PhalloBoards - An Online Community to Discuss Penile Girth Enhancement

ryebread77 wrote: Update: 12/17/2022

So it has been a week since I got 5 ML of Bellafill. Most of the bruising is gone but still tender. I massaged and took hot baths as much as possible but it seems like I have about four nodules under the skin which is tender as well. What do I do? Do I need to go back to Dr. Carney? I may wait to see if it goes away over the next few weeks. Thoughts?

Nodules are common with fillers that work through neocollagenesis (e.g. Bellafill, Linnea Safe, Ellanse, Radiesse), due to some unpredictability inherent to injecting larger volumes. They are completely benign and harmless, but can sometimes be an aesthetic nuisance. Some tend to be small and improve over time on their own, others are simply too palpable and will require a future intervention to resolve.

For this reason, most men wait 4-6 weeks, and if there are no improvements, can see their Doctor to have it corrected.

ou812 wrote: Thanks for sharing your experience so far. Did he actually use 60 cc of fat along with the surgimend? That sounds like a lot seeing that most injectable procedures are in the 5ml to 20 ml range. Any idea of the thickness of the surgimend alone?

There are different volumes injected based on the type of filler.

For example, you have fillers that are in it of themselves the majority contributor of your new-found girth, like fat transfers and silicone oil (note* I do not recommend silicone oil in the penis, however fat transfers are fine). Because the material itself is largely responsible for your gains, you'll find that higher volumes will be injected to reach the desired goal. This is why you typically see 20cc-80cc's involved in fat transfers, silicone oil, and other fillers that are the "girth" themselves.

Then on the other hand you have fillers that induce significant collagen production (e.g. PMMA, Ellanse, Radiesse), and that collagen is largely what makes up your new-found girth. For this reason, you only need to inject 5-20 mL of product because much of your acquired girth will be from collagen creation and NOT the filler itself. For example, PMMA's microspheres themselves aren't what you grab when you're holding your thickened shaft; instead, you are feeling a special type of collagen that was triggered by the presence of those PMMA microspheres.

I hope that makes sense? Some fillers ARE your gains, while others TRIGGER your gains, and this leads to a discrepancy in how much is needed to get similar results. I'll have to keep brainstorming to see if I can simplify this further in follow-up topics.

Skeptical_One wrote:

hotdirt9114 wrote: Is Silikon oil a bad thing? This is what Medical Man Cave said to me:

Our procedure produces permanent results. No need to come back in for top ups. We do not use a permanent filler. The oil based silicon that we use is replaced with naturally produced Collagen. After 30 day the oil based silicon will be flushed out of your body, leaving you with only the naturally produced collagen. This is what produces the permanent gain in girth. The procedure will not affect your ability to get an erection or change any level of sensation in the penis. Everything will look even , there will not be a spongy or lumpy feel or look to your penis. After the collagen fully forms, you will see an increase of about ¾” in girth and you may see a small increase in length at the head of the penis. The shaft and head of the penis will look even, due to the even distribution of the injected product and collagen growth.

This is unfortunate. I was hoping we could have a Colorado-based Sponsor here but upon learning this I'm afraid I won't be reaching out.

Silicone oil is deceptive in that it can certainly provide instantaneous and aesthetically-pleasing girth, but can come with serious issues if & when complications arise. Also, given all the other relatively safer filler options available (PMMA, Ellanse, HA, Radiesse, Renuva, and Fat), why even play with fire??

And as far as Mancave's assertion that the silicone would be "replaced" with you collagen, that's simply untrue. Collagen may develop, sure, but the silicone isn't going anywhere and will remain in your penis. I'm troubled they are being so inaccurate here.

That thing about the silicone being "flushed" out of the body is intriguing, but totally unbelievable. At the same time, it makes me wonder if anyone came across such claims before?

Here we have someone claiming that the silicone will be "replaced" by collagen, and the silicone will be flushed out of the body. As far as I know, silicone is one of the substances that are likely to be able to transition elsewhere in the body, but it cannot leave the body.

