TOPIC: New HA filler claiming to last up to 5 years

Dr Oates wrote: Quite a few of these patients travel from overseas which would make sting issues more difficult. Fortunately things have all been fine so far. As I have mentioned before I have seen granuloma from Ellanse in the face. Big granuloma. They were manangable with injections of steroid but would hate to seem in a penis. I discuss this at length with patients. But it is very easy for patients (anyone one on any subject really) to gloss over the risks that are uncommon.

This would be one of my primary considerations--that the practice doing the procedure is well prepared to deal with any complications, discusses them in advance, AND that I could get to them quickly if needed. Personally, I wouldn\'t find it to be an acceptable situation if I were any farther away than about a 2 hour flight.

Have you done a writeup about the granuloma?

www.ncbi.nlm.nih.gov/pubmed/29757038

[1. I am 100% certain. It was really easy to dissolve it with Hyalese.]

Teoysal Ultra Deep takes significantly more dissolving than Voluma.
If you read mediatps thread he states:

\"Most of the Voluma seems to have disappeared minus a small lump on the bottom side of my shaft near the base which was the firmer teosyal ultra deep. I\'m hoping I can leave this and go ahead with the next treatment regardless. \"



It can not be the case, the product is Teoysal\'s most dense.

[You have commercial interest for the statements you make - I don\'t. The burden is on you to prove otherwise.]

It is firm and resists dissolving with Hyalase. I do agree with you however that it does not make an ideal PE filler when injected in large volumes. I believe a patient had this filler with Dr Oates and it was not a success at his clinic.

[Your statement of 2 or 4 cc per session doesn\'t make any sense. What will 2 cc do? Why bother to subject the patient to that torture? So to get as little as 10 cc they have to come 5 times to you? How on earth would you even distribute 2 cc along the shaft? Do you realize that what you\'re saying is illogical?]

It pools together if you inject too much of it together. It needs to be spread finely.

[you know they say little knowledge is dangerous and that is very true in PE.]

\"Little knowledge is dangerous\" - Is this an Australian expression, it\'s a good one.

[Why don\'t you ask Dr Casavantes and any other experienced injector? Avanti Derma recommends Circumcision for a good result for your information. This does not only have to do with the quantity they can inject, but the actual aesthetics as they explained to me years ago when I was curious about PMMA.]

Being Circumcised or uncircumcised makes little difference to the result when injected correctly, except for the issue of filler migration particularly to the Foreskin, and the risk of Phimosis.

[Do you even know what an accordion effect is? Do you know that it only occurs in uncut men and that it is extremely common? Do you think one can fuck with an accordion?]

I am sorry for you if you had a bad experience with the accordion effect. How was the filler injected was my original question (which layer, which entry point/s)? You were not an Androfill patient, which clinic did you go to?

[Sorry, given the commercial nature of your account, I don\'t have the time or the interest in educating you.]

Good. Your time is better spent learning about the Dunning'Kruger effect.



You do mean to be, but I don\'t mind.

[but if you really believe the things you say about Voluma and Teosyal Ultra Deep and uncut men, it only implies your doctor doesn\'t care, doesn\'t follow up, and is generally sloppy and not thorough when injecting and afterwards.]
I am not writing all this for your benefit. As I stated, I am writing it for the poor bastard who will save for months and come to you to have Teosyal ultra deep injected based on your claims that it feels \'hard as wood\' when in fact it feels soft as shit. In fact soft as shit is an understatement. Educate yourself about the high hydrophilic nature of this filler and the problems it causes when you have a large quantity injected.]

We don\'t particularly promote Teoysal Ultra Deep, it is less than 1% of the filler we use. I am simply saying it is very dense. Your experience with Teoysal Ultra Deep is contrary to what I have seen in the clinic. I know it to be very difficult to dissolve and harder than Voluma, very firm. We are not promoting it, and I do agree that it is not an ideal PE filler in most circumstances.

[Also, that being said, do tell us a bit more if your can. How large are the nodes? Did they appear at the injection points, or elsewhere? Are they hard? If they are small and do not respond to steroids, can they be surgically removed or is the risk of scarring high?]

Good questions.

Dr Oates:
Can I ask what is your experience in dealing with complications?
Have you had to deal with basic complications after Ellanse such as a bad shape or filler migration and how was this dealt with if it occurred, or how can it be dealt with when it happens?
Ellanse is very interesting, but we do not have enough information in order to promote this as a safe product.
I hope your work will prove it to be safe product. If you publish something in a peer-reviewed journal then at least we can point to your study when the GMC asks us why we are using Ellanse in the penis here.

