TOPIC: PMMA Journal - Avanti Derma w/ Dr. Casavantes (Photos Inside)

Hey all!

I’ve been lurking around in the background of PhalloBoards for several years and now I'm happy to be able to contribute to the conversation with this amazing community. I have my first scheduled appointment for PMMA tomorrow March 11th with Dr. C.

It's wild to think that when I first started Hanging around PhalloBoards it was when I was considering going to doctor Ellist. I will be forever thankful to all of those who shared their honest experiences to prevent me from going down that road. I am confident in my decision to visit Dr. C and Avanti Derma for my first PMMA session. I’m super excited about it actually, though making sure to tone that exuberance down to keep my expectations grounded. And just to gush one more time about PhalloBoards, I'm so thankful for this group, for SkepticalOne, and for all moderators and contributors who have made me feel informed so I can sleep somewhat well the night before I head to Mexico. I can't imagine I would be able to do this if it wasn't for this forum.

It feels like backstories have gone out of fashion in the message boards, so I'll keep it to the nuts and bolts of pictures and progress reports for now. But please let me know if you have any questions I'll be happy to get into any details as I start this journey.

Below are my stats and I'll post my pre-op pictures tomorrow.

I am 33 years old, healthy
FL: 4.75
FGMs: 4.25''
EL: 7.25''
EGMs: 4.9''
EGbase: 5.25

My goals are that I would love to keep the proportions of my shaft the same, just larger, hopefully between .75''- 1'' MS growth. If I could reach EGMS 5.75 I would be ecstatic. But the priority is to maintain a natural looking unit.

If anyone else from the forum happens to coincidentally be going to Avanti this week, I'll be in Tijuana through March 14th - happy to meet up with a fellow traveler to swap stories and pass some time.

Thank you all for your time and generosity over the years. Here we go!

I just arrived at the Grand Tijuana (the hotel recommended by Avanti Derma). A shuttle picked me up promptly at my arrival in San Diego and brought me across the border. The driver was super friendly and our conversation kept my mood and spirits excited for the quick trip. I definitely recommend taking Avanti up on their shuttle service.

Looking around the hotel area, and it's a solid place to weather out this highly sensitive procedure where one needs to buckle down nerves for a drastic body change and focus on healing. There are plenty of food options close by including within the hotel. Wifi is fast - beds are comfortable. I ate myself some brunch to make sure I was sated before the upcoming event.

Attached are pictures of my unit pre-procedure. Wild to think that I'll be looking down to see something new and improved quite soon.

Speaking of which, Avanti has sent me an email of post-care procedures - which is one more example of the professionalism they have supplied thus far, before I even have walked through the door. The aftercare procedures are nothing overwhelming - but its a reminder about how crucial aftercare is to this entire process - and that it's entirely up to me to ensure that it's carried out. The best results in this forum were from users who followed the aftercare steps precisely.

That's it for all the procedural stuff. I'll follow up with a more personal post on the emotional and mental component in just a moment.

So, this post is less data-driven and more about the mental and emotional component of this journey, so please feel free to skip - but since I found tremendous comfort and value in these sorts of posts in my own journey I wanted to make sure I included my own context to pay it forward.

As the time to the procedure approaches, nervousness is definitely building. I am about to enter into a procedure that I literally will not be able to speak to anyone else in my real life about. Not friends, not family, not future lovers. It's a life long secret kept only between myself and the other travelers on this website. It's quite strange when you think about it and lends itself again to the importance of this community and its upkeep. It's valuable to be conscious of the magnitude of this choice. If anyone who has had the procedure before has ever doubted the value of continuing to post years after - I'm here to tell you that I may have just called all this off at the last minute if you hadn't updated years after the fact.

So why am I doing something that will create such a barrier?
Twofold. When I was about 13 years old, I had my first sexual experience receiving oral sex. My partner mocked me mercilessly about my size at the time and then proceeded to spread rumors to anyone who would listen about it within our neighborhood and school. I hope none of you gentlemen have ever had such a shaming experience - but it was quite effective in finding a permanent home in my memory bank - one I haven't been able to shake in 20 years. I don't want to hold onto something from so long ago but it has followed me in every sexual experience since, that lingering feeling. In fact, I can't even enjoy receiving oral sex because it's so closely associated with that event - my mind is always racing to negative thoughts. Obviously, there is continued mental work that needs to be done here - but I'm confident that good results here in this process will help pave the way to be more present during sex henceforth and less backward-looking.

