TOPIC: Accordion Effect and Botox

I wanted to get a general picture and opinions on people who had Botox and/or accordion effect from fillers

- Does the accordion effect generally reduce as the PMMA starts to form collagen? In other words is it a lot worse in the beginning then usually decreases with time?
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- Do tight compression wraps help with it or does massaging help with reducing it?

- Is it worth getting Botox 1-2 weeks after fillers or would that not help much considering most of the PMMA seems to have settled within 72 hours?

Any experiences/Dr Inputs would also be much appreciated.

@Avanti_Derma could chime in, they may be the only Sponsor or Provider I know of that use the term "accordion effect" in their literature/brochures and have the volume (i.e. sample size) to adequately address this very niche question.

I wonder if Botox could potentially relieve some of the "accordion effect" but in all honestly, uncircumcised penises are hard for me to relate to tangibly, no matter how many photos, diagrams, and material I have seen/read on it over the years -- the idea of having foreskin and how I can imagine it would behave with filler, much less Botox are purely speculation in my mind.

A post from PhalloBoards 2.0 talking about the accordion effect.
“The accordion effect is due to the filler interacting with the dermal layer; the closer to buck's fascia the less the effect. the skin of the penis is loosely attached to the underlying fascia called scarpa or colle's fascia, it is a loose connective tissue that allow the upper skin to behave more like a fluid than a solid object. Think of two sliding doors made of rubber passing each other, one door the outer door can move freely and isn't connected to the inner door; the outer door(the skin)can stretch, shrink and move freely past the inner door regardless of the size of the inner door(buck's fascia), however, if there are any connections between the outer door and the inner sliding door then as the outer rubber door moves past the inner door where it is attached it bunch's up like an accordion. The other possibility which is similar to the above procedure is if too much filler is at the base between the pubic/penile ligment at scarpa fascia where both join a inadvertent binding is formed and you can get a bunching of the skin here. And there is a very thin layer of muscle tissue(thicker towards the Foreskin and the scrotal web) that is just under the dermis called Dartos fascia that shouldn't have filler injected into it because filler and muscle don't get along and cause bunching and nodules. Once again the solution is to place filler on buck's fascia on each side of the ligament, which is hard to do because the ligament fans out from the pubic bone to integrate itself with buck's fascia. Few docs understand this anatomy and that is why you see the accordion effect, it has nothing to do whether one is cut or not. A Circumcised penis will do the same if one were to retract their skin, but since it is rarely done except for aggressive masturbation no one complains of it.”

Would be cool to have some doctors chime in on this one. Going to ask my doc about it when I see him, though from what I gather having had the procedures myself with cannula they went wrong and had an accordion vs needle placing the filler deeper which is harder when Erect, and also acts different when the penis is Flaccid, I would imagine it’s all down to injection depth.

@LeonardoMedicine seems to be the top notch guy on Botox - would it be effective doing Botox post filler possibly a few days later to help with the accordion effect or bunching up? We haven’t been able to find an answer regarding post filler

The benefit is best when performed 2 weeks prior to filling. For clients flying from out of town, we inject immediately prior to filling. It’s not ideal but some clients have responded well and benefited from a quicker onset using Dysport instead of Botox. Injecting a couple days after filling is too late for any benefit in regards to mitigating shrinkage to prevent contour irregularities.