PhalloBoards - An Online Community to Discuss Penile Girth Enhancement

This topic will serve to publish periodic Q&A's from Moderators and Forum Members alike on all matters related to Dr. Victor Liu's Plastic Surgery Practice. He will share details about his services as well as his opinions & insights on all matters male enhancement.


(Q1.) Can you share with me what you provide in the way of testicular enhancement?
When one or both testicles are missing resulting from trauma, surgery or congenital, the appearance can be improved by putting in a testicular implant which can be done under local anesthesia with practically no downtime. In cases of testicles sitting "too high" it can can corrected by scrotal enhancement. The testicle is attached to the bottom of the scrotum by the cremasteric muscle. By enlarging and stiffening of the scrotal wall the testicle is pulled downwards back into the scrotal cavity thus giving the scrotum a more normal and pleasing appearance.


(Q2.) Could you describe your lengthening procedure?
The upper part of the base of the penis is attached to the under surface of the pubic bone by the suspensory ligaments. Up to 1/3 of the penis shaft is behind the bone and cannot be seen nor is it "functional" There are two suspensory ligaments, the superficial and the deep ones. The superficial one (fundiform ligament) is a continuation of a layer of the abdominal wall called the scarpa's fascia. The deep one is the commonly called suspensory ligament of the penis. By dividing these ligaments the penis can be pushed forward and therefore the functional part of the penis becomes longer. The amount of elongation depends on several factors: 1. How much of the penis is behind the bone; 2.The width and slope of the bone (pubic symphysis); 3.The soft tissues around the area (are they tight or loose, stiff or flexible are some of the factors) Each individual is unique and and the amount of lengthening is different for each person.


(Q3.) What type of fillers do you use?
Both temporary and permanent fillers, including Juvederm, Restylane, Voluma, Radiesse, and Bellafill.


(Q4.) Do you offer financing?
We do not but can use Credit Care.

The problem I've had with this "Loria proprietary filler" nonsense that's been peddled for years is how absurd that excuse really is. There is NO REASON your performing physician can't disclose the ingredients, fillers, and materials being put inside of you. Not only is it your right to know as a patient, but this kind of info could come in handy should you (heaven-forbid) deal with a complication down the road.

No offense to Dr. Dellinger or Elysian, but he ought to toss this Loria garbage out and go to something with a considerably better safety profile for the penis (like Hyaluronic Acid, Radiesse, Bellafill, or even FFT). I have a feeling he may not be privy to the quackery that is Loria-anything.

To all the readers here who may be unfamiliar, the issue with silicone oil is that it can be (a) very prone to migration; (b) when complications arise, they can be much more severe than other fillers; and (c) because results can look so good post-op, it makes it all the more deceptive to those who are not "in the know."

It should be said that the vast majority of practitioners leading in the field of male enhancement either don't use silicone fillers or prefer not using silicone fillers in the penis, and that too should be worth noting. I have only ONE Sponsor who happens to use silicone in other areas of the body (which I can't speak for), and does offer it if asked, but is NOT permitted to advertise it here (a compromise made because he has so much expertise in other male procedures, including lengthening and testicular). Think about this: if all of these phallo-doctors have off-label access to silicone oil, why don't they also use it? The answer is quite simple: no one wants to deal with the issues associated with a poor silicone result.

That said, I don't want to alarm you Magic_Wand, if you were administered Silikon1000 via microdroplet technique, it probably isn't so bad. I can't see why they would do it any other way if all you wanted corrected was the gap.

Hello good Phalloboards members! This thread will serve as my record through the phalloplasty process, what I have learned, and my current progress/thoughts.

Let’s start at the top…

Motivation:

All my life I have been self conscious about my penis size. I was bullied for it in middle school. But this is only one factor contributing to my desire for a larger penis.

At the end of the day, size does matter. I have been married for a decade and have wonderful children. Sex still feels great, but it’s not as tight as it used to be. Yes, my current size can get the job done - and if getting the job done was all that mattered, then I’d be happy. But that’s like settling for a C. I want to go for an A+ experience. Bigger = more sensation = possibility for more pleasure. Seems simple enough.

My Current Size: (See Attached Pictures)

And here come the stats…

Flaccid Length: 4”
Flaccid Girth: 4”
Pelvic Bone Erect Length: 6.2”
Erect Girth: 4.6”

It was a little colder when I took these pictures, but I generally hang a little longer.

