TOPIC: My journey with Dr. Victor Liu - Alloderm & Ligament (for girth & length)

Hello everyone.
I read with interest what you all have to say. There seems to be some confusion on post-op care especially for those who had ligament detachment procedures. I hope I can clarify it here.
For penis elongation the detachment of the superficial suspensory ligaments must be complete, however the deep suspensory ligaments should only be detached about 90% leaving about 10% intact to maintain stability. The space produced by the division of the ligaments must be filled with tissues mobilized from the surrounding tissues. This serves 2 purposes: 1. to prevent re-attachment of the ligaments, and 2. to stabilize and strengthen the base of the penis. In addition, very often there are other adhesions that need to be detached as well and this can be determined at the time of surgery. Contrary to what many people say, it is very rare to find re-attachment of the cut ends of the ligaments to each other. However, the cut ends or the rest of the operated areas can attach to the surrounding tissues and may, therefore, prevent the penis from being extended. This is the main reason why post-operative extension of the penis is important.
My routine post-op care in regards to extension of the penis is as follows:
Starting on the first day after surgery, the patient will have to do manual extension himself. It is important how it is done so that no damage is done to the surgical site. The patient is thoroughly instructed on how to do it and the importance of this is very much stressed to the patient. This has to be done at least six times a day, everyday for a minimum of 3 months. At the end of one month, the patient is started on extension devices, in addition to the manual extensions. So far I have not found a commercially available device that is satisfactory because the suction pump or the rings used in these devices may cause damage the the penis itself. So, I have designed and manufactured my own device given freely to the patient. However, even this is sometimes not satisfactory and therefore, the manual extension is most important.
I hope the above answers some of your questions. If not, you are welcomed to ask me directly here or call me at 650-697-8888 or write to This email address is being protected from spambots. You need JavaScript enabled to view it.
Best wishes to all!

Thanks for chiming in @PhalloplasticSurgeon_DrLiu !! And there you go all, you heard it from the man himself

SouthBay612 wrote:

New1inch wrote: @SouthBay612 so glans enhancement is possible now??!! Haven’t been here in a while and I’ve been waiting on a procedure like this. Did you see any visual enhancement, and Is the glans enhancement permanent?

Yes there is a noticeable difference. It has stayed proportional, and since my shaft is now larger that means the glans also is. Dr Liu used Bellafill (which is permanent) mixed with Voluma (short term). The Bellafill builds collagen over time so the results aren’t immediately noticeable, which is why he mixes with Voluma, which gives immediate size while the collagen starts to build up.

We should be roughly to the "done making collagen" point in the glans, how are you getting on here? Has it grown with the PMMA to the scale that people have been able to grow the shaft, or do you think it's still mostly HA gains?

I know I'm nearly 2 years out from my HA and I still do have my sort of HA skeleton under the coronal ridge, it's just shrunk a bit. Not gone, but smaller (and still awesome, I feel like it gives my dong more "texture" and drag). I'd love what I originally had with the HA to be permanent - of course, now that I type this we may not know how your PMMA-only driven glans gains are for years, especially if my HA is still not totally gone this late on.

@itgoesthud for the glans I wish I would have taken before measurements but I did not. I can say it is larger than before and feels proportional to my larger penis. I’m not sure how much is HA vs PMMA at this point since it has really only been about six months total for me.

Hi all -
I recently gave a Q&A 6-month update to a fellow forum member via private message. A lot of good questions so I am sharing the responses here. Some of the responses are condensed for posting publicly and to protect privacy.

How far post op are you and how do you feel overall about getting the procedure? Was it worth it, game changer at all? Its very pricey and of course theres always risks.

1000% worth it for me, 6 months post-op. It has been a complete game changer. I'm more confident in bed and enjoy having a 'bulge' in my shorts.

What all did you get done and how much Girth were you able to gain?

I did Alloderm + fat transfer (PMMA in glans). If I had to do it all over again I would have opted for PMMA instead of the fat transfer because some of the fat absorbed and it created some symmetry issues, which I then went and and touched up with PMMA (I wrote about that in my post)

I also had my ligament cut for lengthening.

Results are here - although it has been a while since I've gone through and measured everything. It certainly hasn't gotten any smaller, though. If anything, a tad larger.

FL: 3.5" pre-op, 4.7" post-op and post-stretching/Hanging for 3 months--> 1.2"
FG: 3" pre-op, 4.5" post-op (technically 2.9 and 4.4 but I'm rounding) --> 1.5" gain

EL: 5" pre-op, 5.3" post-op and post-stretching/Hanging for 3 months - 0.3" gain
EG:4" pre-op, 5" post-op --> 1" gain


How does it feel and look compared to a normal penis? Others have mentioned Surgimend can feel firm.