Silicone breast implants vs saline implants are a perfect example. If the saline implant is ruptured, it will indeed leave the body, but this is absolutely not the case with silicone implants. Because of how common silicone implants are, and having been around so long, it is well-known how silicone reacts in the body.

hotdirt9114 wrote: Is Silikon oil a bad thing? This is what Medical Man Cave said to me:

Our procedure produces permanent results. No need to come back in for top ups. We do not use a permanent filler. The oil based silicon that we use is replaced with naturally produced Collagen. After 30 day the oil based silicon will be flushed out of your body, leaving you with only the naturally produced collagen. This is what produces the permanent gain in girth. The procedure will not affect your ability to get an erection or change any level of sensation in the penis. Everything will look even , there will not be a spongy or lumpy feel or look to your penis. After the collagen fully forms, you will see an increase of about ¾” in girth and you may see a small increase in length at the head of the penis. The shaft and head of the penis will look even, due to the even distribution of the injected product and collagen growth.

This is unfortunate. I was hoping we could have a Colorado-based Sponsor here but upon learning this I'm afraid I won't be reaching out.

Silicone oil is deceptive in that it can certainly provide instantaneous and aesthetically-pleasing girth, but can come with serious issues if & when complications arise. Also, given all the other relatively safer filler options available (PMMA, Ellanse, HA, Radiesse, Renuva, and Fat), why even play with fire??

And as far as Mancave's assertion that the silicone would be "replaced" with you collagen, that's simply untrue. Collagen may develop, sure, but the silicone isn't going anywhere and will remain in your penis. I'm troubled they are being so inaccurate here.

Screen2584 wrote:

Skeptical_One wrote: Honestly if you are looking for a filler without the surgical factor (and the harvesting of your own tissue), then virtually any dermal filler would suffice, including PMMA, Ellanse, Renuva, Radiesse, and Hyaluronic Acid (HA).

The advantages to dermal grafts like Alloderm is that they alleviate known irregularities posed by fillers, like nodules and lumps, so having them used as a filler takes away from that strength. I mean don't get me wrong, I suppose it could work in a filler form, but how well I don't know.

The brand Surgimend is the dermal graft matrix adopted by the resident American Plastic Surgeon Sponsors of this site, and is pretty much is like an Alloderm.

So if I understand you correctly, then dermal grafts are less likely to cause irregularities, compared to fillers? That is encouraging for me to hear who got dermal fat graft 11 weeks ago.

Not exactly. The dermal grafts matrices I was referring to were the synthetic kinds (e.g. Surgimend, Alloderm, Belladerm). These are "synthetic" in that they are derived from human or animal dermis. A dermal fat graft taken directly from the host (like from under the buttocks) may not be as precision-cut when compared to something made in a lab, and won't necessarily be free from irregularities.

Screen2584 wrote: I assume it would be allowed to link to them because they are a sponsor of the board? www.calibreclinic.com.au/product-options

Of course. Not only that, but virtually any link, article, or study that is relevant to the topic can be posted, Sponsor or not. This forum is meant to expand the knowledge database of this field and any credible information ought to be shared.

Skeptical_One wrote: Honestly if you are looking for a filler without the surgical factor (and the harvesting of your own tissue), then virtually any dermal filler would suffice, including PMMA, Ellanse, Renuva, Radiesse, and Hyaluronic Acid (HA).

The advantages to dermal grafts like Alloderm is that they alleviate known irregularities posed by fillers, like nodules and lumps, so having them used as a filler takes away from that strength. I mean don't get me wrong, I suppose it could work in a filler form, but how well I don't know.

The brand Surgimend is the dermal graft matrix adopted by the resident American Plastic Surgeon Sponsors of this site, and is pretty much is like an Alloderm.

So if I understand you correctly, then dermal grafts are less likely to cause irregularities, compared to fillers? That is encouraging for me to hear who got dermal fat graft 11 weeks ago.

I saw that CALIBRE Clinic in Australia has a very interesting page where they compare different procedures they offer, including different kinds of fillers and dermal fat graft, and I assume it would be allowed to link to them because they are a sponsor of the board? www.calibreclinic.com.au/product-options

When it comes to PPMA, FFT and dermal fat graft they list irregularities as being common, but it seems they are of different kinds.

For PPMA they list: nodules, granulomas, product hardening and lumpiness.

For FFT they list: skin fibrosis, scarring, and possible skin necrosis.

