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TOPIC: Dr. Leonardo PhalloBoards FAQs

Dr. Leonardo PhalloBoards FAQs 3 months 2 weeks ago #1308718767

How much Girth/circumference can you achieve with Girth enhancement injections?

I never promise a circumference or number as many factors can affect the end result. The longer the shaft, the more product is needed to create the same Girth enhancement as a shorter penis. There's no accounting for how much initial Girth is a result of swelling from the procedure, local anesthesia placed under the skin prior to filling, and Radiesse which loves to swell. HA also craves water and holds on to it such that the retained Girth may be similar to dimensions from swelling. As such, it's tough to predict. To assist with expectations, just about all of my before and after photos are taken Erect with the amount of volume injected labeled. Most of the patients are 4.5-5.5" Erect. Some are longer, some shorter. After photos with steri-strips (strip bandages) are taken immediately after. After photos without steri-strips are typically at least 2 weeks after the procedure. With the hybrid blend of Radiesse + HA, often what you see immediately after, is close to what you retain after swelling has subsided.



How many sessions can a patient expect to achieve an ideal result?

It really depends on the patient's goal and budget. Most patients have been happy with 2 Hybrids (3mL Radiesse + 2mL HA) + 2HA (2mL) which equates to 7mL of volume. However, there is much more of a "WOW FACTOR" when the initial procedure is injected with 3 Hybrids (4.5mL Radiesse + 3mL HA) + 2HA (2mL) which accounts for 9.5mL of volume. Hence, this is my current minimum volume necessary to treat. Additional volume added during the same treatment is highly discounted if the client really wants to go bigger. Top ups start with 2 hybrids (3.0mL Radiesse + 2.0mL HA) for 5mL prior to discount pricing. The pricing breakdown makes it favorable to stage and build as the client's budget allows. Some top up every 4-12mos.



How long can filler injections take and what kind of anesthesia is used?

My appointments are at least 2 hours long. This is not an assembly line approach for me. I like to take my time. During the 2 hours, I take photos Flaccid, then I induce an Erection using an injection of Trimix, then take Erect photos.

I employ 4 levels of numbing which also takes some additional time. I use topical numbing cream which is applied for 20min, then I perform a dorsal penile nerve block (similar to what a dentist would do to numb teeth) and allow it to settle for 10min. I inject lidocaine with my first pass with the cannula under the skin. Then I fill with my blend of hybrid filler which is mixed with more local anesthesia. My patients are comfortable enough that they have no hesitation in returning for a top up.

After the shaft augmentation, I take Erect photos with measurements. Then proceed to glans augmentation if desired. The glans injections tend to be bloody such that it makes photography difficult. That's why I take measurements beforehand. The rest of the appointment is used to reverse the Trimix Erection and discuss post-care instructions.




Can Girth injections affect the function or sensitivity of the penis? What complications are there to consider?

The biggest fear with injecting filler is Vascular Occlusion (VO). That's when filler is inadvertently injected into an artery thereby starving the tissue it is meant to nourish resulting in tissue death/Necrosis. This is more likely to occur when a needle is used to inject the product. Use of a cannula reduces the risk since the tip is blunt. The larger the cannula, the more blunt the tip such that it becomes increasingly difficult to enter an artery. It is not absent of risk but much safer compared to injecting with a needle.

More common complications would include bleeding, bruising, and swelling. These are common with any injection technique. There can also be prolonged swelling/edema and contour irregularity. These can be easily treated with a light dissolve using hyaluronidase. In addition, positioning the penis upwards allows gravity to drain residual swelling. The hybrid is dissolvable even though it is composed of Radiesse. Contour irregularity from penile retraction (shrinkage) can be minimized by pre-screening the patient weeks prior to filler augmentation and pre-treating with Botox to facilitate relaxation of the penis in the Flaccid state.

Penile augmentation should not affect erectile function as the filler is placed between connective tissue planes but outside of the Corpus Cavernosa, the chambers of the penis that accept blood to engorge the penis. The filler does not affect blood flow unless the penis is overfilled resulting in a "compartment syndrome" where there is too much pressure in the confined space such that blood flow is compromised. The advantage of augmenting the penis while it is Erect is that I can gauge whether or not the penis can accommodate more volume. If the skin is too tight while Erect, I am aware no more filler can be injected. This may not be appreciated if the augmentation is performed on a Flaccid penis only to be later surprised during an Erection.

An augmentation free of any serious complications actually results in a more sensitive/pleasurable experience. The augmented penis feels fuller in one's hands. It's a tighter fit during oral, vaginal, or anal sex. The penis feels heavier. All of this adds to the sexual experience. Glans augmentation with filler is a treatment for premature ejaculation (PE). The filler acts as a barrier between nerve endings and stimulus. For those not experiencing PE, orgasm is not delayed appreciably.




-Dr. Leonardo
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