PhalloBoards member "Chester" asks:
"Hi Doctor, before I ask my question, I'm happy to report that the procedure has been a huge success. Thank you for your great work! My question has to do with the impact a filler in your penis has on blood pressure. There is only so much size and mass in the penis, and if you're adding filler volume, one stands to reason that there will be added pressure on the veins in the penis. I'm curious about your thoughts regarding long-term impact this has on blood pressure. I ask because, as we age, blood pressure tends to go up, and I think this topic is important yet rarely addressed. Personally I'm in my forties and there's a history of hypertension in my family, along with being pre-hypertensive."
I’m happy to hear you’re pleased with your outcome Chester.
When girth is added to the penis via any sort of injectable or FFT, that enhancement occurs by adding the bulking agent into to the subcutaneous tissue “surrounding” the vascularized penile organ. The incredibly small capillaries located within the subcutaneous tissue are not affected by total body blood pressure – they are simply too minuscule and remote to be impacted. If you added additional girth augmentation later, our limitation is the degree of stretch within that subcutaneous tissue – not the penis organ. Human tissue is very stretchable with time. You just can’t force stretch it without risks.
Your erection process to attain a full engorgement is an automated sealing process within the organ. If you provided increased blood force it won’t change the amount of blood provided to the penis as it locks itself closed once a full dose of blood is in place for optimal penetration size. Alas, high blood pressure tends to cause an opposite effect on men and their erections as veins in the body can and will harden from high blood pressure, resulting in erectile dysfunction symptoms from insufficient arterial blood flow. Remember, your penis is located on the very edge of your body. That means it gets lower priority of blood flow when resources are limited – as with patients exhibiting cold hands and feet.
Finally, some blood pressure medicines are notorious for triggering significant ED issues as they medicate the same sort of situation I just described. The hypertension drug we recommend patients not use for their blood pressure condition relative to penile performance is Propranolol. We’ve discovered it not only causes ED but also triggers penile fibrosis: the building block of Peyronie’s disease.
PhalloBoards member "Think" asks:
"Texture / hardness is also a question ... I know I've been very happy with Ellanse in that regard, as have others with PMMA ... it feels really hard and natural when erect ... some have not with HA because it felt "squishy", although some have ... so how does FFT compare? More variable like HA?"
FFT is almost identical to the feel of Ellanse in subsequent texture for the first couple of years after your augmentation. In years later as the augmented subcutaneous tissue stretches, it gets a little softer – but never as soft as H/A – unless...a patients receives multiple surgeries of FFT over time. Patients who add 2-3 inches of FFT girth with multiple procedures will often end up with a “squishy” hand when erect.
I’m sure you’re already aware a female partner can’t detect a difference in the rigidity of the penile shaft – they only feel the variation in total measured girth. Most sex toys involving vaginal penetration in today's market have a softer outer finish for improved comfort.
PhalloBoards member "Kpk1435" asks (regarding Rejuvall's lengthening):
"Do you know if it will be a horizontal cut or a VY log cut? I been thinking about lig cut for quite some time now but I can’t make up my mind because I am kind of worried about the angle drop. I searched online to see if there will be any before and after pics but can’t find none. Also do you know how much are they charging? If it is appropriate to ask such question here in the forum. I would greatly appreciate your response. Thank you."
I’m going to provide a very lengthy response to your question in order to help you and others make the best possible decision for yourself in this regard.
Let’s start with the ligaments themselves. Every guy has a different number, size, tautness and exact location of their suspensory ligaments. They were designed into men during a time of evolution when sex between human beings was often a very violent process. Keep in mind: we might like using our sexual organs for fun, but their sole purpose physiologically is the procreation of our species. Many, many, many years ago we needed a lot of structural support at the base of the penis in order to consummate sex. If we had sex like that nowadays we would probably be charged with a crime.
What you “see” of your penis is where the organ becomes visible from underneath the pelvic bone. Your penis organ actually starts near the anus. The suspensory ligaments are connected to the base of the penis from the pelvic bone.
There are actually four aspects to optimal penile lengthening. One, is the cutting of the ligaments at the base of the penis. The second is the release of the deep ligament. The third is repositioning as much of the penis organ that’s situated on the inside to an outward location as is safely possible. And finally, there’s stretching.
It might be helpful to envision the suspensory ligaments at the base of the penis like the base roots you see around a tree in your front yard and the deep ligament as the tap root of that same tree.
I bring this up because we see lots of patients who had a previous ligament release performed and complained they actually “lost” length. How could that happen? It happens because of patients seeking a minimized scar in achieving penile length.