For dermal fat graft they write: "Fat graft has tendency to result in some lumpiness. Scar tissue is material (both at harvest site and where penis is re-stitched), which can result in deformity."

Interestingly, it says that the lumpiness with dermal fat graft can be corrected. I had my dermal fat graft almost 11 weeks ago, and there is a lump at the base of the penis, as I have previously shown. I am very curious if anyone has any idea how CALIBRE Clinic would correct it?

I saw that Dr. Jayson Oates wrote on the forum 04/12/16: "Surgery with lengthening and dermal fat grafts can be successful, with the right surgeon. But is major surgery, very expensive (>$30K in Australia) and has protracted down time."

Interestingly, it seems they do not offer the lengthening procedure anymore, based on their website. That would be interesting to know why?

As for what procedure they seem to prefer, it is obviously hyaluronic acid. Both several years ago and now it is clear it is their preferred procedure. They give it a risk rating of 1/3, compared to 3/3 for PPMA, FFT and dermal fat graft.

They also state that irregularities are "possible" rather than "common". I guess the low-risk rating might partially be because it is reversible?

What they write about complications is: "Nodules may form early or possible scar granulomas at a later date, but can generally be resolved quickly with Hyalase/steroid injections."

Honestly if you are looking for a filler without the surgical factor (and the harvesting of your own tissue), then virtually any dermal filler would suffice, including PMMA, Ellanse, Renuva, Radiesse, and Hyaluronic Acid (HA).

The advantages to dermal grafts like Alloderm is that they alleviate known irregularities posed by fillers, like nodules and lumps, so having them used as a filler takes away from that strength. I mean don't get me wrong, I suppose it could work in a filler form, but how well I don't know.

The brand Surgimend is the dermal graft matrix adopted by the resident American Plastic Surgeon Sponsors of this site, and is pretty much is like an Alloderm.

I won't speak for others but there are a few things that do weigh in favor of the cost-benefit of HA:
(1) It has a strong safety profile. It's used all over in cosmetic medicine with reportedly low complication rates AND happens to be a naturally occurring substance in your own body.
(2) Somewhat reversible. I've read varying degrees to the extent it can be reversed with hyaluronidase, which could be useful for those who need corrections or for those who want to remove it. Fillers that rely on bio-stimulatory effects (Ellanse, PMMA, Radiesse) require more invasive measures to remove.
(3) For some guys, NOT being permanent is attractive. Not all results are equal -- if you aren't happy, you aren't stuck with it forever, nor will you have to worry about any additional measures down the road for removal. Plus, not all experiences are the same -- maybe your partner doesn't like your oversized girth, at least you know in a few years it will return to as it was before. You may think that sounds crazy but I've seen reports of bigger men being turned down quickies (vaginal tearing) and anal (self-explanatory).

In the same breath, obviously top-offs periodically can prove cost-prohibitive for some folks, especially if your body is the type to breakdown fillers quicker. If budget & logistics play a significant role in your long-term plans, then alternative fillers or procedures may make more sense.

A lot of guys have shared that they like the idea of HA being their "first time" filler. This way they can decide whether or not they even like girth enhancement before pursuing any additional appointments. They can also see if HA makes them happy, continuing with it every few years, or if they rather opt for more permanent options instead.

I hope HA guys chime in

Thanks, and I appreciate yours as well.
Interesting enough there was no immediate aftercare after the bellafill injections. No wrapping etc... The only aftercare was doing the pumping starting several days after said injections. On a recent visit I had one syringe of hyerdilute radiesse injected into the shaft to correct a hyperpigmentation. The Dr. said I may also receive a little increase in girth, but it is too early to know that. Interesting enough after that injection my retraction got a lot less which I am very happy with that as well. Gainswave was also done at this last visit but no prp this time.

Tim62411 wrote: I also see a lot of people talking about PMMA Avanti Derma. skeptical_one: if it were you, would you be going the surgical route or filler route if you had BPEL of 6” and erect girth of 5” mid shaft. I know surgery is about the only option for a length increase.

My role here prevents me from "trying to play favorites" or "what would you pick" scenarios, because it will create a conflict-of-interest. That said, I can propose to you pros & cons worth considering, and you make the best judgment given your circumstances.