[So much empty words and yet no substance. You haven\'t answered any of the questions.
You operate in a country where most men are uncircumcised and you don\'t know about the accordion effect because it doesn\'t happen in your practice. Wow. You must be miracle workers. Do you know how ridiculous you sound especially based on all reports about the accordion effect here, including mine? Who is going to believe you anything you say after this? Who is going to come to your practice for treatment? I would think \'Stay away from these charlatans, they don\'t even know what complications arise in uncut men, let alone know how to avoid them or treat them.]

1. I think you probably had it injected too superficially, and/or too far into the foreskin region / too much near the glans. Why don\'t you explain more including who the doctor was and aspects of the injection technique and aftercare.

2. Inject less towards the foreskin, tapering the filler, inject deep to the dartos.

[Take a lesson from Dr Casavantes. Not only he admits it happens and is likely to happen, but he describes ways you can treat It, options and risks. He posts even pictures to illustrate it.]

3. This is the Dr using PMMA? It is not a huge problem in the 1,100 patients we have seen unless injected poorly.
www.makemeheal.com/directory/view.php?userentry_id=27133

Aleksk - who was your doctor, and how was your filler injected please?

This might help to shed more light on your experience.

[With yours \'It doesn\'t happen to us because we are better than anyone\', you\'re not alleviating anyone\'s fears. You just sound like charlatans. So you\'re better than Casavantes and Oates? Ok, good. How?
You haven\'t answered where you inject the 2cc. A single push of the cannula would dispense significant part of those 2 cc because of its thickness. Where do you inject it? Top, base, mid-shaft? Why? This 2 cc sounds like something I\'ve never heard of before so do elaborate what your protocol is and why.]

4. You can ask this to mediatps or anyone who has had 2ml Teoysal Ultra Deep.

This is the maximum we inject because it is too firm and pools together if too much is injected.
Injected at the base. Less likely to be irritating (due in part to firmness) than if injected near the head. To allow patients the opportunity to try the firmness of the product without having too much (in case they don\'t like the product it is better than they had 2 ml than 10 ml, so we are conservative). Once it is injected it can be spread through the layer. Filler does not stay, in this layer, exactly where it is injected. It can be spread.

[All I hear from you is how difficult it is to dissolve TUD. Well in my case it wasn\'t, I am speaking from my own experience. Besides, it is really not important given all the questions you haven\'t addressed. The fact is it is 100% dissolveable. It may take sometimes more than one application of the dissolving agent, but then so what?]

5. Forgive me but I don\'t think you had TUD. It is 100% dissolvable, you are correct.

[Of course I had TUD. Dr Oates can confirm it. Do not insult my intelligence by telling me I don\'t know what product I had. And of course it was injected correctly. I hate repeating myself but you\'re forcing me to.]

1. My angle with this is more \'did you see the box, do you have the batch stickers, who was the doctor\'. I get unsolicited messages on whatsapp frequently from China wanting to sell boxes of \'Voluma\' for $45 with all the packaging and paperwork. I am trying to figure out why your experience with this product is so different from what we have observed.

[You don\'t seem to grasp the concept of highly hydrophilic fillers. This[ is why I said to you little knowledge is dangerous. The fact that the filler is firm doesn\'t mean it stays firm once injected.]

2. I grasp isovolumetric degradation. Also it is not news to me that HA attracts water and that there are variations in the physical characteristics of HA fillers (cohesivity/vertical projection), elasticity, viscous and elastic modulous and the combination, as well as the degree to which the specific filler is hydrophilic.

[Everyone here believes me when I say I couldn\'t have penetrative sex because of its squishy-ness for a simple reason: I am not the only one. We have multiple reports of people dissolving your praised voluma for the same reason.]

3. I believe you. Who injected it and how was it injected? (repeating the question again why are you hesitant to expand on this?).

What is interesting in your case is that you didn\'t have much filler injected? Could you please provide an outline of your procedure with all relevant aspects.
I caution patients not to have too much filler. If your penis becomes let\'s say above 1.5 inches filler to 4.5 inches actual penis, it is clearly going to have a weaker structure.