As far as where I fall in the distribution, I’m right about smack dab in the middle of average.
My girth is 46th percentile.
My length is 82nd percentile.

Would be nice to have a bit more girth… that leads me to my:

Goals:

I think my length is fine. Sometimes I hit my wife’s cervix in certain positions and feeling around in there, the canal ends maybe 4” from the opening. Girth is where it’s at.

I’m going for somewhere between 5.5” and 6” in girth. Function over form.

Oddly enough, I don’t really care about having a big bulge. In fact, I’d prefer not to really have a large bulge if possible… but if things go well, this likely can’t be helped.

Step 1 -- The Consultations

I like to know how things work. The more I can learn, the better. Phalloboards have been extremely helpful when researching the types of fillers that can be used for girth enhancement. I was actually very close to getting the Penuma device when I stumbled across Phalloboards and discovered that it was clearly the wrong option.

Here are the folks I consulted with over the last two weeks:

Dr. Jane Chung

• Jenesis Lipoplasty and Laster
• Recommended Filler: Juvederm Ultra XC+ (HA)
• Cost per cc: $950
• Experience: Over 1000 cases (10 years)
• Summary: Love her as a doctor. Her work is masterful, but extremely expensive. She doesn’t use Voluma which surprised me and only would go for 5-9 CCs in the shaft for the first treatment.

Dr. Victor Liu, MD

• Own practice
• Cost per treatment (as much Oil as you can take): $8,000
• Experience: Roughly 80 Cases
• Summary: Dr. Liu was very straightforward and nice. A very experienced plastic surgeon that seems to specialize in more female services. I found him through realself.

Ian Garcia

• Avanti Derma
• Recommended Filler: Linea Avanti (PMMA)
• Available Filler: Ellanse (PCL)
• Cost per treatment: $5000 (PMMA), $450 per cc (PCL)
• Experience: 4-5k
• Summary: I loved talking with Ian. Super professional and insightful. I’m a little nervous about going out of the country for treatment, but these guys are professionals. Reading Dr. C’s posts throughout phalloboards really makes me respect their practice.

Dr. TJ Tsay

• Ageless MD
• Recommended Filler: Juvederm Voluma (HA)
• Available Filler: Hyperdilute Radiesse (CaHA)
• Cost per treatment: $850/cc Voluma, $650/cc Radiesse
• Experience: Didn’t ask number, but seems very experienced.
• Summary: Talking with Dr. Tsay was great. He is incredibly knowledgeable and answered several questions I had about the different filler technologies. His practice in LA is great and I’d feel very comfortable in his care.

The consultation phase was great. For anyone considering fillers, PLEASE speak to many different physicians. As you can see from my experience, each practice offers different options that have pros/cons.

If I had to rank my preference based on physician, it would be: Dr. Tsay, Avanti Derma, Dr. Jane, then Dr. Victor.

Step 2 -- Deciding what to go with

Now, this is the hard part. Let’s start by comparing and contrasting fillers.

Disclaimer: I’m not a doctor - just some dude who talks to doctors and reads a ton on the internet. How I see it, there are two types of fillers: volume fillers and dermal fillers.

Both work in the same subdermal level of the skin but end up with slightly different results. Volume fillers create volume with the substance that is injected by capturing water and expanding (Like HA) or an inert volume like silicon oil. Many dermal fillers stimulate collagen growth. This is done with some type of collagen stimulant like plastic microspheres or some other material (we will break this down a little more in a second). Over time, your body produces collagen around these spheres and effectively thickens that layer of the skin adding volume. These fillers are typically injected with a vehicle that acts somewhat as a volume filler while your own collagen builds up. The vehicle is typically dissolved within a few weeks.

Okay… So let’s compare and contrast our filler options:

HA
Temporary (9 months to 18 months)
Pros: Safe. Reversible. Time Tested.
Cons: Softer finish. Metabolizes pretty quickly. Expensive.

Silicon Oil
Permanent
Pros: Instant volume. Cheaper
Cons: Horror stories of people getting degloved with it. Volume filler, so likely to end up squishy.

PMMA
Permanent
Pros: Collagen stimulating. Firmer finish. Fairly inexpensive at Avanti Derma (Bellafill is crazy expensive though)
Cons: Degloving is scary if things go wrong. Not recommended past two sessions if you want more girth. Risk of granulomas are higher.

