PhalloBoards - An Online Community to Discuss Penile Girth Enhancement

EZdoesit wrote: Hey Doctor, I am currently interested in this because I have had a couple rounds of PMMA with Avanti, however the gains have slowly diminished. I would love to have another round done where I can get a big jump in terms of gains and am torn between getting more PMMA or going the HA route on top of existing PMMA like Justn8 has had with great results. Can you advice on this? If I were to add your blend, would it be I have to get a top up of 10ML(which I would opt for) every 2-4 years? Thanks for your input.

I can't speak for the doctor but with my case we opted for now to only use HA (in addition to PRP and some other things) just to avoid any possible issues with the existing PMMA. I may be totally off base or incorrect but I feel like HA only has avoided causing any fibrosis, which may have happened with more stimulatory filler like Radiesse. Considering the size I wanted and how much I've received, this likely was the best route and I've been very happy.

The only reason I bring that up is because I know many guys who keep getting PMMA seem to hit a wall of sorts where it's difficult to add more and move a cannula around. I believe that can happen with any sphere filler but hopefully the doc will chime in and correct me if I'm mistaken.

I would imagine you would need some kind of filler after you heal up to get back a normal shape.

I guess maybe the temporary ones like HA filler or Radiesse. After seeing Alias9 results I'm going to hit up Avanti Derma with the next two procedures using Linneasafe PMMA.

@Girther and @Skeptical_One Here's more information about the origin of the Hybrid Blend.

Girther wrote: @Skeptical_One I’m rather curious to hear your unbiased personal thoughts on this combination of Radiesse plus HA together as the enhancement approach? To my knowledge, not too many practitioners do this combo. What are your views on the combination along with any concerns you may have with Radiesse and HA together?

I feel that if both fillers are already viable fillers by themselves (i.e. shown to work in the penis, FDA approved, etc.), then mixing them may have benefits that were previously not well understood or known. I would argue it's the most experimental and cutting edge in terms of innovation in male injectable phalloplasty, because there is a thought-process that could suggest mixing two types of fillers like Radiesse (which induce collagen growth) and Hyaluronic Acid (which requires hydration), that each can benefit from each other's strengths and may serve to be a more robust filler.

Many guys have had one filler first done, and later had other fillers placed over what was already a foundation of a prior filler, so it isn't a stretch to say mixing them would necessarily be an issue. My concern is if the mixtures don't improve the overall result, which isn't in the best interest of the Doctor if he intends on promoting it (which is why I suspect there may be some merit). Furthermore, Dr. Leonardo has seemingly been getting good results and he ( @LeonardoMedicine ) can perhaps chime in more on the efficacy of combining (regulatory-body approved fillers) for girth enhancement.

@Skeptical_One I’m rather curious to hear your unbiased personal thoughts on this combination of Radiesse plus HA together as the enhancement approach? To my knowledge, not too many practitioners do this combo. What are your views on the combination along with any concerns you may have with Radiesse and HA together?

@lurkin is right, by submitting photos grants the user Lifetime Premium Membership (at no cost), so @atxguy should be able to see his attachments now.

I also implore @atxguy to continue his discussion in a new topic so that we don't unintentionally steer the topic off course, this is still Member "uncuthero's" original thread after all. Respectfully, thanks.

And for newcomers to this thread, atxguy had work done by a Loria-affiliated Surgeon (this is the literal opposite of an accolade or accomplishment), and on this surgeon's own website talks about the infamous "proprietary filler" -- a strong indication that we're dealing with a medical device that as far as I know has no FDA clearance or approval (dermal fillers/soft tissue fillers are classified as medical devices by the FDA). I mean, isn't this illegal, never mind the ethics of it all? By all accounts, there is strong reason to believe this magical formula of a filler contains silicone oil, which is regarded as a high-risk and ineffective filler for girth enhancement by both the general conensus of the PhalloBoards Community as well as the unanimous warning(s) by all PhalloBoards Sponsors (as well as non-Sponsors too). The idea that it being patented gives it any merit is laughable. But hey, don't take my word for it, read up on atxguy's posts (click his username, scroll through his posts/topics), who I also hope posts his own Report in the near future so more men can see the dangers of using silicone oil in male enhancement.

Nodules can happen regardless of filler, but silicone oil presents additional complications; with PMMA (or most acceptable fillers for girth), I usually consider surgical removal of any of nodules to be a true last resort, but with silicone oil, removal is a legitimate 1st option among treatment considerations depending on the surgeon who's repairing the work done. Not all those who get silicone are condemned to a fate of permanent aesthetic irregularity or inevitable complication (be it short or long-term), but the risks are not worth the reward, especially when other fillers out there present so much higher efficacy.