[I am speaking from my own personal experience and refer to other people\'s experiences as well as scientific facts. My motivations are clear.
You, on the other hand, make claims you can\'t substantiate. ]

4. I don\'t disagree that you had a bad experience, but you are slightly too aggressive from the start. I lived in Australia and I get that this is a common style of communication. You had a bad experience with TUD, I think it is the wrong product to be injecting in more than 2/4 ml maximum at a time and I doubt any doctor would make this mistake, but can we get to the bottom of your case with some details?

[By the way, be careful about insulting Casavantes on this board. Posting that makemeheal link doesn\'t advance our discussion. The man seems to know the challenges and pitfalls of injecting in uncircumcised penises.]

5. I didn\'t. I googled the doctor and that was the link that came up. The patient comments in the link are a bit insulting.

[You clearly don\'t, demonstrating that by saying it\'s really the same. So I am asking everyone on this board to take a note of that, especially anyone uncircumcised before approaching your practice.]

6. Why is it clear? Do you know that this accordion effect can occur in uncut patients too? If you think it is just about the Foreskin you are wrong.

[If you keep making the same claims about how much better you are than anyone in the field and not substantiating it, then buy a magazine advertisement. That\'s like taking one way. Don\'t bother to engage here.]

7. I don\'t like these advertorials and docutorials (I mean sponsored TV documentary type advertorials) that I see in GQ, on BBC etc.

[Do you think I don\'t want to believe you? How I wish it was true what you\'re saying. I would be on the first plane to UK to get a procedure with you.]

8. What specifically don\'t you believe? If you are in the UK anytime as Australians often are, then call in and have a sensible amount (10ml) of Voluma injected properly, and report back on it.
Pay only for the filler. You can also have 1 ml of TUD injected in a specific location where you can locate it and feel how hard it is, and then verify that it stays hard and compare it with the TUD you had. (Agree, TUD is unsuitable for PE in large volumes, but for different reasons than you suggest, namely too painfully firm).

If you have a huge amount of filler, or if the filler is injected badly (including too superficial or too much towards the head), or it is the wrong type, then you are going to have problems including accordion effect, which is not limited to uncut patients.

You\'re not really listening. I made a reference to Dr Oates, so rest assured I didn\'t get a fake product.

If it is Dr Oates who gave you this bad result did he explain what he thinks went wrong?

I am someone with average length, average girth and average amount of foreskin without any anatomical or otherwise irregularities. I got Teosyal Ultra Deep, which on paper should have been a good filler. I had an excellent injector.

If you had had filler injected well and your instructions in regard to aftercare were good, this would not have happened.

What you had (in regards to lumps under the foreskin) is either filler injected too far into the foreskin region, or too superficially or both.

If during the recovery, the penis is not supported (if the penis is hanging down loose in boxers) then filler can migrate down with gravity.

Did you use a thin bandage specifically for behind the glans?

In regard to your accordion issue, this is different from a filler under the foreskin issue. The filler was likely injected without sufficient taper so that rear filler supports the front within the layer; or was not injected deep to dartos, or both.

By taper I mean as in patient A at the following link, and it is important not just to resist accordion but also to minimise the risk of adding to phimosis in uncut patients
www.androfill.com/penis-enlargement-before-and-after/

Are you getting any further ideas as to what might have happened reading this information?

Despite all this, my result was exceptionally bad - extremely pronounced accordion effect and filler that felt as soft as shit, both flaccid and erect. It was so bad I couldn\'t have almost any sex at all. My report here is corroborated by other men who had their HA dissolved. This is especially true for uncircumcised men. I can\'t stress this enough.

I believe you, I know costas had his HA dissolved which was really disappointing, I think he had the accordion effect on an occassion after he subsequently went to Moorgate. For our part I think Dr H could have injected his filler with a better taper and with more filler deep to the dartos, which is why I offered to do it again for him at no cost, even after he had additional filler injected elsewhere.

For mediatps, I think he started this thread asking about a 5-year version of HA, so it does not seem he was particularly unhappy with HA. His Androfill results seemed good, and I understand he was mainly after a longer duration substance.

If there are men there who are happy with their HA, we need to find out what this means. Do they have a superior result? If so why? What\'s different?

As described above.

What about Dexterphall? and others.

For accordion issue.
- Taper to the glans so rear filler supports forward filler within the layer
- Inject deep to the dartos in the layer between dartos and bucks
- Don\'t inject too much, maximum 1.0 inch gain really should be the goal with HA.

