TOPIC: Need advice on next steps

I got Volume added by Dr. Shafer in late August and have had some complications. I have been extremely busy with work so I have not been able to go back in to see him as I live quite far away but it is quite lumpy, uneven and some of the lumps are unusually firm. I was going to ask if this would be permanent... I haven't had sex since getting this done as I am not in a relationship and became surprisingly busy with work. I wanted to understand what it could possibly be and if I could be fixed. I was hoping it wouldn't be scar tissue and if it was what should I do? One of the lumps is a bit painful as well.

HA is not permanent but can last longer than initially predicted/thought in the injected layer. There are ways to expedite its Removal or break it down via hyaluronidase. HA is naturally produced in the body, and (relatively speaking) possesses the best safety profile amongst fillers - so I have good reason to believe your situation is correctable.

Mind if I ask (1) have you reached out to Dr. Shafer re: said-issues?
(2) describe the kind of pain, severity, frequency, and where on the shaft?
(3) is the pain only noticed when stimulated or can it occasionally be noticed without any stimuli?
(4) were these issues there from the beginning or did they develop (or worsen) over time?

From the surface information I have, I wouldn't be alarmed but contacting Dr. Shafer will be my biggest recommendation. If you don't mind sharing answers to the above questions I can maybe dig up some former patients with similar circumstances and see how those turned out. Complications can & do happen in elective medicine, but they can also be corrected, especially given the product involved and the performing physician (he's legitimate).

So I have pain on the right mid side of the shaft where there is an unusually rough lump. I also have like swollen veins (looks like venous congestion). These issues weren't there before but I am seeing Dr. Shafer in a few weeks. I would've gone earlier to get these fixed as its been going on for about 3 months but I was super busy with work and haven't had the time. Hopefully it all gets cleared up! @Skeptical_One

Going in to see shafer in about an hour and half, will update with how things turn out. Pretty nervous due to hard bumps and lumps as well as swollen veins it seems. Wish me luck

jeff21 wrote: Going in to see shafer in about an hour and half, will update with how things turn out. Pretty nervous due to hard bumps and lumps as well as swollen veins it seems. Wish me luck

Fortunately he's a masterful surgeon so I anticipate he'll figure out how to resolve the issue - also, being HA will prove beneficial in the long-run. Good luck!

So he told me that it seemed as though filler collected in certain places as well as "foreign body reactions". Didn't really understand what that meant to well but he basically said it the dissolvent enzyme coupled with time should help. He told me to re-evaluate in a week and a half or so, and schedule again to remove filler if that wasn't enough removed. So at this point, its really just waiting and seeing.

He could have been referring to a granuloma, which is a risk all filler procedures have. Fortunately it isn't something that will impair the health or function of your penis, and is largely an aesthetic nuisance -- note* however I don't know that he meant granuloma, only speculation on my part.

These are uncommon but can happen. I've heard/seen Dr. Casavantes, Dr. Oates, and others report having dealt with these in the past, but in their estimation quite rare.

You are right about the waiting game - like I said in previous posts, having HA makes this situation the easiest to resolve (a granuloma with Ellanse or PMMA would be a bit more challenging, albeit manageable). The real question becomes whether or not your immune response is too aggressive for high volume filler or if you can get work done again without the same complications. I'd be curious to get Dr. Shafer's opinion on that in the follow-up.

Good luck & happy healing!

My first round of the dissolving material was about 2 weeks ago and it is starting to seem to me that my issues are not that of foreign body reaction but some sort of swelling/fluid/cyst. There are these little swollen capsule like beads/bumps that I can feel between my fingers and they feel squishy/swollen. They become much more noticeable when Erect so I apologize for the Flaccid photos. I’ll add Erect photos later. I didn’t realize how bad it was until the dissolvent was injected cuz now I can feel it all. Could it be a lymphocele or some edema? Very considered cuz this means it’s been here for 6 months! Hasn’t gotten since the injection of the dissolving agent either. I’m calling Dr Shafer tomorrow morning to set an appointment and am considering reaching out to Dr Solomon or Dr Alter to see if need this issue to be fixed by them. kinda freaked out! Pls let me know what you all think cuz I really don’t like having these bumpy squishy erections.