PCL/CaHA
Temporary/Semi-permanent
Pros: Collagen stimulating. Firmer Finish. Reasonably priced.
Cons: Uncertainty about dissolving period.


Lots of information here, but here is where I’m at. I don’t want a squishy finish. I don’t think my wife would love it either. That kills Silicon Oil and HA (in the shaft, definitely considering the glans for HA though)

That leaves me with PMMA or PCL/CaHA. I think I have three options:

Option 1 - Go PMMA. People have been doing it for a long time and the negatives we have seen on the cheeks in 15 year patients won’t apply as much to the penis as there isn’t really fat to wither away around the PMMA. Though, this is permanent. What if the ideal filler comes out and it can give you 2” in girth?! Did I pull the trigger too early? On the other hand, if I can hit my goal with PMMA, why not just settle for this.

Option 2 - Go 1 year Ellanse or Radiesse then switch to PMMA. Talking with Ian, this is certainly possible but most physicians will recommend the PCL/CaHA is fully dissolved before injecting PMMA. This sounds like an appealing option. It gives me the opportunity to try it out and learn how to do post care with collagen stimulants before learning on a permanent option. However, this is more expensive AND I’m not sure if I will want to have to wait for things to full dissolve after experiencing a better size.

Option 3 - Go with 3 year Ellanse. I’ve heard this can be a great option as it’s temporary, but will last quite a long time. Reports of people not seeing any loss in two years seems to be pretty common. Getting topped off with Ellanse would be fairly easy and mitigate risks for deformity if something went wrong. You still get the firmness, but I've heard this can have a slightly rougher finish than PMMA. One of the questions I’ve had about Ellanse is will the penis start to deform as the spheres start to dissolve. Assuming they likely won't dissolve evenly over the penis, it seems like you are likely to get lumps as you reach the end of its life lifecycle.

I need your help!

Questions:
Has anyone gone through a full PCL dissolve? Any issue? What was it like?
PMMA 10% seems to be the best way to reduce the likelihood of nodules/granulomas. Thoughts?
Has anyone tried taking Collagen supplements (Protein, pills, etc.) prior to a PMMA or PCL treatment? Think it would help boost production around the spheres?

Right now, I’m leaning towards Option 3. I’m 30 years old with hopefully 60 more years of sex ahead of me. It would be a shame to be permanently deformed. Ellanse seems like it really checks all the boxes. Money isn’t a super big problem for me, but I’d like to not pay more than I have to. Plus, I trust Avanti Derma based on their prior work. What do you think?

I’ll keep everyone posted on my progress + photos.

Unhung1 wrote: seems like you got ripped off and if no one else wants to say it i am cause like you said this effects anyone who been considering getting it like me. i dont believe that 6 month bs for a second and its the 1st time i heard it in this thread. my complete understanding was swelling at 1st so thats when your the biggest then around a month later is your final results. your not magically gonna grow another inch in 6 months.

just like everything else in life it just seems like some will have a better experience then others.

to clarify what i mean by ripped off. im not necessarily saying they skimped on the actual product they gave you, although im not ruling it out. but their website and all the testimonies say you will gain atleast 1 inch in erect girth in 2 procedures and you didnt come close to that.

thats a rip off bottom line

I'm afraid you don't know what "rip off" means. It implies that the seller cheated or deceived the buyer, and that's incredibly unfair given the current information available (let alone the Clinic's upstanding reputation).

The PMMA filler is a collagen-inducing filler, meaning your gains are predicated on your body's reaction to the microspheres. In other words, collagen-inducing fillers like PMMA, Ellanse, and Radiesse cannot guarantee a specific gain, only a range. This is unlike volume fillers (Hyaluronic Acid & Fat) where you can instantly predict gains because the girth comes from the filler itself.

Traditionally their PMMA range has been 1.25cm-2.5cm (0.5" to 1") because this is the average seen by their patients, not a guarantee on your appointment date. That said, it is an advertised range and the 0.3cm is well below this, therefore I hope and suspect Avanti Derma will review this situation if & when Dobra69 reaches out to them.

There is a thin line between "dissatisfied vs ripped off," and a lot of that comes with context. I think we give all parties a chance to address the situation before drawing conclusions, especially given Avanti Derma's proven professionalism in the past. Dobra69, have you reached out to them regarding your unhappiness with the gains? And if so, what was their response?