The appeal of Surgimend in your case is two-fold:
(1) because the dermal graft is precisely cut to size, you won't have to deal with the aesthetic irreuglarities that comes with fillers (e.g. nodules, ridges, bumps). The shaft theoretically should be uniform in contour. It's also a material rich in collagen and will mimic gains achieved with fillers. The only downside here (really depending on who you ask) is that the girth is somewhat capped. In other words, once you have your procedure done, there is no "topping off" or "adding more girth." You'll want to ask the Doctors yourself but I believe gains of 0.5"-1.0" in girth are plausible, and that's quite significant (if you were 5.75" in erect girth, you're effectively Magnum XL).

(2) The two Doctors you are considering (Dr. Liu & Dr. Solomon) can both perform Ligamentolysis (lengthening) and Surgimend on the same day, making logistics and costs much more manageable. The only downside here is that recovery time is typically longer when getting multiple procedures done same day.

In contrast, if you get fillers performed, you'll still have to visit a Surgeon to get ligamentolysis. Fillers are also known to require multiple appointments to achieve desired aesthetics and size, bringing potential costs on par with the surgical route.

Fillers greatest advantage are that they are non-surgical, making them outpatient and recovery quicker. PMMA in particular makes your "skin thicker" as opposed to your "shaft thicker" (like Surgimend would).

Avanti Derma is certainly a great Clinic, and the reason you see a lot of them here is because PMMA dominated the discussion for most of this site's existence, before topics like Ellanse, Radiesse, HA, Renuva, and PRP-Treated FFT became regarded as effective alternatives in the filler discussion today. The good news is that now we have options, which also expands our ability to choose our physician, region, budget, etc.

As for Surgimend, it's the only surgical (*not non-surgical) option I recommend, and most other surgical alternatives are either obsolete or too risky for me to consider.

I hope that helps.

The following are Q&A submissions from Dr. Tsay.

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(1.) How much girth/circumference can you achieve with girth enhancement?
Generally speaking, for our fat transfer patients, we can put upwards of 50cc’s of fat at a time, and patients can expect a 15-25% increase in girth in a single session. For example, if you start with a flaccid circumference of 4 inches, you could reasonably expect to go to 5 inches in circumferential measurement (which can be visually significant).

For dermal fillers, we don’t want to put too much in at one time. I generally like to cap that out between 10-15cc’s per visit. You’re going to get a mild increase in girth in one session. When you build upon that over multiple sessions, I find that 50cc’s (in total) is the sweet spot for the average size penis to really see a significant girth enhancement.


(2.) How long can filler injections take and what kind of anesthesia is used?
This procedure is all done under local anesthesia. I find that this is generally sufficient enough, and we also offer nitrous oxide (i.e. laughing gas) if you are at all nervous prior to coming in. We can also prescribe sedatives that will give you a calming experience throughout the procedure.


(3.) Can girth injections affect the function or sensitivity of the penis? What complications are there to consider?
Some of the common complications are bruising and swelling. This is usually self-limited and lasts 7-10 days. We usually recommend not to use the organ (penis) for at least one week after the procedure. Not only will the penis be sore, but there will be open wounds that need to be completely healed before resuming any sexual activity.


(4.) How does the newly girth enhanced penis feel?
We usually follow up with the procedure about 2-3 weeks afterwards, and at that time the swelling is gone, the bruising is gone, and you can really appreciate the final result from either the fat transfer or dermal filler placement.


(5.) Can you gain length from girth injections?
So the procedures (fat or dermal filler) don’t give you an increase in length per se, but more than half my clients who state they appreciate the increase in girth, also say that their flaccid length increases as well. So that is a beneficial “side effect” of girth enhancement.


(6.) What to expect with a procedure?
At Ageless MD, we offer a variety of different fillers, as well as fat transfer, to enhance the overall girth of your flaccid and erect penis. We also use dermal fillers to enhance and increase the size of the glans.


(7.) Can you tell us more about the use of Platelet Rich Plasma (PRP) to aid gains?
Many of our patients combine their penile enhancement with PRP. When that happens, the PRP has regenerative properties, so it increases the quality of the erection, the duration of the erection, and the sensation around the glans.