They appear to be nodules, and so should be correctable. I'm not sure how well HA takes to "breaking up via cannula" like PMMA, but I can't imagine it being too dissimilar and would ask Dr. Shafer if this is worth consideration.

Also, given that the issues aren't "major complications" and largely aesthetic, my recommendation would be to continue treatment with Dr. Shafer since I'm not sure what Dr. Alter or Dr. Solomon would do that Dr. Shafer isn't already qualified/trained to do, in terms of fixing your problem. I'd pursue 2nd/3rd opinions if you decide more aggressive solutions are required, which I'd be surprised considering HA's temporary nature.

Also, while this may seem counter-intuitive, the idea of re-filling the shaft with HA is also another option. You see, the dissolving agent used may not get 100% of the filler in one-go, hence why you have residual nodules after your initial treatment. I'd wonder if getting a "layer" of HA re-injected while breaking up the nodules would prove more effective than outright eliminating the HA altogether? Just thinking aloud here. Thanks for sharing/updating.

Hi guys! Scary update but an update nonetheless. So I saw Dr Shafer on Friday to get my unknown masses treated. he seemed pretty unworried about them which was relatively comforting but I was still nervous since they were all over, squishy, and felt more like some sort of fluid like swelling. He injected some of them with a mixture of an "anti-inflammatory" and kenalog. Since then they have gotten even bigger and feel much stiffer, not to mention they are pretty painful. I know its only been a few days but Im concerned that if they were like fluid swelling instead of normal scar tissue/nodules it could've made it worse. What should I do? Just wait and report back in about 2ish weeks? Considering discussing surgery to remove all of this stuff w Dr Solomon or Dr alter. Its been really rough for me since my dick has not been normal for the past 6 months. Maybe more hyaluronidase later? Dunno what to do and will add pictures soon but I can't right now. @Skeptical_One

Best of luck to you Jeff. I really hope they get your issues resolved quickly. It’s stories like yours that make me really hesitant to take the plunge. And you only had HA, which should be much easier to correct than PMMA\Ellanse, which is what I’m considering. Thank you for sharing.

Do he mention if your unevenness/lumps came from inadequate massaging/aftercare? Or did you just have a bad reaction that couldn’t have been prevented?

Hey @Girthyplease , he said it was a foreign body reaction but it only seems to be getting worse after his last injection of the anti inflammatory/kenalog. Really freaking out since nothing has gotten better over time since I got fillers placed in about 7 months ago. I think it might be some sort of lymphatic issue rather than inflammation or scar tissue and I am hoping this injection did not make the problem worse. I would love to hear feedback from others as well as to what to do because I thought HA was reversible and at this point all I want is my old penis back.

jeff21 wrote: Hey @Girthyplease , he said it was a foreign body reaction but it only seems to be getting worse after his last injection of the anti inflammatory/kenalog. Really freaking out since nothing has gotten better over time since I got fillers placed in about 7 months ago. I think it might be some sort of lymphatic issue rather than inflammation or scar tissue and I am hoping this injection did not make the problem worse. I would love to hear feedback from others as well as to what to do because I thought HA was reversible and at this point all I want is my old penis back.

I would allow things to run its course as far as treatment is concerned. It sounds like perhaps you are dealing with a granuloma (but can't say for certain), which is a risk all dermal fillers possess regardless of filler or doctor, but isn't a grave complication.

In other words, you very well may be that "1%" that has a foreign body reaction to filler, even to one as benign as hyaluronic acid. For this reason I would continue following Dr. Shafer's treatment solutions. I would not pursue any drastic measures with other physicians as Dr. Shafer alone is as qualified to perform them if necessary, and your situation hardly warrants it.

Short of the situation becoming worse in pain, I would ride out this current protocol. I believe you'll be fine in the end

Would you mind chiming in with what you think would be my next course of action @Dr_Oates @Avanti_Derma

Thanks for the reassurance @Skeptical_One - sorry for potentially seeming dramatic, I'm just extremely concerned. I will stick with Dr Shafer for the time being, if this continues past the next few months then I will potentially consider other treatment.