TOPIC: GROTOX® & My History with Penile Botulinum Toxin (Botox)

I had a patient approach me in 2019 asking about penile botox to improve size. I thought he was mistaken because I could not think of any role Botox would have in the penis. Traditionally Neuromodulators/Neurotoxins like Botox, Dysport, and Xeomin have been used to temporarily relax muscles of facial expression so that wrinkles could not be formed when activating those muscles.

I conducted a literature search at the time and found 2 articles about using Botox for the treatment of ED. I thought about using Botox to address shrinkage. The dartos muscle is responsible for the retraction reflex of the penis. If I could relax this muscle, perhaps Botox could be used to combat shrinkage. The only problem is within the penile shaft the dartos muscle is basically connective tissue and not muscle. I tested out various injection patterns and depth. I found that it was more beneficial to inject Botox deep into the corpus carvernosum much like PRP for the P-Shot and Trimix.

I discovered that not only did it help improve erectile performance, but it also helped relax retractions. In addition, it helped improve endurance. I trademarked/registered the name, GROTOX® (Botulinum Toxin for Growers) in Canada. A year later Yan Trokel, a physician in NYC, approached me to collaborate on my work. He basically rebranded the name to Magnym™ and never reimbursed me for my time and effort. We have since parted ways but he still uses my before and after photos along with patient testimonials in his public speaking engagements. In 2022, Dr. Charles Runels came out with Bocox™, a similar procedure. I met with him in the November 2022 to become an official trainer of his. I made him aware that I was performing penile Botox 3 years earlier than him. He wasn’t aware of the indications for shrinkage and premature ejaculation. Although similar, Bocox™ and GROTOX® are different techniques. I had 3 years more experience and have optimized patient selection, dosing, injection pattern, and aftercare for the best outcomes.

The mechanism of action in the corpus cavernosum is to temporarily relax muscle tone thereby creating a low pressure system to facilitate blood flow to the penis. There are flow velocity studies that substantiate this claim. After the erection subsides, the muscles within the corpus cavernosa do not fully contract and empty out the penis. This residual blood volume leaves the penis in a perpetual state of having a “chubby”. This added weight indirectly combats the retraction of the dartos muscle allowing the penis to hang longer in the flaccid state. This is how we turn “growers” into “showers”. Considering the penis is not fully empty, erections are easier to achieve since less blood is required to fill the penis. If the penis is 50-75% full in the flaccid state, you only need 25-50% more blood to fully engorge the penis. In terms of its mechanism of action to treat premature ejaculation, Botox is anti-sympathetic. Our autonomic nerve system requires sympathetic tone to “shoot” I.e. ejaculate. Botox reduces this sympathetic tone to allow one to last longer. It makes the world of a difference for those suffering from premature ejaculation. For those without this problem, ejaculation will be delayed but it will not prevent climax like how some may feel taking SSRI antidepressants.

GROTOX® is a prerequisite to dermal filler augmentation in those with retraction. This prevents the accordion-like pattern caused by filler migration in light of shrinkage. If we dose optimally, there is really very little aftercare needed to prevent filler migration like constantly having the penis extended with traction devices or wearing a sleeve. My patients basically avoid intercourse and masturbation for 2 weeks. That’s the extent of their aftercare.

I’ve included before and after photos of clients who received GROTOX® +/- Scrotox. Please note one patient who had been receiving GROTOX® every 3 months for 4 years. His retractions were so severe he appeared uncircumcised. When he presented for his next dose, one would assume the product had worn off but he was still very much relaxed. The longer one uses Botox on a regular basis (every 3 months), the stronger the results. When filler is added, the additional weight helps the penis hang better in the flaccid state. Often men who receive filler augmentation no longer require GROTOX®. However, some still do if their retractions are severe.

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I wasn't aware it can help improve Erection quality?

And I'm assuming it can reduce or eliminate cooler temperature retraction or?

Think I might have to give this a go... Lol

@Dr_Leonardo,
For retractors like my self who have already had HA fillers. Do you recommend Grotox? Would you do it at the time of the HA injection or would it be done a couple of weeks before HA?

@justn8 Yes, it can do those things for you. However, you are going to be a challenge because you have a thick layer of filler in the way of the needle.

@Dmango The product is injected 2 weeks prior to filling. If you still have retractions after 2 weeks, you would require another dose. If you already have HA filler and you are hanging better with less retraction, you may not need it. Ultimately, you would need a consultation with me so I can examine and assess you.

@curiousfiller please read this post regarding penile Botox.