For filler migration, lumps under foreskin when pulling it back.
- Don\'t inject too far into the under foreskin area
- Wear supportive underwear, don\'t let it dangle after the procedure
- Compress bandage behind glans
- Hyalase spot-dissolve if that still occurs

Or are they SUBJECTIVELY happy? Because I chatted on this forum with men and the conversation would go like this:

ME: Hey man, I hear you\'re happy with your HA.
HE: Yes, I am very happy.
ME: I had it as well and had these type of issues....blah blah blah...
HE: Oh, I have many of those issues as well. My filler also bunches up like that. It also looks weird when I pull my foreskin back. Yes, it\'s definitely detectable when I retract my foreskin.

The filler under the foreskin issue is a flaw in the injection and aftercare and easily addressed. In the injecting, do as described above.
In the aftercare what can help to prevent filler migrating into the region under the foreskin (visible when you pull it back) is:

1. I know it sounds basic but wearing supportive underwear (Y-fronts) so it does not dangle down loose while it is integrating (gravity pulling the filler down if dangling loosely in boxers).
2. Thin compress bandage wrapped behind the head.
3. If any lumps at all after 1 and 2 (unlikely) dissolve with HA

ME: And you\'re happy despite this?
HE: Yes, you see I don\'t care about aesthetics. I really don\'t. I love the extra volume and weight in my pants. My wife of 25 years also loves it.
ME: Ah, ok. I see. Well my situation is different because more than anything else I care about aesthetics and the filler being undetectable. I am dating a lot.

You see, \"i am happy with my result\" is very fucking subjective.

Yes I get you.
The aesthetics are important which is even more so why HA should be used over Ellanse (because HA is alterable if there ever is a problem).

Imagine little lumps of stray Ellanse in the under foreskin region you describe, not able to be dissolved. It is less likely to happen because Ellanse is thick (less liquid and possibly less likely to migrate with gravity), but it can happen.

My exceptional analytical skills however (if I may say so myself) have led me to conclude that those of us who are not happy are men who care about aesthetics (we also tend to care about our faces and bodies as much as our dicks), are likely single and dating, and have social and sex lives where we actively pursue sex with different and often new partners.

In other words, HA (and very likely other fillers) doesn\'t work well in uncircumcised men (and very likely in circumcised as we have reports of those who have dissolved it on this board as well). However, if your expectations are low/different in terms of aesthetics and you have a shitload money to spend on top ups, you will be happy.

You are mistaken about being uncut meaning you will have a bad result... only if the technique and aftercare were poor.
If your injector injects HA too superficially and /or/ too close to the head and the aftercare is poor, then you will have exactly the result that you describe you had.

i am happy to be proved wrong. I would be delighted. Let me see reports of happy men who are happy because their result is OBJECTIVELY good. Let me see their dicks with the foreskin pulled back. Don\'t show me pictures of dicks with the foreskin over the glans. These are useless.

HA under the foreskin is something that we addressed back in late 2015 after around 30 cases. Inject deeper, further from the glans, wear supportive underwear (don\'t let the penis hang down while the filler is integrating), and compress behind glans.

We hardly ever see this issue anymore... I almost never see what you are describing unless they are patients coming to us from abroad or elsewhere in the UK. If it did happen in our clinic then we would spot dissolve the filler under the foreskin.

Because in real life, when someone gets on their knees to give you a blowjob, the first thing they do instinctively pull your foreskin back. When you are about to penetrate someone, your foreskin goes back as well. And that\'s when the filler bunches up in accordion and you look ridiculous. And you are lucky if you can penetrate.

Absolutely. It needs to perform well under real circumstances and be undetectable or almost undetectable unless one knows exactly what to look for.

In real life, you are not a statue like David in Florence with the static dick and the foreskin eternally frozen over the glans.
And yes, anyone would notice. Unless your partner is a 13th century nun from a medieval monastery who has never seen a dick. She is somehow transported in a time machine and it just happens that she is going to have sex with you for the first time. She looks at your accordion dick and thinks \"Hmmm...so that\'s what dicks look like\".

Guys, if you are uncircumcised take my word for it - fillers are obvious. It\'s your decision whether or not this is acceptable to you.

You had a poor result from. I am telling you what most likely went wrong. Give Dr Oates a hard time about what went wrong, he seems a very good doctor and can explain it to all.

The issues you describe (accordion and filler migration) also occur with Ellanse (but are then not reversible), however, you seem to be a supporter of Ellanse (despite \'benefiting\' from a substance you could dissolve away).