Dr. Loria, you mean the hair restoration specialist & nutritionist who jumped onto the phalloplasty-bandwagon because he could make a killing pumping dicks full of (dangerous) silicone oil, and lying on his website that he's a cosmetic surgeon (which should be actionable by the Board of Medicine in Florida), you mean that Dr. Loria?

The Dr. Loria who years ago got caught multiple times creating fake accounts here, and even impersonated me on other penis forums because he has the maturity of his front desk resceptionist and not a full fledged physician?

The Dr. Loria who claims his concoction filler has PMMA and other mixes, but ultimately turned out to be straightup silicone? You know, the silicone that NO OTHER ethcial Doctor in the U.S. uses for penis enlargement, despite having access to it.

I wouldn't trust Dr. Loria to clip my nails. I wouldn't extend Dr. Loria Sponsorship here even if he offered to buy me a Ferrari. So I can't imagine I'd trust any of his trainees no matter how skilled they are, and I sincerely hope Dr. Berrett figures out this "cash cow" isn't worth his medical credibility.

The PhalloBoards is and will forever remain a No-Silicone-Zone. Besides, with SO many proven fillers on the market (HA, Radiesse, PMMA, Ellanse, and Fat), why even chance it with a "mystery" injection given by a guy trained by the "legendary" Dr. L?

Some-Book2543 wrote: Thanks for replying Skeptical_One! I am new to the site, but I have read through some archived forums. The Penuma definitely does not seem popular here, and for good reason from a lot of the stories. However, on other sites and forums, I am finding more people with positive results than negative. So I am weighing all sides. This site does seem like a haven for folks with terrible outcomes. That said, fat transfers and dermal matrices seem even way more risky than the Penuma. I've seen reports of necrosis, and horribly shaped endings. Forgive me for still learning, but what are some of the non-surgical girth enhancements you referenced?

What other sites exactly? You mean the Penuma subreddit that does some soft censorship (I posted once or twice asking questions about the complaints people have made on places like this forum and they weren't having it). I say "soft" because they do still let a good number of dissatisfied and/or removal patients post, although if they still exist I don't know (??).

As someone who's moderated the only forum devoted to the topic of surgical penis enlargement for over a decade, I would strongly suggest taking my word that fat transfers aren't as "dangerous" as a rigid silicone implant, in-fact, the fat is your own tissue. That's neither here or there.

As for non-surgical girth options, there are a few popular & viable ones spoken of today:

Hyaluronic Acid (HA): Temporary filler that provides instant volume. Temporary implies that you may require top-offs in the future as the product will absorb over time. Anecdotal evidence suggests HA can survive 18+ months before a top-off. HA naturally occurs in the body and is relatively safe for cosmetic use.

Ellanse: Long-term temporary filler that stimulates collagen growth for girth. This is predicted to survive 2-4 years (possibly longer?) before any necessary top-offs.

Radiesse: Much like Ellanse in how it generates new girth, but not reported to last nearly as long.

PMMA: The only recommended permanent filler option available. Trade-off is travel to Mexico (Avanti Derma), since the American iteration of PMMA (patent-enforced) is not only very expensive per volume, but uses a bovine carrier making it less ideal for penile application.

Avoid silicone fillers.

The aforementioned, especially HA, Ellanse, and PMMA, are most popular here. Deciding what's best for an individual depends on a number of variables (advantages of temporary-vs-permanence, travel & costs, expertise of practitioner, etc.)

Skeptical_One wrote: A few observations made from recent comments in this thread:

I definitely admire Dr. Carney's candidness and "medically-conservative" approach, and I believe he's performed enough procedures & corrections (stemming from other clinic's work) to formulate a very credible opinion on all-matters phalloplasty. As for his observation with Ellanse, he isn't wrong about the contour irregularities, but I would caution readers to note that it was a matter of professional opinion, and not a condemnation of the filler itself (heck, he's injected Ellanse prior to the FDA stating that it must be halted till trials are complete).