Secondly, I've focused very much on being a giver while having sex throughout my life. I love women and if I'm lucky enough to be sleeping with one, I want her to have as much pleasure as I am. Most of the time it feels like I go down on a woman for her orgasm, and then the sex is for me... I mean its enjoyable for them.... but because the fit isn't quite as good it doesn't quite reach that otherwordly nothing else matters in this moment experience. I'm hoping that after this procedure, it will help sex be more of an explosive experience more of the time.

So there ya have it. The whole picture. I hope someone somewhere gets value out of it. I'm about 90 minutes away from meeting Dr. C and the team for the first time - If you're reading this, please send me good thoughts and energy from wherever you are

Thank you all

You're right, those who update & post years after the fact, they really are the greatest of contributors. Hopefully you'll be among the Legends who will keep us up-to-date in years to come.

It's unfortunate you have to deal with a sexual experience that occurred when your penis was probably not at its current dimensions. A 7x5 is certifiably big, but you're already in TJ and I'm not about to talk you out of it now lol. Fortunately, if you're going to get any work done, you're in good hands. And no, this has nothing to do with Sponsorship. I saw Dr. C nine years ago and it's changed my sex life ever since. Still thicker than a Magnum XL and complication-free.

Good luck!
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You are large at 7x5 (is that NBPEL by the way?), but it’s understandable to want more for the “wow” effect on your partners faces.
Good luck!

Hey ya'll thanks so much for writing back!

@SkepticalOne I greatly appreciate your reply. Its true that my dimensions had changed since that moment - but there have still been enough indignities along the way that has convinced me that if there emerged a reasonably safe way to add girth - I would do it.

Your validation from your own personal experience with Dr. C means the world and was the best comment I could have read right as I came out of post op before staring at my bandaged up penis for the night. And yes I am absolutely committed to being a regularly posting member of this group for as long as its up!!

@Gg82 The measurement is BPEL as I read that was the more reliable metric. I’m thin, so not a lot of fat pad to push through to get that number. I’ll be more accurate with my acronyms in the future And I’ll post some pre-opt erection photos once I have a decent post-op one to put side by side for comparison.

Will update with a play by play of the lead-up and aftermath of the procedure in a few moments.

So this posting will be a meticulously detailed account of what it felt like leading up to and during the procedure. It’s certainly long-winded, but as I mentioned, these sorts of point of view accounts really helped me when I was making my decision - so I wanted to be as detailed as possible so that any others that might be interested or nervous can get a sense of the experience to choose for themselves.

Result pictures and post-opt measurements will be in the next post for those who just want to get to the data.

But for now - story time.

I've just finished posting and I got an hour left before my appointment. I know my most valuable bits are about to be poked and prodded, so I eat a big lunch to make sure I keep up the fortitude for it. My mind was racing so I wanted to get out of the hotel and walk around to find a local restaurant. My basic Spanish gets me some laughs but ultimately a good meal which I eat in silence - thinking about the magnitude of what I’m about to do.

I walk over to the complex which houses Avanti Derma which is literally a 1 minute stroll from my hotel. The Avanti Derma office itself is clean and professional looking with attention to it's interior aesthetics letting me know that the team here cares about their branding, imaging, and that their patients feel that entering the office. Great signs so far.

The woman at the front desk checks me in, and then leads me out of the more public reception room into a smaller private waiting room - which was fantastic because as great as the place looked my nervousness levels were still unceasingly rising.

She hands me the paperwork asking for past medical history, allergies etc. which I filled out swiftly, but when I got to the standard disclaimers my growing nervousness finally hit near panic. It wasn’t anything that was written on the paperwork itself that catalyzed this - because its all stuff I knew already. But it was all suddenly becoming very very real. This procedure was moments away. I was about to have an injection in my penis. What the fuck am I doing?

At that point I’m starting to think I should just eat the deposit I’ve paid, apologize profusely for wasting everyone’s time and get back home and rethink this whole thing.

Right at that moment, Ian comes in. Now, it helps to know that I’ve been emailing with Ian several times daily for the past two weeks - bombarding him with questions. He has ALWAYS been patient and thorough with his answers and NEVER salesy or pushy with anything. I have never once gotten the feeling that he angling to SELL me on this procedure at all. His motive was to give me the information I would need to make my own decision, whenever that might come.

Fortunately, that attitude continued in the office even though I was upfront with my current doubts. I word vomited my concerns and Ian listened and gave me the information I now needed to work through. Mostly rehearsing and revisiting potential side effects, and how Avanti Derma would support me if further procedures would be needed.

Again this is all stuff I knew already, but it was calming to have an open and honest conversation from the provider themselves, in person, about their history with this procedure and their experience working with achieving the best results as well as with working to solve the complications that may arise. We spoke for nearly 20 minutes and then entered Dr. Casavantes.