By the time I saw Dr. Liu he was preferring to use Alloderm because of patients who were reporting issues with firmness - although he did say he thinks this improves with time. The benefit of Surgimend is that one can realize greater gains in Girth without needing as much filler/fat to supplement. But now I'm sure you know Surgimend got pulled off the market so it's not even an option anymore.

If I had the choice to do it all over again and had the option, I'd go with Alloderm again. My gains in Girth were as much as one would get with Surgimend because of the combination Dr. Liu uses with filler or fat. My penis is soft when Flaccid and firm when Erect, just like a normal penis.

There are a couple of areas that I can squeeze and feel where the Alloderm meets my shaft even now (six months out) so I think if I really let someone inspect down there when Flaccid they may notice notice something. Dr. Liu tells me the Alloderm will continue integrating and eventually this will be totally unnoticeable. I suppose if that doesn't happen I can consider a filler touch-up.

But, I've been seeing a new partner for the past few months and he's never even noticed, and as a gay male this is impressive because obviously gay men know what penises look and feel like because they have one of their own.

Along those same lines... I've also seen my fair share, and they come in all different shapes and sizes, so comparatively it does look and feel "normal."

Are you able to use it like you would've before or do you have to be more careful with it in bed now?

I am having the best sex of my life, and it is not gentle. lol. And since I mentioned already that I'm gay, I'll clarify that yes I am the 'giver,' which by the way I rarely had confidence to do in the past. It's like something in me which has been there all along has gotten unleashed! lol.

After the healing period (5 weeks) there are no restrictions and no concerns of needing to be careful.

Are there negatives to having it done or did you lose any length? Ive heard that is sometimes common.

I didn't lose length, but I had my lig cut as well. I will share that it felt a little restricted at first and it wasn't until after manual stretching and consistent Hanging (using Dr. Liu's Hanging device) for a couple months that I was really able to realize the increase in Erect length from the ligament cut.

Whether or not you have your ligament cut, Dr. Liu will likely tell you to stretch or hang because I think it's a common report that people lose a bit of length - prob either due to the stitches which take time to dissolve or scar tissue (just my guess).

Lastly, is there anything you would recommend as far as post op care that you would've done better or paid more attention to so I don't overlook or miss anything?

Really pay attention when they give you wrapping instructions and DO NOT wrap too tight (especially with the extra wrap they give you for near the base and the shaft). I wrapped too tight thinking I needed to for the fat/filler to stay (this is 100% not necessary) and I ended up with a little 'ring' indent around my base. I got this fixed with my PMMA touch-up mentioned above.

Manual stretching - Not totally sure if Dr. Liu will have you start manual stretching right away because it doesn't sound like you are having a lig cut. If for some reason he does have you do this be very careful not to stretch or put tension on your Y scar. I did when I still had stitches, and it stretched my scar. Dr. Liu has since revised that so all good there.

Lastly, Dr. Liu and his staff have a nifty little app for messaging. They want you to send photos every few days when you do a re-wrap. I was unclear about some things in the aftercare instructions and I sent a lot of questions to get clarification in the app. At first I thought this may be annoying but at the end of the day Dr. Liu wants your results to be perfect and would prefer you ask questions if you have them. And you're always welcome to PM me.

Anything you might wish to add would be super helpful and informational as theres not too many people out there with personal experience compared to PMMA. I really do appreciate your time in answering some of these questions.

I've had quite a few folks message me now and confirm they were going through with their own procedures, and I know for a fact Dr. Liu performs MANY of these. I think it would be nice if other people could share their experiences here on the forum to 'pay it forward.'

Finally, the benefit of this procedure, which is widely discussed on this forum and by SO - it's one-and-done...mostly. It's more money up front, but you theoretically don't have to go back several times for more. Having said that, I think people need to be realistic that penis augmentation is a journey regardless. As I mentioned I had to go back to address some symmetry issues from the fat dissolving and my stretched Y-scar. With PMMA, one could end up with a Nodule which needs addressing or even need to do a PMMA touch-up for symmetry. If issues arise, Dr. Liu will address them, but be patient with your body and give it time to heal.