You see, all dermal fillers that require significant collagen production (i.e. PMMA, Ellanse, and Radiesse) means there is an element of unpredictability in how that collagen may develop patient-to-patient; sure, much of this can be mitigated with proper injection technique, but there is always variability with the collagen. Also, it's difficult to know how rigorous each patient will follow post-op protocol, which too can lead to aesthetic irregularities. The "rubbery" feel is there (especially in larger volumes/multiple sessions), but is only detectable by those who know it's already inside of you, like you and your doctor (never has anyone here reported that a partner complained about a rubbery shaft). Like PMMA, the added collagen thickens the skin, hence the "rubbery" feel when pinched. As someone who has some of the thickest skin via dermal fillers, I can tell you that I have had zero suspicion among double-digit partners.

As for their website's clarification on costs & procedures, I forwarded the feedback directly to their Offices and hope they'll provide some updates.

Lastly, the idea of posting "After" photos months later is a bit challenging. You'll find that no Clinic publishes Before & After's outside a clinical setting, and that explains why the "after" photos are immediately post-op. Trying to ask your patients to send you dick pics from the comfort of their homes to publish online is both unprofessional and unscientific. Furthermore, if a patient comes in for a second round, that Clinical picture effectively becomes a "Before" photo. That's precisely why this forum's Progress Report section is so useful, it provides insight to would-be patients on more realistic, long-term expectations.

As for gauging long-term "after" results, these doctors do in-fact have a good grasp because many times these patients come in for a second round, meaning the doctor gets to examine his or her work long-term; also, I'm certain some patients send photos to their practitioner over months & years, and this site remains an invaluable source for comparison as well. In other words, most of these physicians are pretty familiar with the "final outcomes."

Every provider (AD, Morganstern, androfill, etc) has before and after photos on their website. Those photos are taken immediately after the procedure and are not indicative of the final outcome. I’m not suggesting the doctors have patients send them dick pics I’m simply stating that one shouldn’t base his expectations on those photos. Your dick will not look like those “after” pictures 6 weeks after your procedure. One will get a much better idea of realistic expectations from progress pics they see on this board. I would say the same for the feel of the fillers. I trust the hundreds of members of this forum to give honest feedback on the feel of their penis over the physicians who see them 3 times at most. Brass tacks - this forum is invaluable for setting expectations. I relied on the feedback here to make my decision and it led me down the right path.

Thanks for forwarding the concern to them. When I brought up something else that I read on the website, they pretty much indicated that some of that info was a bit outdated.

Skeptical_One wrote: A few observations made from recent comments in this thread:

I definitely admire Dr. Carney's candidness and "medically-conservative" approach, and I believe he's performed enough procedures & corrections (stemming from other clinic's work) to formulate a very credible opinion on all-matters phalloplasty. As for his observation with Ellanse, he isn't wrong about the contour irregularities, but I would caution readers to note that it was a matter of professional opinion, and not a condemnation of the filler itself (heck, he's injected Ellanse prior to the FDA stating that it must be halted till trials are complete).

You see, all dermal fillers that require significant collagen production (i.e. PMMA, Ellanse, and Radiesse) means there is an element of unpredictability in how that collagen may develop patient-to-patient; sure, much of this can be mitigated with proper injection technique, but there is always variability with the collagen. Also, it's difficult to know how rigorous each patient will follow post-op protocol, which too can lead to aesthetic irregularities. The "rubbery" feel is there (especially in larger volumes/multiple sessions), but is only detectable by those who know it's already inside of you, like you and your doctor (never has anyone here reported that a partner complained about a rubbery shaft). Like PMMA, the added collagen thickens the skin, hence the "rubbery" feel when pinched. As someone who has some of the thickest skin via dermal fillers, I can tell you that I have had zero suspicion among double-digit partners.

As for their website's clarification on costs & procedures, I forwarded the feedback directly to their Offices and hope they'll provide some updates.

Lastly, the idea of posting "After" photos months later is a bit challenging. You'll find that no Clinic publishes Before & After's outside a clinical setting, and that explains why the "after" photos are immediately post-op. Trying to ask your patients to send you dick pics from the comfort of their homes to publish online is both unprofessional and unscientific. Furthermore, if a patient comes in for a second round, that Clinical picture effectively becomes a "Before" photo. That's precisely why this forum's Progress Report section is so useful, it provides insight to would-be patients on more realistic, long-term expectations.

As for gauging long-term "after" results, these doctors do in-fact have a good grasp because many times these patients come in for a second round, meaning the doctor gets to examine his or her work long-term; also, I'm certain some patients send photos to their practitioner over months & years, and this site remains an invaluable source for comparison as well. In other words, most of these physicians are pretty familiar with the "final outcomes."

