or make it permanent. Whatever Girth is gained from the HA will eventually have to be replaced. This is just my opinion but I wouldn't want to go through all the trouble of a prep layer (or two if I'm reading their site correctly) before ever receiving any PMMA.

"We discovered that beginning augmentation with PMMA almost always results in the immediate formation of granuloma, which makes for a less than ideal foundation to establish symmetrical penile thickness." Rejuvall

This is a very audacious statement. First of all, to my knowledge only relatively recently has Rejuvall been using Bellafill. Are they saying they found this information out throughout their own administration of Bellafill?

Second, I think Dr. Casavantes, after more than a decade of using Linnea Safe would tell you that granulomas are more rare than they are common and his clients certainly don't "almost always" form granulomas after their first round. But again, I'm not sure what information was gathered for Rejuvall to make that claim.

justn8 wrote: While mine was not done together or in tandem, I have had HA added to my PMMA and to be frank... I love the feel of it. It's very smooth and consistent. So I can kind of believe Rejuvall's claims when it comes to the benefits of incorporating some HA. It sounds to me like they also also use the HA to help create space and see if guys are happy with filler in general prior to adding something permanent.

Even though my procedure wasn't done together, I've had HA added to my PMMA, and I must say I love the result. It's smooth and consistent. Rejuvall's claims about the benefits of incorporating HA seem believable. It seems they use HA to create space and test satisfaction before adding something permanent.

Ok this will be the third time trying to post this, so hopefully it post and there are no repeats.

I finally found the pricing on Rejuvall and they are charging $8000 for 8ml. That's significant.

Rupeka is charging $5500 for 10ml. This is a significant price difference.

I've already had HA in the past so I know I'll need a lot to get what I want girthwise. I'm only looking to gain an Inch but I'm 7.5" lengthwise so I'll need at least 16-20ml if not a little more.

That's a hard pill to swallow at the prices that Rejuvall is charging.

Any thoughts are appreciated.

Hyperbol wrote: This is a very audacious statement. First of all, to my knowledge only relatively recently has Rejuvall been using Bellafill. Are they saying they found this information out throughout their own administration of Bellafill?

They were using Ellanse when it was being trialed, which more-or-less works the same way as PMMA in terms of neocollagenesis -- and they've always had access to Bellafill, just preferring Fat and Hyaluronic Acid (HA), just like how all Clinics have their own preferences.

Furthermore, they have dealt with repairs & revisions from providers of PMMA (not necessarily Avanti Derma, just in general), so are quite privy to this area of enhancement.

More importantly however, is that Rejuvall works with an esteemed Reconstructive Urological Surgeon, Dr. Carney, giving him considerable purview & authority in this area. So to use the word "audacious" is audacious in it of itself. It's akin to me calling my auto mechanic audacious for telling me what's wrong with my car because of some YouTube videos I watched. I know you probably didn't mean to come off this way, but I believe we owe it to Rejuvall (who has taken time out of their day to kindly provide multiple responses) to engage in constructive discourse. I ask we give them that.