In regards to the amount of penile elongation by division of the suspensory ligaments it depends on many factors.:

1. The anatomy of the area, including the amount of penis shaft behind the bone (symphysis pubis), the more behind, the more it can be pushed out thus the more elongation; the angle of the tilt of the bone; the amount of surrounding soft tissue and the general structure of the area.
2. Presence of scrotal webbing, the presence of excess fat and/or skin in the area,
3.Whether the penis has a tendency to retract,
4.The surgical technique; the superficial suspensory ligaments have to be totally divided, the deep suspensory ligaments should be about 80-90% divided. Not dividing it totally and moving surrounding tissue to re-enforce the structure are important to obtain stability of the penis. Completely dividing the deep suspensory ligaments may give extra lengthening but this extra increase would be negated by the instability of the base of the penis thereby the whole penis may retract during sexual intercourse and losing the functional length of the penis. I have been asked about whether it is necessary to do a V-Y extension of the skin. This should be routinely done if there is any tightness of the skin at and above the base of the dorsum of the penis shaft.
5. In addition to dividing the suspensory ligaments it may also be necessary to divide any attachment of the penis shaft to the surrounding tissue which may restrict the extension of the penis
6. The importance of post-op care must be emphasized. This has been discussed in detail in a previous discussion

In my experience, the average increase in length is about 1 inch, although I have patients with increase of as much as 2 1/2 inches and as little as 1/4 inch or less.
I never tell the patient how much lengthening to expect because I simply do not know before the surgery.

Hope this is helpful. For more questions, please write in this forum or to me directly This email address is being protected from spambots. You need JavaScript enabled to view it.

SouthBay612 wrote: Results are here - although it has been a while since I've gone through and measured everything. It certainly hasn't gotten any smaller, though. If anything, a tad larger.

FL: 3.5" pre-op, 4.7" post-op and post-stretching/hanging for 3 months--> 1.2"
FG: 3" pre-op, 4.5" post-op (technically 2.9 and 4.4 but I'm rounding) --> 1.5" gain

EL: 5" pre-op, 5.3" post-op and post-stretching/hanging for 3 months - 0.3" gain
EG:4" pre-op, 5" post-op --> 1" gain

Update on LENGTH measurements today (still about 6 months post-op): with a very firm erection, I measured 5.7" in erect length... which is a full 0.7" in gain. It has seemed longer lately but I just haven't gotten around to taking updated measurements in a while, but I saw @PhalloplasticSurgeon_DrLiu 's post about lig cut expectations so figured I would update my measurements. The ones I posted earlier this week were older. Erection quality obviously matters here but 0.7" exceeds my expectations from the lig cut surgery, as some have said this surgery has no impact to erect length at all. As a reminder I had no EL growth at first, but with consistent hanging/stretching I have been able to achieve a fairly significant (at least in my eyes) gain.

Flaccid, I'm now measuring 4.9" - this increase is also assumingly from consistent hanging/stretching and makes sense given the erect length increase.

Here are my latest stats:
FL: 3.5" pre-op, 4.9" post-op and post-stretching/hanging for 3 months--> 1.4"
FG: 3" pre-op, 4.5" post-op (technically 2.9 and 4.4 but I'm rounding) --> 1.5" gain

EL: 5" pre-op, 5.7" post-op and post-stretching/hanging for 3 months --> 0.7" gain
EG:4" pre-op, 5" post-op --> 1" gain

Hi South Bay,

I live in San Jose and have been following your thread for a long time now, it's been extremely informative and educational. Wanted to thank you for sharing all that you have. Seriously, I wish more shared their experiences, it helps calm the nerves that's for damn sure.

So.. I'm having the same procedure you had and it's scheduled for next week. Ligs will be cut and I will be getting an alloderm graft with a few injections to top it off.

I'm really nervous and a little spooked tbh. I just picked up all the medications and went back over the instructional PDF, it's intense.

Going to rapid fire some questions if that's ok...I know you must be inundated with messages, so I apologize in advance..
Is there anything you regret from this procedure? It's a lot of money as well (even though that's the least of my concerns). Is the angle of the erection now different? Did you lose any sensitivity? Any problems now achieving/keeping an erection? Skin color changes? How difficult was it to stick to the instructions? (wrapping, cleaning, etc). Is it possible to hang with a noose or something following the procedure?(I have a vacuum hanger, a noose stretcher that attaches to the knee and an extender that grips on the glans only). I'm also really worried about becoming too large for my wife. Was that a concern and have you had trouble with your partner?
My current EG is ~5.6" (natural girth prob closer to 5.3" since I still have a tiny bit of HA filler left). My current EL is ~6.75" bone pressed, ~6.4" non-bone pressed (saw that this procedure doesn't really do anything for EL unless you hang often which I plan on doing. Your EL gains were remarkable imo). Last question.. how is your surgical scar? Is it very noticable? How high is it? I'm hoping it's low enough around hair or something. I want to be able to go to the pool/beach with my family and friends and not have that stick out.. pretty worried about that
I ordered silicone scar sheets just in case

Anyways, thank you again for everything you've shared. Trying to keep my nerves calm as the procedure gets closer.