A few observations made from recent comments in this thread:

I definitely admire Dr. Carney's candidness and "medically-conservative" approach, and I believe he's performed enough procedures & corrections (stemming from other clinic's work) to formulate a very credible opinion on all-matters phalloplasty. As for his observation with Ellanse, he isn't wrong about the contour irregularities, but I would caution readers to note that it was a matter of professional opinion, and not a condemnation of the filler itself (heck, he's injected Ellanse prior to the FDA stating that it must be halted till trials are complete).

You see, all dermal fillers that require significant collagen production (i.e. PMMA, Ellanse, and Radiesse) means there is an element of unpredictability in how that collagen may develop patient-to-patient; sure, much of this can be mitigated with proper injection technique, but there is always variability with the collagen. Also, it's difficult to know how rigorous each patient will follow post-op protocol, which too can lead to aesthetic irregularities. The "rubbery" feel is there (especially in larger volumes/multiple sessions), but is only detectable by those who know it's already inside of you, like you and your doctor (never has anyone here reported that a partner complained about a rubbery shaft). Like PMMA, the added collagen thickens the skin, hence the "rubbery" feel when pinched. As someone who has some of the thickest skin via dermal fillers, I can tell you that I have had zero suspicion among double-digit partners.

As for their website's clarification on costs & procedures, I forwarded the feedback directly to their Offices and hope they'll provide some updates.

Lastly, the idea of posting "After" photos months later is a bit challenging. You'll find that no Clinic publishes Before & After's outside a clinical setting, and that explains why the "after" photos are immediately post-op. Trying to ask your patients to send you dick pics from the comfort of their homes to publish online is both unprofessional and unscientific. Furthermore, if a patient comes in for a second round, that Clinical picture effectively becomes a "Before" photo. That's precisely why this forum's Progress Report section is so useful, it provides insight to would-be patients on more realistic, long-term expectations.

As for gauging long-term "after" results, these doctors do in-fact have a good grasp because many times these patients come in for a second round, meaning the doctor gets to examine his or her work long-term; also, I'm certain some patients send photos to their practitioner over months & years, and this site remains an invaluable source for comparison as well. In other words, most of these physicians are pretty familiar with the "final outcomes."

I agree with Buckeye about being completely transparent with your healthcare provider, it's in everyone's best interest to come clean so that a proper diagnosis can be made.

A urologist would be the person to see, yes, but I'd also recommend seeing someone who has actually performed corrections on men with filler injections, including silicone... at the very least for a second opinion in the event your first doctor recommends anything drastic. Dr. Carney comes to mind, he works out of Atlanta and I'm fairly confident he's dealt with silicone filler issues before.

Either way, silicone in it of itself isn't a "sentencing" for your penis, and there are people with silicone that are okay, but this is a stark reminder to newcomers how essential it is to find ethical and experienced practitioners using either hyaluronic acid (HA) or dermal fillers like Radiesse, Ellanse, or PMMA, (no silicone) and that even going down this route isn't without risk.

I think you'll be okay, and if you have the time/budget, Dr. Carney is an option worth considering because you won't have to feel the need to "hide" any details and you'd be talking to someone who has dealt with your specific issue before. You have to remember that modern phalloplasty is still relatively "new" and many healthcare providers might not have a clue what you did or how to go about treating complications, hence my recommendations. Good luck!

Sounds scam-ish but I'd like to know more details; I could be wrong but I'm pretty sure there is more to it than just "pure blood", like perhaps a different therapy similar to PRP to make it practical for filler (or growth factor) use.

If you want actual gains, get a proper filler with a proven track record; I can't imagine why one would take a silly gamble when HA, Fat, Ellanse, Radiesse, Renuva, and PMMA are on the market! If your friend is comfortable talking penis enlargement, then show him this website. I would like to know more about the procedure he's talking about, because if it is a scam, I'd like my readers to know.

Rnair wrote: Hi, I'm an internal medicine physician myself and am looking for girth enlargement, what would you recommend for me , I am uncircumcised and can travel to california, located at washington presently.

I'd give their office a call and ask to speak to Dr. Tsay; he's very well reputed for his skill-set in aesthetic medicine and offers a variety of filler options from Hyaluronic Acid (HA), Radiesse (similar to Ellanse), and Renuva (stock may be limited due to covid-impacted industries).