If we only cut the top suspensory ligaments (like the roots around the base of our imaginary tree) – the deep ligament (the tap root) will still hinder the penis from successful stretching. We found this most common for patients who had a ligament release performed through the scrotum to make it a “scar-less” procedure. Patients who had such procedures and are almost always unhappy with their length outcome are sometimes informed it’s likely “the ligament reattached”. However, we’ve discovered that wasn’t the case when we performed a subsequent lengthening surgery. The reason was rooted in the fact the deep ligament held fast and internal scar tissue underneath the skin from the procedure triggered new tautness and a reduction of penile length.
While a VY-plasty is suitable for some patients, we found that we get the most optimal lengthening results via a 2-3-inch singular incision running straight up from the base of the penis at the pelvic bone. This opening allows optimal access the suspensory ligaments, the deep ligament and repositioning of the penis, as able.
It’s important to understand that the penis doesn’t just “jump forward” following a release of the ligaments – they’re not that tight on 99% of patients. That’s why the penile repositioning is so important for most patients – along with the fact it inhibits the likelihood of ligament reattachment. It leaves a scar akin to a hernia operation which is what most single male patients use to describe where they got it in the future.
The degree of work with stretching on the part of the patient following surgery is often under-amplified by some doctors but a crucial aspect of increased penile length. It starts 2-3 weeks after your procedure with a traction device that causes mild tension on the organ while it’s still healing from surgery. At this juncture, we want to inhibit any post-surgical retraction of the penis and loss of any of the hard-earned gains you enjoyed post-surgical. Tissue will naturally retract following any procedure and you want to make sure your penis doesn’t get involved in that process through mild traction. A couple of months later after things are completely healed, you’ll want to evolve to using weights to stretch the penis organ. Results from stretching are no longer inhibited by the strong ligaments you had cut for length. This program will trigger the cells to slightly tear and grow back larger over time – in a process similar to building muscle mass to your biceps. Alas, it’s time consuming. You need to stretch for two hours daily for six months after the procedure to achieve best results.
The fear of a significant change in erect angle while standing up is most often promulgated by doctors who don’t perform penile lengthening procedures. The angle changes 5-20 degree’s depending upon your present angle when standing up straight. It drops more on a percentage basis if your engorgement points near straight upward and less if you’re presently situated me straight ahead. Most men are prone on a bed when erect and never notice that difference.
A bigger consideration for some if the subsequent “looseness” at the base of the shaft following a ligament release. While most sexual positions are still fine in this state, the force of a partner coming down at an angle as with “cowgirl and reverse cowgirl” are challenging without putting your fingers at the base of the penis to add support. Thus, if “rodeo” sex is your favorite pastime, you need to think long and hard before considering a penile lengthening procedure.
Thus, in summary:
1. You must have a ligament release in order to achieve real and lasting increase in penile length.
2. Only cutting the top ligaments to reduce scaring reduces the likelihood your lengthening will succeed. You need the deep ligament cut as well.
3. The post-surgical erect angle isn’t usually a big deal. The subsequent “looseness” at the base of the penis during rigorous sex is a more important consideration for some patients.
4. Stretching is required to achieve optimal results. If you’re not able or willing to invest the time in post-surgical stretching, it’s probably not worth your time and money to invest in a lengthening procedure.
We presently charge $9,800 for our optimal lengthening procedure that includes release of top and deep ligaments plus penile repositioning, anesthesia and supporting stretching devices.
Know that’s a lot of information but I hope it helps you make the best decision for your particular case.
Last edit: by Skeptical_One.
Given the recent discussion regarding fat injection permanency, the PhalloBoards Administrator (Skeptical One) went ahead and submitted a broad question aiming to have everyone's concerns and questions addressed: "How does Rejuvall's approach differ from previous iterations of free fat transfer (FFT), what to expect (gains, recovery, potential complications, etc), and how to reconcile FFT's inconsistent past with Rejuvall's advancements?"
I was rather surprised hearing that the sentiment on the PhalloBoards is that an FFT is not a permanent girth enhancing procedure. Fat tissue that survives the transplant process is a permanent outcome. However, as I thought more about it the next day and realized why lots of people might not feel that way.
Surgically-speaking, a penile FFT is considered to be a fairly simple procedure. However, as you’ll soon discover it’s deceiving in that regard.
I regularly perform organ transplants in the hospital that are considered dangerous and overwhelming to some surgeons. I can tell you with assurance that an FFT penile procedure is far more challenging to achieve a successful transplant than most doctors and patients realize.
An FFT is a “transplant”, and like every other type of human transplant procedure, there’s a lot of places it can fail since we’re trying to move a living organism from one location to another. When a patient gets an FFT and ends up eventually “losing it all”, that simply means the transplanted tissue eventually died and was reabsorbed into the body as waste.
To succeed in this procedure, your doctor must get six points just right. Shortcomings with any aspect will affect the final outcome.