(8.) What is your preference of filler and/or brand?
At Ageless MD, we use a variety of different filler products to enhance the girth of your penis. The most obvious would be fat tissue; this involves a fat transfer via miniature liposuction from your lower belly. We process the fat to be micronized, and used in a syringe to be injected all along your shaft to increase your girth. I believe fat is the best filler, assuming you have enough to harvest for girth enhancement.

If you don’t have enough fat, there are a lot of other choices such as fillers made of Hyaluronic Acid (HA). There is also another filler called Radiesse that we use and that’s made of Calcium Hydroxyapatite (CaHa). The reason I like this filler in particular, is that CaHa is found in your bones. What better product that is already naturally occurring in your body, that we can use to put into the penis to mimic a firm, hard erection.

Conceivably a lot - however, I wouldn't advise going overboard with HA filler. Men here, especially those without any work done, have no idea how significant 0.5"-1.0" is in actual girth. The change in volume is quite significant.

If you want a natural end-result with HA, go with practical goals (like I said, try not to exceed 1 inch in circumference). This not only will improve how it feels and looks, but will be much easier to manage if you need future revision work.

To be honest, I think going overboard with any filler increases the risk for aesthetic irregularity. I think the "squishiness" effect is a bit overblown - your natural erect penis still has some "give," much like why dildos are not rock hard like vibrators. Furthermore, overfilling is equally problematic for more permanent fillers like Ellanse or PMMA, where the skin can become "too rubbery" to the touch.

In other words, HA, Fat, Ellanse, Radiesse, Renuva, and PMMA are all viable fillers when (1) medical grade; (2) performed by a qualified & experienced practitioner; and (3) not over-filled, especially not all at once.

I also agree with Hyperbol - regardless of the contour/palpability of your penis, the vast majority of partners are going to dwell on how much it fills them up... if they've seen enough penises they'll know how much variation there is in size, shape, veins, coloration, etc. What COULD raise suspicion is if you over do it. Just like lips, you ever see a woman with disproportionally large lips? The ones who add just enough to plump them up get away just fine, same applies.

On a side note, if you have a significant other who's comfortable with your decision and aesthetics aren't high on your priority list, then sure, you can probably exceed 1 inch, many have. Just be aware of your circumstances when making these decisions.

Honestly any filler will do, it's a matter of communicating your desire to your practitioner on what you're trying to achieve: for example, those with "baseball bat" style penises will likely want most of the filler at the base, tapering upward toward the glans. This can be achieved with Hyaluronic Acid (HA), Radiesse, Renuva, (your own) Fat, Ellanse, or PMMA; in other words, all viable penile fillers.

I'm waiting for Dr. Tsay to provide me with his Restylane Lyft for $5500 for 10 mL Summer 2022 Special banner.

Normally Hyaluronic Acid (HA) injections in the US can start at $7,000-$8,000+.

10 mL is a modest volume, and depending on your length, can provide substantial gains. I try and encourage my Sponsors to issue specials so that my readership can reap the benefits.

felipebr wrote: I am planning my trip to Tijuana soon to get Circumference Augmentation in Avanti by Dr. M. Initially I was thinking of choosing the PPMA option as it is forever and seems safe.
But here in Brazil women had a lot of problems with PPMA in their buttocks, and the problems appeared years after the procedures so I'm a little afraid, I know Avanti has a good reputation and a good technique.

Anyone now about future problems and complication with PMMA for pennis enlargement? Is it better to choose the Ellansé?

I'm sorry but I would trust nothing coming out of Brazil. I've seen cases that turned out to be shoddy doctors using questionable silicone oil or who knows whatever else. Medical-grade PMMA injected by an experienced & qualified practitioner is relatively safe. I say relatively as in its comparison to cosmetic medicine in North America, who knows what's going in more corrupt places like Brazil.

Stick to PMMA, Ellanse, HA, Radiesse, or Fat if you're looking for non-surgical. Surgimend is the only surgical option I'd recommend. Avanti Derma practices ethical medicine, and Dr. Morales has a positive reputation. Just feel free to reach out to them about the Brazilian horror stories, they know the truth behind a lot of those myths. Good luck.