Avanti_Derma wrote: Hello @briceb ,
The only product that I would use for glans enhancement is hyaluronic acid because it is a substance that naturally exists in our bodies.
HA is a soluble, reversible gel that protects, to some extent, patients from potential accidents such as spongiousum body collapse and pressure-related necrosis of the mucous membrane/epithelium.
What worries me the most is the thickness of the glans epithelium. It is very thin (around 2mm) and easy to penetrate with a needle, ending up in the spongiosum body's depth and depositing the product right into the bloodstream; micro-cannulas don't work here.
Of course, the following statement only exists in my imagination: if some HA enters the bloodstream, it is possible that by the time that it ends up in the micro-vascularity of the lungs, it has been somehow dissolved or diluted.
On the other hand, if any of the microsphere-based products (Ellansé, Radiesse or Linnea) are accidentally injected into the corpus spongiosum, we know for sure that they won't be dissolved and will create a small (hopefully) pulmonary embolism.
For everybody's disappointment, the glans is not an area that has the ideal anatomical structures for the implantation of a soft tissue filler, much less to receive any type of prosthetic implants.
The best you can hope for is a mediocre and temporary result with the use of HA, the safest product for the area.
DrC

Hi Dr C!

As I said we have been injecting 4 ml HA and doing multiple sessions for the glans. But it is NOT safe in the blood stream. It can result in a syndrome like Fat Emboli Syndrome and there have been a number of deaths - primarily with intravaginal injections.

Hello @briceb ,
The only product that I would use for glans enhancement is hyaluronic acid because it is a substance that naturally exists in our bodies.
HA is a soluble, reversible gel that protects, to some extent, patients from potential accidents such as spongiousum body collapse and pressure-related necrosis of the mucous membrane/epithelium.
What worries me the most is the thickness of the glans epithelium. It is very thin (around 2mm) and easy to penetrate with a needle, ending up in the spongiosum body's depth and depositing the product right into the bloodstream; micro-cannulas don't work here.
Of course, the following statement only exists in my imagination: if some HA enters the bloodstream, it is possible that by the time that it ends up in the micro-vascularity of the lungs, it has been somehow dissolved or diluted.
On the other hand, if any of the microsphere-based products (Ellansé, Radiesse or Linnea) are accidentally injected into the corpus spongiosum, we know for sure that they won't be dissolved and will create a small (hopefully) pulmonary embolism.
For everybody's disappointment, the glans is not an area that has the ideal anatomical structures for the implantation of a soft tissue filler, much less to receive any type of prosthetic implants.
The best you can hope for is a mediocre and temporary result with the use of HA, the safest product for the area.
DrC

davekay wrote: hello s.o.

first off, thank you for this site its been most helpful and why i am back now.

i chose dr. zimmerman because of his credentials and his team. i had spoken with a few drs via zoom (dr jane in ca and "the" dr c") on the way to that decision.

please excuse my word choice re the radiesse, i did mean when it dissipates. on that, i havent noticed any loss yet and would rather not see any so i was going to go just before that would start and my guess would be about a year. i am over 50 and my body doesnt do anything fast anymore so hopefully it wont chew thru the radiesse that fast, either

spending wise it was about 5k for the radiesse and a little more than twice that for the bellafill. i got about 3/4 both times and yes, if radiesse was permanent like bellafill i would choose that, agreed.

i did see the vials and the lot numbers are in my patient file along with my before pic. i will email kanani and get those sent to me. what info am i looking for? i would say for the record that i have had all positive experiences there to date and dont suspect anything but going forward.

Okay, the fact that you spent twice as much on Bellafill makes sense -- it isn't often you get Bellafill reports because the cost is oftentimes prohibitive. I suspect at those prices, you are in-fact getting what you paid for. I always ask members who are seeing Doctors that aren't mentioned frequently to furnish what they inject -- this is due to the industry having a poor track record & history, and why I don't just bring on anyone as a Sponsor (as I'm sure you know). I'm sure Dr. Z is legit and I'd be curious to see how he stacks up.

Thanks for starting the progress report - per my guidelines you are granted lifetime premium membership

I'll be interested in following your progress; despite Bellafill's high costs, it would be interesting to see if it's indeed viable (in the long-term) regardless. Good news is that it is still technically medical-grade PMMA, so that's always good.