At this point it feels like I’m meeting a celebrity - I’ve read about Dr. C so often through the boards and it was great to feel his warmth and noted excellent bed side manner in person. I’ve been to tons of medical practitioners and specialists in my life - but Dr. C immediately felt like he was more like a family doctor with whom I had been seeing since I was a child - as opposed to the specialist I met just moments ago. And thats a great feeling. It felt like he was going to be my partner in this process - whether it was going to be one session or multiple. He helped me understand what was before me and all the steps we were going to take to ensure the best results possible.

He spoke to me about the long experience working with PMMA, the good and the bad, and even his experience putting PMMA in his own body - which all put me at ease - especially knowing the doctor himself has used his own product.

With the Dr. C and Ian talks I’m feeling ready. I trust this team.
"give me those calming pills you mentioned" - there they go, down the hatch.
Ok its party time.

I get into my medical robes. Doctor Morales enters and now I feel like I got the whole dream team here with me in the room. I’m starting to feel a little goofy from the mild calming pill I just took, and everyone has got some banter going on so the pre-procedure has a light and fun tone that puts me at ease.

Now the needles come out.

Doctor Morales introduces the numbing agents that will be injected into my penis and surrounding area. In is indeed slightly painful to have your penis injected - but honestly not as a bad as I had imagined. Ian keeps me talking throughout this process and always has a comforting arm on my shoulder as each shot is introduced.

We then get into the PRP session - an optional (but recommended) process where they draw blood from my body to use as extra plasma to prep the area for the procedure and then used afterward to help in aftercare.

At this point, my dick is completely numb. And that is thus far the strangest sensation. To know that a whole bunch of hands are now on my unit injecting it and rolling it around, and I can’t feel a damn thing is weird.

Then the PMMA process starts. Ian gives me a stress ball to squeeze.

Dr. Casavantes makes some marks for injection points and the whole room gets a quiet and focused air. Dr. C, Dr. Morales and Ian are entirely zoned into what’s going on… I didn’t have the stomach to watch my penis, so I just watched them work. I kept quiet and made sure to lay still, only interrupted periodically for them to ask me how I was feeling.

I was given at total of 18cc
12cc x30% + 6cc x10%
In my pre-opt talk with Dr. C I didn't ask for anything in particular and left it to the doctor and his expertise to choose the best amount for my unit, knowing that naturalism and minimizing complications were my highest priorities.

After about 45 minutes (roughly) - they said it was done and I could take a look.

And I saw a really fat dick looking back at me. It was quite impressive indeed.

There were definitely some discoloration and lumpiness that made it look asymmetrical, but Ian assured me that this would all be worked on in the post care.

With that said - the post care lessons began. Ian walked me through what I should do overnight before I would be seeing him the following morning.

So… how I've understood it… The “product” of PMMA has bunched up in certain areas. Where it bunches up is dependent on your anatomy. Parts of your shaft will just be more welcoming to its storage than others - its OUR job now to massage those lumps out of those paths of least resistance and ensure even distribution of the product before it starts to harden.

I was surprised at how malleable “the product” is within the penis post op. It’s actually kind of funny. Ian described it as having pile of puddy or clay to be able to mold and shape. I’m still giddy from the calming pill so this makes me laugh more than it should.

Ian gave me a thorough lesson on aftercare, gave me a goody bag filled with medicine, a stretcher, and directions for the next 16 hours - and then I was off on my own.

Attached are pictures of what the penis looks like with bandages and what the penis looks like bruised up. I’ve reattached the picture of what the pre-opt flacid penis looks like so you can see the comparison.

Day 2 starts tomorrow. Let me know if you have any questions or if I can send any other pictures that might be useful.

Your penis is very well proportioned for a good result in my opinion. Having a glans that is noticeably bigger than the shaft, is a real advantage when getting filler.

Thanks very much for taking the time to go into so much detail. I'm sure many guys will benefit from your efforts in the future.

Good luck with your recovery.

Thanks so much for weighing in hoddle10!!! I really hope so. Your post back in 2011 was one of the major reasons I started to seriously consider PMMA to begin with - that along with all of your contributions since. I've truly appreciated all of your thoughts and posts over the years

Ok it's been 24 hours after procedure:

My penis is quite bruised and swollen. I would have normally been concerned but three crucial things are keeping me excited:

1. Remembering that I’ve seen pictures of this before with other Phallo contributors - and it is indeed commonplace for the penis to be red and bruised up from what I've seen here.
2. Ian from AD's continued support: I’ve been to see him this morning @9AM for a follow up and luckily his schedule allowed for me to see him again this afternoon. He’s assured me that while it is indeed swollen - it’s to be expected and is very normal for this part of the process. He's helped correct my massaging and after care techniques and I'm getting better at it. The shape of my unit is looking damn good when you don't consider the post op soreness.
3. Aside from the swollen bruises, my penis feels fine. I can still pee straight, and there is no pain unless I touch it.