Again, I don't wish to steer or hijack the original poster's Reporting here, so I ask this discussion be carried over into a new topic if atxguy wishes to continue discussing his matters with us, it would be most appreciated, and it will be easier for us to provide advice and insight all in one place instead of hopping around different topics. Thanks.


*LATE EDIT: It seems Loria and Dellinger (and others) may be in a legal dispute according to some searches, but I can't tell for exactly what yet. What seems strange is that Dr. Dellinger still refers to his use of a "proprietary filler" and I wonder if that's just oversight by his website administrator, or that perhaps he's created his own variation of this garbage proprietary filler and maybe Loria is after him (and others) in litigation -->
See here: https://dockets.justia.com/docket/florida/flsdce/9:2024cv80198/662585 , as well as a few other links when doing a simple search of both Dellinger and Loria's names together, but all are seemingly paywalled unfortunately.
I would normally look into it and would have shared all the details with the Forum, but short of it being Loria losing his license and/or going to jail, I'm torn on giving him any press beyond that (on one hand it's pertinent to the topic of this website and on the other hand, like I said before, short of it being genuinely good news, i.e. JUSTICE, then I would rather just keep that taint off the Forums.
Suffice to say, I cannot say the current state of Loria and his Affiliates and if there are more than one version of a "proprietary filler" on the market, and if you see this term, stay FAR FAR away (although this should not be confused with "proprietary method or technique").
If you'd like a shortlist of injectables you can trust, just consider Medical Grade Hyaluronic Acid (HA), PMMA (known as Bellafill in the US, and Linnea Safe in Mexico to only be trusted with Avanti Derma, as there are silicone injectors in Tijuana who falsely claim to be using PMMA), Radiesse, Ellanse (found in Europe and Mexico), and Fat Transfers (FFTs), when performed by a trusted Practitioner.

How does a newly girth enhanced penis feel?

It depends on who performed the procedure and their technique. I’ve had a few patients come to me after having been augmented superficially with HA filler. It felt squishy and appeared like a large blister on the dorsum of the penis.

I’ve used HA, HA + PRP, Radiesse, and Radiesse + HA injected deep below the superficial fascia. The texture is more solid and not squishy. Some of my clients have had the variety of choices but tend to favor the Radiesse + HA blend. It feels dense and heavy like their own flesh. On occasion, there may be a firm palpable nodule that develops. It can soften over time without intervention or may be spot dissolved. Generally, my augmentation patients report improved sensitivity since their penis fits tighter in a mouth, vagina, anus, or hand.



How long can you wait before resuming intimacy or strenuous activity?

For the best results, I recommend 2 weeks of abstinence from masturbation, sex, and lower body cardio. I want the filler to settle into place during the time frame without too much repetitive forces acting on the product. Against my advice some patients have tested it out after only 1 week without issue, others developed contour irregularities.

One patient was so proud of his new bulge he wore his tight fitting cycling shorts and went for a 50km ride. Most of his filler settled to the right side of his penis. I refilled his left side. It looked great but he didn’t budget for this unplanned procedure. 2 weeks after filling, he was able to cycle without product displacement.

Against my advice one patient had unprotected vaginal intercourse after 3 days. He developed an infection because bacteria had seeded into the injection sites since they had not closed fully. I had to dissolve and drain an abscess, but he recovered after completing a course of antibiotics.

Patients are allowed to work out after 3 days. Strenuous activity prior to 3 days may lead to increased swelling. After 3 days exercise should be limited to upper body workouts. Lower extremity work outs should not be too repetitive during this time frame.

I tell my patients this could be the hardest 2 weeks of their life. Everyone is so eager to put their augmented penis to use but restraint and discipline leads to better outcomes.



Can you gain length from girth injections?

Length increase after girth enhancement is more apparent in those who suffer from retractions and have been pretreated with GROTOX® (penile Botox). Flaccid length can improve as there is more weight allowing the penis to hang especially if the glans is augmented with filler.



Any risk of Filler Migration?

Yes, especially if one does not adhere to the 2 weeks of abstinence from masturbation, intercourse, or lower body cardio. Please refer to my discussion from the earlier question.

The product is ideally placed deep sandwiched between the superficial and deep fascia. Since I use a cannula to administer the product, there is a chance that the product may backtrack to the superficial layer through the tunnel created by the cannula. There is also a chance the cannula tip may end up a little superficial since it is a blind technique. Although I aim deep, I cannot guarantee every single drop of filler is going to be placed and maintained in its ideal location. In the event of superficial placement or backtracking into the superficial layer, the product may appear as a hard lump/nodule that can be spot dissolved with hyaluronidase. This goes for the Radiesse-HA blend as well.