Cheers

Hi @Tyl2704 - congrats on your procedure! See below for my responses:

Is there anything you regret from this procedure? It's a lot of money as well (even though that's the least of my concerns).

In my recovery thread you'll see that I did a little filler touch up a few months after the procedure. At that point I opted for a bit of extra filler just for some additional size all around. I wish I wouldn't have done that because that created some additional irregularities/nodules which I'm still working on correcting. I wish I would have just done the minor filler touchup and left it there. The results from the Alloderm + lig cut were great. No regrets from that.

Is the angle of the erection now different?
No different. Dr. Liu leaves about 10% of the ligament so the angle stays in tact. I've always 'biased' leftward and I still bias leftward.

Did you lose any sensitivity?
No loss in sensitivity.

Any problems now achieving/keeping an erection?
None at all. If anything it's better because I don't have any size anxiety like I had before.

Skin color changes?
Not really... the skin was more reddish at first because of swelling.

How difficult was it to stick to the instructions? (wrapping, cleaning, etc).
Not difficult, but it does get annoying to be wrapped up for so long, mostly just because you have a new penis and you want to stare at it in awe. lol. There were some diet instructions that I didn't follow after speaking with Dr. Liu. He said what's most important is getting a lot of protein, which I already do. The other stuff isn't as important.

Showering is a bit of a pain with the wrap. After a couple of weeks I ended up just taking my bandage off for my showers and then re-wrapping after.

Is it possible to hang with a noose or something following the procedure? (I have a vacuum hanger, a noose stretcher that attaches to the knee and an extender that grips on the glans only).
No noose and no vacuums allowed! It's not good for the Alloderm, especially at first. Dr. Liu will give you a weighted sleeve to use after your 4-5 week initial healing period.

I'm also really worried about becoming too large for my wife. Was that a concern and have you had trouble with your partner?
My current EG is ~5.6" (natural girth prob closer to 5.3" since I still have a tiny bit of HA filler left). My current EL is ~6.75" bone pressed, ~6.4" non-bone pressed (saw that this procedure doesn't really do anything for EL unless you hang often which I plan on doing. Your EL gains were remarkable imo).
I started off quite a bit smaller than you so it wasn't a concern of mine. @Dream has done a bit of an analysis on ideal sizing for women so you should check out his posts.

Last question.. how is your surgical scar? Is it very noticable? How high is it? I'm hoping it's low enough around hair or something. I want to be able to go to the pool/beach with my family and friends and not have that stick out.. pretty worried about that
Just be careful with your manual stretching at first. Dr. Liu will give you instructions. I pulled too hard manually and put too much tension on my scar within the first couple weeks and this caused it to stretch. It is a "Y" shape when doing the lig cut and the "V" portion may be noticeable. Eventually scars turn to a thin white line and are barely noticeable, and the silicone strips will help. I actually use some of those as well. If I'm ever getting with someone new and want to hide it completely I apply a tiny bit of Dermablend Quick-Fix body makeup and it completely covers it up. Keep in mind I just had mine revised from the first procedure because it was stretched out so it's freshly red again.

Best of luck on your procedure and let me know if you have any questions after!

Hi SouthBay612,

Thanks for the feedback. I also have been following your progress. Have you gain anymore Erect length since your last update?
I believe you had gained 0.7 Inch in Erect length last time I check.
Anyway, I am also thinking of getting my lig cut. I am just saving money to do it soon.

Take care

Thanks southbay!
Really appreciate taking the time to answer all of those questions. That did help put my mind at ease a bit

It looks like you and others that have got alloderm gained on average 1" of girth. That would put me right around 6.5, mby slightly less as the HA disappears. Reading through the thread from @Dream ...I may be pushing it. Will chat with my wife more about this. Wondering if it might be an issue.

Thank you again!

@Hobby19cm no further gains but I’ve moved to a maintenance routine for hanging and stretching so I wouldn’t expect anymore at this point.

@Dream would 6.5" girth be a negative in your opinion?

PSA

I've been enjoying connecting with everyone who is interested in my procedure and for those also undergoing surgery with Dr. Liu. I get really busy during the week so would prefer if everyone could post questions directly to the thread here and not via private message. I'd like to keep PMs reserved for only the most sensitive stuff. Otherwise, if you have a question please just ask it here (or even better, you can tag me on your own recovery thread!!) That way the info can be a resource for others in the future.