Finally, in fairness to the skilled phalloplasty surgeons out there performing FFT, I’ve had more than one patient show up in our clinic claiming to have “lost all his previous FFT” with another doctor. However, upon close examination, we discover many of them actually retained a life-lasting portion of transplanted tissue.
How does that happen?
Following any FFT surgical procedure, there’s going to be a good bit of swelling and bruising. It takes months for all that swelling to completely subside. Some men confuse this loss of fluid – which can double the girth of the penis – with loss of fat tissue and lose sight of their pre-procedure width.
We very recently introduced a new non-surgical fat-tissue transplant procedure that will result in most patients adding about a half-inch of girth from a treatment. One of the reasons I was particularly excited to develop this new technology was so we could provide a less invasive and affordable pathway for patients to achieve that “post-surgical swollen girth” that many men adore and get depressed over losing once all healing is complete. It’s worth mentioning that this new procedure is NOT well suited as an initial procedure for men already over seven inches as we’re restricted in the amount of transplant tissue we can successfully collect from this pathway.
Another FFT complaint we sometimes encounter is patients were left with palpable fat “bumps or nodules” in their penis in the months or years following surgery. It seems some of you are aware that our clinic is able to redeploy the same technology we use to break up fibrosis and plaque in the penis that’s commonly associated with Peyronie’s disease to resolve these nodules since we’ve had a number of patients visit from around the globe for such repairs who indicated they heard about us on the PhalloBoards. However, I want to be clear that 98% of such nodules associated with an FFT are not from “fat tissue”. Rather, they’re pockets of excess edema which became trapped during the post-surgical healing process.
Most FFT surgeons recommend massaging the transplanted tissue for a period of time following your procedure to help reduce the likelihood of this unsightly outcome.
PhalloBoards member Moemoe asks: "Does Dr. Carney do the z-plasty?"
When it comes to skin repositioning in concert with a ligament release for penile lengthening, I will perform either a VY plasty, a Z-plasty, a double Z-plasty or a Heineke Mikulicz procedure in order to achieve the best lengthening outcome for each particular patient.
There’s no such thing as a “one size fits all” for the biggest outcomes with cosmetic penis enlargement. Would you want to get a haircut from a barber who only cuts hair in one style? Such an approach would look great on some guys but terrible on others.
I approach each case based upon the specific needs and anatomy of the patient.
PhalloBoards member D4Melons asks: "I notice there is a Morganstern Health website, a Morganstern Urology website, and a Morganstern Rejuvall website. Does it matter which site I use or is there one you recommend for people looking up penis enlargement? Thanks for your time."
All of these websites represent the same facility. As I understand it from our team, some of the sites rank higher for different search terms related to all aspects of healthcare provided by our clinic. Thus, all are kept active.
Going forward, they’re planning a monumental update and expansion at Rejuvall.com for the penis enlargement aspect of the enterprise. Although Steven L. Morganstern is our esteemed founder and also my dear friend, I didn’t dream of reaching the pinnacle of my career with another surgeon’s name on my business card. Sorry – that’s a little joke between me and Dr. Morganstern.
Look for the Rejuvall website to be the primary source of information regarding our newest procedures in the months ahead.
Last edit: by Skeptical_One.
I FINALLY found one report in the 2.0 forum of someone who had this procedure done, in 2017. Username was Wantbigger15 but I guess users of the 2.0 forum didn't carry over because that username yields zero results when I search it now : (
If anyone is aware of anyone else that has done this I'd love to know who.
Please use this topic to make comments regarding the content specifically within the Q&A or to submit questions for future Q&As. All other discussion (irrespective of topic) need to be in a separate thread (devoted to that topic's discussion).
I'll be removing this post shortly, but with enough time for you to see why it has been deleted. Be mindful of the categories and topic themes you're casually responding to, they can detract from pertinent information others are seeking out, like consultation-quality medical opinions at no cost to the reader (but not officially consultations).
" A patient has to possess the right proportion of height and weight. He needs to be fairly healthy as patients addicted to potato chips and comparable junk food usually have fat that won’t transplant with success"
Dr. Carney, I was told that I am not a good candidate for transfer because of my excellent health and physical conditioning. I was told that the fat tissue in men who workout regularly is not conducive to the surgery because the fat will contain 'striations' that yield bad results. It was explained to me that if I wanted this surgery I would need to stop exercising and gain 20 pounds or more of fat.
But what you state here sounds like the opposite, it sounds like you are saying that the fat gained from eating without exercise is the wrong type of fat as well. Can you comment more on this please?
Hey was just wondering how to get in touch about having a procedure done what is the correct website or a number where your office could be reached
Hello Dr Carney,
I'm very much considering Rejuvall's length procedure, what sort of aftercare is involved?
I currently have a Prince Albert piercing through bottom of the glans, would that interfere with any of the procedure?
Thank you in advance for your help!