After 2 weeks of abstinence from masturbation, intercourse, or lower body cardio, large scale filler migration is not as likely. There could be contour irregularities that develop from the breakdown of product over time or spot filler migration. These can be treated with either a spot dissolve or filler top up.



Granulomas: What are they, what are the risks, and how are they treated?

A granuloma is a small, localized cluster of immune cells that forms in response to inflammation or infection. They are essentially white blood cells that "wall off" substances that the body does not recognize as itself like bacteria or foreign objects. Granulomas are formed to protect the rest of the body from the foreign substances.

Certain fillers are more prone to granuloma formation like PLLA (Sculptra) and although rare, HA Vycross products (Voluma). PLLA relies on an inflammatory response to stimulate collagen production. PLLA are irregularly shaped spikey complexes that trigger immune cells.

Radiesse, on the other hand, are smooth microspheres that fly under the immune response radar. That’s why I enjoy using Radiesse for collagen and elastin production. Radiesse can form nodules, hard lumps, that tend to be self-limiting. This means that over time they can soften and become irrelevant. They can also be dispersed by normal saline and massage. The Radiesse-HA hybrid can be dissolved by Hyaluronidase.

Granulomas tend to be persistent scars. One treatment recommendation requires injection of a cocktail of 2 steroids and 5-FU, an antineoplastic agent. Steroids can break down collagen fibers, reduce inflammation, and weaken the immune response. 5-FU inhibits the proliferation of fibroblasts, the main cell mediators of scar formation. If injection therapy fails, granulomas must be excised leaving the patient with incisional scars.

Product choice, injection depth (deeper is better), and an aseptic/sterile technique (reduce bacterial load) are key factors in reducing the chances of Granuloma formation.



-Dr. Leonardo

I had 20 syringes of (radiesse + volux, and Revanesse Versa+ near the circumcision scar) about 3 weeks ago and will be going back for a touch up next week. There are a few things I want to change and would love some guidance on how best to do this. Here are my concerns:

1) My penis was perfectly straight before adding filler but now curves slightly to one side. I'm guessing this is is a result of what appears to be extra filler on one side of my penis. Is it possible this filler "moved" from one side to the other or was it injected this way? Should I dissolve some of the filler on one side or just add more to the other?

2) Related to (1), there is an unsightly lump of filler on one side near the tip when flacid. This is most pronounced when my penis is retracted and is quite embarrassing. I'm wondering if this is another reason to dissolve the filler on one side or if adding more to the other side will balance it out when combined with some other change? Note that the practitioner used Revanesse Versa+ near the tip.

3) Also related to (1) and (2), there is a section of my penis near the tip that appears to be the original girth when erect. This is more obvious on the left side (when looking down at my own penis). I think this is what makes the result look the least natural. What should be done about this?

4) There is a gap between the start of the filler and the base of my penis when fully erect (especially when pulling the shaft forward). Again, this looks really strange. Should I ask for additional filler to be put here? Is it possible the filler was initially all the way to the base but then forced towards the tip when my penis was contracted.

Also worth noting I am definitely a grower and I'm wondering if this has resulted in some of the gaps near the base and tip. I was not fully hard during the procedure (the practitioner only injected a small amount of trimix) so perhaps the length of my penis was not completely obvious at the time.

Thanks in advance!

Longjourney wrote: So hard to figure out which product is best overall. Ellanse or PMMA. Pros and cons to both. I’m likely getting a procedure in less than a month and need to decide quickly. Spent years thinking about it and recently rejoined this site to read up on all the progress reports and view pics. From my visual observations the ellanse looks better in most cases not all. Seems like both have had great outcomes. The issue is not having follow ups from those 5-10 years later to find out. My last consultation it was suggested 10 cc ellanse but if I want PMMA it would be more filler for same result. Price would be very similar not enough to be a consideration. Aesthetics are my main focus. I want it to be as natural looking and feeling as possible. Any input would be greatly appreciated as I’m looking at flights today and need to make my final decision soon.

If there was a "best overall," it would almost certainly be endorsed universally by most quality practitioners. The reality is that each product and/or procedure have their pros & cons, and a lot of why a Practitioner may choose one over another is a matter of preference, risk aversion, and/or prior experience/training. Couple this reality with men (prospective patients) having their own preferences (temporary, long-term temporary, and permanent) plus risk aversion, it really comes down to doing your homework, having consultations if & when possible, setting realistic goals, and being sure you are prepared logistically & financially for at least the first year or two post-op.

Ellanse is certainly an intriguing filler among the options available. It seems to provide a robust collagen production akin to PMMA, without the permanency of the microspheres that were there to induce the neocollagenesis in the first place. Having long-term gains (maybe 5 or 10 year maintenance versus annual maintenance with fillers like Hyaluronic Acid / H.A.) sounds great, especially when the PCL microspheres should eventually breakdown & dissipate (unlike PMMA, which remains there for a lifetime).

