TOPIC: Complications 3 years later - looking for advice.

Hi all,

I’m seeking some advice for complications I’ve had from Voluma. For some context, 4 years ago I began using voluma through a provider on this site (won’t name them because I don’t believe it’s his fault). I had little complications but then 3 years ago, after getting some more voluma added I had complications.

I had a bunch of lumps and little bumps as well. I went in to the get the filler removed relatively soon after and the issues still persisted. Then my father passed away and a few other personal things happened - it put me in a dark place and I ignored my issues till now.

Currently, I have a lump on the top of my shaft (feels kind of squishy and a little movable), along with a bunch of smaller (very tiny/almost pimple like but under the skin) bumps all over (maybe like 7 or 8 of these). I have also noticed that over time my Dick has become a bit smaller and my erections a bit weaker. These all have made me insecure and because of personal issues I put dealing with this off since it can feel overwhelming.

Any thoughts on who does the best Revision work? Have saved a very substantial amount so cost wouldn’t be prohibitive here. I’d like the best treatment I can pay for! Thanks all - would appreciate any additional advice you guys have!

Hello,

Sorry you are having this problem. Pictures would be helpful but understandable if you don't want to post them. Do you feel that what your feeling is the filler itself ( as a side note the Voluma actually lasts longer than we think in my opinion), because if it is the filler it should be pretty easy to correct.
Also some of the symptoms (ED) you are having may be unrelated to the filler for that reason I think its important to seek out a physician in your local area and start addressing some of these issue even if that is not where you end up getting your final solution.

Dr. S

Interesting. Following this thread because I've wondered how long tern degradation is. I'm very high volume with HA now so I'm sure at some point it will happen.

I do feel like it should be fairly easy to remedy for an experienced practitioner if the lumps are directly related to the filler itself.

Would a small session of fresh filler reintegrate everything and smooth it out? Or an attempt at full dissolving?


@LeonardoMedicine do you have any input? Dr Sullivan was gracious enough to chime in as well.

It may be prudent to return to your original provider to assess how things have developed. I don't like using Voluma as it is prone to delayed onset nodules and even granulomas. It is highly cross-linked to provide for longevity but it may be more difficult to dissolve, but eventually it can be dissolved after several sessions at times. Due to the nature of stress and aging in general, your ED symptoms may be unrelated to the fillers. Although if the appearance and texture of your penis makes you self-conscious, it can affect your erections from a more psychological aspect rather than physiological.

Hi @Dr_Sullivan and @LeonardoMedicine

Appreciate you both providing some guidance and insight. I will definitely follow through with your advice. For some more context, the initial filler was in late August of 2021 and the hyaluronidase was in February of 2022. This did help reduce the scope of the issue to some degree, but the issue definitely persists. Personal stuff came in the way but I really should have looked to address this earlier. With all the time that has passed, is this an issue that can still be addressed?

My main concern is that I might have some sort of edema, or lymphedema/lymphatic swelling. Don't even know if that's treatable. It's actually a few small lumps (rather than just one) on the top of the shaft and they kind of move with my foreskin. They seem to expand when I get an erection as well. They feel a little movable (as in they can move within the skin a tiny tiny tiny bit but can move around with the skin) and at their core feel firm but feel a bit squishier around it.

I will upload images as well over the next few days. Currently traveling for work, but will address when I get set up.

Did you get HA?

It’s HA - it’s voluma. Quick question for the thread - if it is nodules or other complications. Would it be much harder to fix since the original filling was roughyl 3 years ago and the hylarudonise was also over 2 year ago?

if you don't like Voluma than which do you prefer?

If it's just a Nodule which is more like a clump of HA, it can be dissolved even years out. If it's a granuloma, the body has walled it off to protect you from the foreign material. It can be more persistent and difficult to treat. I'm not sure if having it linger longer makes much of a difference in terms of ability to treat. Worse case scenario is it needs to be cut out. Those tend to be more like hard lumps though. It doesn't sound like that's the case from the way you are describing things.

I like Revanesse Contour (not available in the US). Restylane-L, RHA 4, and Revanesse Versa are also good substitutes and available in the US.

LeonardoMedicine wrote: If it's just a Nodule which is more like a clump of HA, it can be dissolved even years out. If it's a granuloma, the body has walled it off to protect you from the foreign material. It can be more persistent and difficult to treat. I'm not sure if having it linger longer makes much of a difference in terms of ability to treat. Worse case scenario is it needs to be cut out. Those tend to be more like hard lumps though. It doesn't sound like that's the case from the way you are describing things.

Would a granuloma cause pain? Is there a way to differentiate?

It can cause local tenderness. Diagnosis is through biopsy but can be treated presumptively. Luckily I have not seen this in my practice.

A granuloma is a very specific type of reaction and in 20 some years I have never seen a granuloma to any HA filler. The great thing about the HA fillers is that it should be possible to completely dissolve the filler---some just require more hylanase than others

I agree. I’ve only heard about HA granulomas but their occurrence is cited in a few studies. Can’t quote the exact number but some are more prone to developing than others but still rare. It’s more common with Sculptra/PLLA.

Hi @LeonardoMedicine and @Dr_Sullivan ,

I really appreciate the responses. I will be sending in photos tomorrow - as that's when I arrive back at home from my work trip. I would appreciate both your feedback if possible.

In the meantime, another quick question: So is it really possible that there's still filler on my shaft? I'd be surprised that it would have lasted this long since its been almost exactly 3 years.