That being said part of the post care is massaging and “rolling” the PMMA in my penis to keep an aesthetically solid shape. And that is quite uncomfortable - not like a shooting screaming kind of pain, but definitely a "breathe heavily while doing this" and something you would avoid if you could. but discomfort now for better results later.

A little levity - it is as surreal as reported for one’s penis to have grown this massive. Little things like - where do I put this big penis when I sleep - suddenly are something you think about.

I haven’t measured myself because I know it won’t be until the collagen starts that I’ll get a sense of the real gains.

i've posted picture of what the swelling looks like.

As for most of the day I spend with the penis in a stretcher and massaging every hour or two.

Please keep sending me good vibes - I'll report again tomorrow Thank you all.

We had a member by the name of gsxr7501941 who ended up being our first community member to "take one for the team" and undergo PMMA enhancement with Dr. C sometime late 2010 or early 2011. To this day, I have not seen the kind of bruising that he had after his first procedure. As a matter of fact, his unit was so black & purple from bruising, I legitimately thought he was possibly experiencing necrotic skin (we had no clue how PMMA and injection procedures played out back then, this was the first documentation from an actual member).

I held out hope and didn't want to alarm him, and figured I'd say something if the discoloration persisted. Sure enough, the penis cleared up and he ended up having an amazing result. It was totally normal, and since then I haven't seen bruising nearly as bad. What would be abnormal is a penis lacking any bruising/swelling at all lol.

Mine had a purple hue and was usually "sore" to the touch when massaging. It had no desire to become Erect for the duration of the swelling/bruising, but everything (including erections) resumed normalcy in like 7-10 days for me (if memory serves correctly, some of this figures I'm giving you may be off by a little).

I suspect this bruising and swelling is typical of HA & Ellanse injections as well.

Thanks for your comprehensive progress reporting and happy healing!
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Yeah I looked horrible with swelling and bruising after Ellanse ... it healed up very quickly and nicely ... I was not as concerned about it because I'd read lots of similar reports. Swelling near the circ scar lingered for a longer time, and I know others experienced that as well.

Thanks so much again for your replies guys.

@SkepticalOne I kept rereading your post last night as a reminder and for some needed comfort to sleep a bit and not let the nervous rattle me up, haha - greatly appreciate your relaying those experiences.
@Think yes my experience is quite similar to yours with large amounts of swelling around the circ scar.

I've posted some pictures for posterity to show how unattractive and somewhat alarming the swelling of your penis can get after the procedure. The pictures are from around 30 hours after the procedure when the area around the circ scar reached its most swollen thus far in the process.

Once again, Ian from Avanti Derma has been wonderfully communicative this entire time. I texted him as soon as I got overly concerned about the swelling and he assured me that the swelling would dissipate in the future - and we altered my post-care routine a bit to adjust for that swelling.

This morning I met with Ian again for further follow-up - and he massaged and rolled my unit back into shape. It sounds ridiculous until you're actually looking at it. But he literally remolded my unit into a near ideal shape in front of my eyes, albeit through a pretty painful moving around of the product through the swollen tissue. Its actually quite astounding the difference between his ability and mine to reshape the penis entirely. After talking it through it's because of my unwillingness thus far to really push into that discomfort and mild pain to move any collection back into the base of the shaft.

The malleability of the product continues to be fascinating. All of this has really echoed to me the utmost importance of aftercare in this procedure. Since the product takes a few days before "settling" how you treat this product in this key window seems to be crucial to the end result.

Right now my penis is bandaged up to compress the swelling near the upper shaft. Ian has been kind enough to agree to meet yet again this afternoon to help with continued aftercare and I hope to be able to show some more encouraging photos later this afternoon.

Thank you all and let me know if I can provide any further information or pictures that could be useful.

Yes, I definitely remember the swelling I had plus the pain when moving the product around. I was not as aggressive as Ian was because I could feel the pain while he couldn't. Ian is instrumental in the finished look of the procedure and was extremely available for aftercare follow ups.

I believe I was still swollen up until about 3 weeks afterward. Even with the PRP the swelling took a while to heal. I think I was a good 5 to 6 weeks out until I felt no differences in pain or pressure or tender spots. It takes a while.

Good luck and your results look great so far!

I can’t see any pics