The accordion effect can happen with either HA or Ellanse if injected poorly, as discussed above. It can happen in both circumcised and uncircumcised men.

Filler migration to the region under the foreskin is a different problem than the accordion effect and can also happen with both HA and Ellanse if the injection is poorly performed with poor distribution of filler and the aftercare/instructions are poor. Come to London and have the result fixed, or ask the doctor who injected you to give it another try.

@androfill - as noted, we go by actual accounts on the forum, otherwise you\'re wasting your time. Also, you should probably learn to quote properly, as it would make it easier to read (for anyone still listening):

www.phpbb.com/community/help/bbcode#f2r0

think wrote: @androfill - as noted, we go by actual accounts on the forum, otherwise you\'re wasting your time. Also, you should probably learn to quote properly, as it would make it easier to read (for anyone still listening):

www.phpbb.com/community/help/bbcode#f2r0

Yes, a thousand times yes!

www.phpbb.com/community/help/bbcode#f2r0
[QUOTE/]

Is it better?
I don\'t want to waste anyone\'s time, least my own.

No, you missed the beginning quote tag

Ok guys, I feel the need to chime in here.

I have had work done with Dr H and I was very impressed. He can come across as a little moody but I trust him as an expert in his field.

I also think Francis is genuinely offering some good information here.

Having had 18ml of HA with Androfill over 2 years and not really having the accordion effect and now going to Italy and having 10ml of PMMA and having the accordion really badly I do believe it is all about where you inject. This is why I have been asking about how the different fillers bind/interact with the shaft. My assumption, based on my differing experiences had been that HA actually bonded to your shaft in someway which is why the skin moved more freely over it. I now believe that actually the PMMA I have is injected too superficially and so just moves wherever the skin goes. This is what I can gather from what Francis is saying here. Francis I may book an appointment to come in and see if Dr. Horn can look and judge what has gone on here, if thats ok?

I am very much regretting having taken the risk that I did. I think there is a lot of great superficial information about different types of fillers, their dangers, etc but not enough about the details of how they are injeced within the penile anatomy. I think for uncircumcised guys this is of paramount importance as we have lots of movement going on down there and so the correct layer is really important. This kind of information really helps us understand how we(uncircumcised guys) should go about our PE

Below are four photos. The two orange ones demonstrate the effects of the accordion effect right now after 10ml of PMMA. The other two are towards the end of 8ml of HA there isnt a huge amount left but you can see that even with the tight forekin pulled back the HA still remains high up the shaft. You can vaguely see it on the top left. I wish I had taken photos like this after the extra 10ml of HA as the effect was the same. The larger quantity of HA stayed higher up the shaft. Now this i believe has nothing to do with the filler but where it was placed.

Also maybe its worth you guys at Androfill just clarifying how you can actually make sure you inject into the right layer? I assume we\'re talking about tiny differences between the skin and actual corpus cavernosum. How can you be certain you are in the right layer? Do you also think the difference in my outcome is entirely related to that? It would be good to hear your thoughts.

Francis, you seem busy. But can I get that information I requested? Glad to see the forum is alive and well, very useful information all around.
Regards
LL

Androfill wrote:

@androfill - as noted, we go by actual accounts on the forum, otherwise you\'re wasting your time. Also, you should probably learn to quote properly, as it would make it easier to read (for anyone still listening):

www.phpbb.com/community/help/bbcode#f2r0
[QUOTE/]

Is it better?
I don\'t want to waste anyone\'s time, least my own.

\mediatps\ wrote: Also maybe its worth you guys at Androfill just clarifying how you can actually make sure you inject into the right layer? I assume we\'re talking about tiny differences between the skin and actual corpus cavernosum. How can you be certain you are in the right layer? Do you also think the difference in my outcome is entirely related to that? It would be good to hear your thoughts.

Dr Horn makes incisions either side of the midline at the junction between the pubis and the penis, for the cannula.

The cannula is 100/120mm and 18G.

It is straightforward to tell you are not just under the skin because the cannula would be showing itself under the skin too easily and moving too freely.
Also in the right layer, the texture/resistance to the cannula is different.
The procedure is recorded live at the Royal Society of Medicine in front of a gynaecology meeting (IAAGSW) in London in the video below. If you skip to 2:30 you can see the diagram of the layers.

Yes, it makes a difference, it is commonly injected too shallow.




I have not seen any other video of Dermal Filler being injected into the correct layer.