Also, I'm not a medical professional. I can share my own experience but if you have any medical questions/concerns please direct them to Dr. Liu or whatever doctor you are working with.

Thanks all for your understanding!

Hi all - it's been a little while since I've given an update. I've done a few things now so let me catch everyone up. All of my work has been done by @PhalloplasticSurgeon_DrLiu

Pre-surgery:
FL: 3.5"
FG: 3"
EL: 5"
EG: 4"

Original surgery - June 8, 2023 - This was Alloderm + a little fat in the shaft and some Bellafill + Voluma in the glans. I also had my ligament cut. I experienced significant gains in girth and flaccid length, but no gains in erect length at first. Dr. Liu gave me a 'weighted vest' and with consistent use (2-3 hours a day for a few months) I did also experience erect length gain.

FL: 4.5"
FG: 4.5"
EL: 5" ... but after a few months of hanging EL became 5.3"
EG: 5"


Bellafill - Aug 14, 2023 - I had an area that was a little uneven from the original procedure and a little ring around my base, likely caused by wrapping the bandage too tight and the fat getting clumped up, so I did a PMMA touch-up. I also opted for a little extra augmentation because why not! It was 9cc total, including 2cc (mixed w/ Voluma) in glans. This went well but I did get some additional unevenness from the PMMA and on October 26, 2023 I got an additional 8cc Bellafill in the shaft. After giving the Bellafill a few months to let the bovine collagen gel carrier dissolve and for more collagen to form I can report I am quite pleased with the end results and [at least for now] my journey is complete.

Today:
FL: 5" -- 1.5" gain total
FG: 4.75" -- 1.75" gain total
EL: 5.7" ... note I have continued hanging about 30-60 minutes per day and I also do manual stretching -- 0.7" gain total
EG: 5.5" -- 1.5" gain total

General observations
- My penis looked more smooth after the surgery and before getting PMMA, but I actually think it looks more natural now since natural penises tend to have little bumps under the skin
- I had my scar revised when I got my Bellafill so had to start the healing process over. It's healing up but it is still red. Eventually it will turn white and for now if I'm wanting to hide it I use a tiny bit of dermablend and it works like a charm
- I'm quite satisfied with the current girth and don't think I would want to go any bigger. It's a significant jump from where I started and anything more would probably be trading off aesthetics
- Bellafill is interesting and I think folks really need to be patient with it. The bovine collagen gel stays for months (3-6 months) before it dissolves and is replaced with collagen, unlike Linneasafe and others. While this isn't necessarily a bad thing, it can cause some unevenness or irregularities until the carrier gel dissolves so patience is a virtue here.
- I have now had Alloderm, fat, PMMA, and PMMA+HA mix, along with my lig cut. While that may seem like a lot to some folks, everyone is different. I've had the benefit of working with a doctor who does it all, so I've been able to continue progress in increments, with whatever 'tool' would fit my goals best at the time. I actually think the mix of Alloderm with additional PMMA augmentation is what has allowed me to achieve such significant girth gains (1.5") while still looking mostly natural, IMO.

The great
- I have the penis I've always wanted... it's frankly surpassed my expectations. I started off pretty thin and recently one of my partners stopped me in the act and said "I forgot how thick you are" ... win!!!
- While yes, I can always look at it and point out areas that I don't think look 100% natural, I actually don't think the average person could tell I've had work done. I've never been questioned.
- I continue to think very highly of Dr. Liu and his team. I am frankly not the most patient person in the world and along this journey I've gotten anxious at times. They've always been available to answer my questions and I've always felt like I could trust them.

The not so great
- Every single procedure has come with its own issues and irregularities. As I've said before this is always a journey and patience is required. MOST issues (unevenness, nodules, firm areas, etc.) can be addressed with minor treatments, but it typically has to be addressed over time and multiple doctor visits.
- I still have little nodules, and one area where my Alloderm is too firm. I've done a round of kenalog and will likely just give it time now to see what improves on its own. Neither of these issues are particularly concerning for me because aesthetic impact is minimal.
- My scar is lower than most (because of my anatomy) and the revision didn't really make it any better - it just started the healing process over again. It'll probably be another 9-12 months before it's totally flat and white.

OKAY - that's it for now. Hope this is helpful. As always feel free to let me know if there are any questions. I prefer you do it on the forum here so it can be a bank of info for all to see. PMs are welcome for those who have recently completed a procedure w/ Dr. Liu and need some extra moral support from someone else who has been through it

Photos attached