On paper this seems like it could be the "best overall," but I have my reservations. I personally believe it's tied amongst the best, but I can't crown it 1st Place (like I can't crown any of the others), for two reasons relevant to the vast majority of this readership:
(1) it is not available or FDA approved in the United States, thus requiring travel (and with subsequent appointments, increased overall costs & logistical complexity); and
(2) its longevity of the filler was sorely misjudged by the Company (they had 1, 2, 3, and 4 Year versions, but it seems like irrespective of your choice, the collagen stays around at least 4-5 years+, forcing them to take the 1 and 2 Year iterations off the shelves). This huge discrepancy by its own manufacturer regarding the lifetime/expiration of the product does give me pause (and may be what has played a role in the delays involving FDA approval, although I don't know that for sure, purely speculation!).

All that said, as far as I can recall, Ellanse for use in the penis started popping up on the PhalloBoards in 2017 (the only place I know of, especially in that year, that would have had substantiated claims of its use) and like I said in a prior post, I can count on one hand the number of men who claim to have lost "some" (not all) of their size since, and I don't know if any in that handful I speak of had any affirmative photos as clear proof.

Given its history, despite the manufacturer's missteps (none of which I found to be anymore of a risk to the patient in terms of penis enlargement when compared to all other methods approved by the PhalloBoards), I believe Ellanse is an excellent dermal filler option for girth enhancement, including Americans who are willing to travel abroad (available in Mexico and Europe). Whether it is better or worse than PMMA (Bellafill or Linnea Safe), Fat Transfer (FFT), Hyaluronic Acid (H.A.), Radiesse (or Radiesse + H.A.), or Dermal Grafts (Alloderm), comes down to preference, discretion, risk aversion, budget, and logistics.

In summary, if any of the following bullet-points don't apply (or matter) to you, than Ellanse is a viable, quality option for girth gains.

• If you are uncircumcised, I would not recommend Ellanse.
• If you require travel to the few trusted places offering Ellanse at present time, and this is not feasible for any reason (e.g. alibis, taking necessary time off, etc.), I also would not recommend Ellanse.
• Despite its designation as long-term temporary, anyone who believes it's temporary or somewhat reversible like Hyaluronic Acid (HA) in the event they really are unhappy with their outcome, the product's life expectancy is undetermined and not recommended to those who are hyper critical of their results, especially in terms of aesthetics. Further elaboration: if you get HA and are unhappy, you at least know that most or all can be reversed, and at worst, won't be longer than 2 years before your penis is "reset" back to its pre-op form; the same cannot be said for Ellanse, despite being designated as a non-permanent filler by its manufacturer.

If the aforementioned bullet-points are of no issue, you can't go wrong with selecting Ellanse, and remains very popular and efficacious as far as Progress Reports are concerned. I hope that helps

Hi ! Sorry for the late reply. I am still overall extremely satisfied. I came back to the office 1 month after to fix a small nodule and even out the shape. Results were even better second time.However my body seems to absorb the product very quickly since its probably 90% gone already, within 5 months. There are some imperfections due to the first injection in which there was radiesse and I have a couple small nodules and irregularities, but still I have much more confidence than I used to. I will probably go back to Dr. Leonardo.

HarmonyCA or Ellanse are my top 2 picks right now for my first filler. Got the money and finally have time away from work. Hoping to get one done next week.

Leonardo Medecine in Toronto offers a hybrid blend of Radiesse (supports collagen growth) and HA. Sounds very similar to HarmonyCA. I'd like to know what's the difference between HarmonyCA and Dr. Leonardos hybrid blend.

It feels like flesh, not squishy. I don’t work with PMMA but I’ve had PMMA patients come in. I prefer the texture of my blend over PMMA. Patients sometime ask to try HA only after having received the blend and they end up preferring the blend.

@Dr_Leonardo,
How does your product feel when erect? Is it hard or squishy like HA. How dos it compare to PMMA?

Woodworking714 wrote:

LeonardoMedicine wrote: My secret sauce has gone through various blends and I’m happy with my current recipe. I don’t know how it will compare to premixed products.

I would like to use my blend in NYC. It’s just a matter of my work partner being able to purchase product at the best prices.

Dr L - do you also use your same blend for Glans enhancement? Do you have any before after for glans increase? Also is it 2 year plus treatment? Thanks again - your work looks AMAZING

Not to speak for someone but I have had him do my glans a few times. No Radiesse in the glans. He'll only do HA to my knowledge. He's also done PRP in it in my case.

I'm sure he can shed more light on what he has done in terms of glans enlargement or enhancement @LeonardoMedicine

How long does Radiesse last for? Do you also do PMMA or the permanent. options?