PhalloBoards - An Online Community to Discuss Penile Girth Enhancement

Thanks for answering all the questions Dr Tsay!

How often would you say a top off after a FT is needed? 50% of the time? A FT is something I would be interested in down the road, and there isn't much information available from my googling and searching these forums even.

I’m also interested in Renuva, and currently am leaning more toward that.

My concerns are that the penis is an area that doesn’t have natural fat cells, thus why a lot of fat transfers come out uneven. So I know you said that you would recommend a FT first and top off with Renuva, but would a FT’s success be higher if you started with Renuva to introduce a foundation of fat cells for the fat from the FT to plug into?

Thanks for your time Dr Tsay!

jrod wrote: Has anyone who had Ellanse 3-4 years ago seen any loss of girth? I haven't heard of a single report.

They actually had 4 Versions of Ellanse and ended up getting rid of their shorter-length (I think it was 1-Year & 2-Year) versions because too many patients were reporting filler retention well beyond the manufacturer's projection. This might sound great if you have it in your penis, but not so much if you have it in your face, and as you age, the filler remains, and while maybe not noticeable to most, definitely noticeable to the patient who was already compelled to inject facial fillers in the first place.

The thinking right now is all about the collagen. There are collagen of the skin, joints, bone marrow, and many other places, it's really remarkable how common (and essential) collagen is to our bodies. Well (and don't cite this, I'm merely relaying musings of some Doctors and the Manufacturer as nothing has been clinically set in stone, at least that I know of), it appears the same kind of collagen produced with PMMA seems to be the same kind of collagen made with Ellanse. The idea was that the PCL particles in Ellanse would eventually break down but would last a bit longer than similar collagen-inducing particles like the ones found in Radiesse, making it a more attractive alternative for those who preferred longer lasting alternatives.

It seems as though the PCL may have very well dissipated, but that PMMA-type collagen in that kind of dense abundance lasts considerably longer, in spite of the absence of the PCL. This is a "shrug the shoulder" moment because well, Ellanse hasn't been around for a while, heck it hasn't even cleared FDA Approval yet (no doubt uncertainties about its longevity probably drags the process). I should stress that I don't think that designates it as dangerous, and I'd go as far as saying its safety profile ought to be on par with PMMA since they effectively work on the same mechanism: biocompatible microspheres suspended in some kind of gel carrier injected into a layer of skin in order to increase volume; only difference is that the PCL eventually gets removed whereas the PMMA particles stay with you forever.

It is presently unknown how long it takes for this amount of concentration of PMMA-like collagen will take to lose size. If you really think about it, Ellanse was made for the face, we're talking like maybe 3-4 cc's at most? The penis contains easily 10x that over the course of 1-3 sessions, which means there is a richer abundance of elastin, connective tissue, and vascularity, likely keeping the collagen going. In other words, this is uncharted territory, although fortunately there is nothing to indicate there is anything to be concerned about, at least not much different from most other fillers. Heck, for penis guys, it's awesome news in my opinion, but if you were a facial patient and got it with the promise of 1-2 years, yea... you have a right to be upset.

In a nutshell, at least as far as I know, it should be regarded as a LONG LONG TERM filler at present time. I'll reach out to my Ellanse providers and see if I can find out any updates. I'm also finding varying degrees of half-life's of different collagen types and they all appear to be rather long (many years), hopefully I can get this answered from an Ellanse provider as well.

Rybrad wrote: 1. This is very expensive and having to top up every 6 months to a year would not be financially attainable for me. However, if I had to top up every 18 months to 2 years, that is doable for me. I was always under the assumption that HA lasted 6 months to a year, but Phallofill is making longer lasting claims. What is your opinion?

The dissipation of temporary fillers like Hyaluronic Acid (HA) or Radiesse seems largely determined by your own body's rate of breaking down and removing foreign substances. Our bodies all seem to vary in rates of speed when it comes to different things. Think how some people can grow really long hair really fast while others would have to commit to years to achieve the same length. Not all processes & physiologies are equal.. There may be other factors at play as well, but in the end you really won't know the extent of retention until you actually get it done. I have absolutely heard of verified 2 year retentions and on the flip side, as low as 6 months.

That said, you have to keep something in mind which may alleviate the cost burden: Typically when people get top-offs, they are injecting less volume, and so in theory you should be paying less than the original price (assuming you are injecting considerably less volume the 2nd time around). Think of this example: after about 18 months you are at a 50% loss of your original HA gains. At this time, if you were to go in for a top-off, you won't need nearly the same volume to reach the size you were the first time around, which would presumably be cheaper. I won't speak for PhalloFILL because despite all the other (non-Dallas) Clinics being affiliated with the company name, they are in-fact independent as a practice & business. You'll have to inquire with whichever location you plan on visiting regarding top-off rates (flat-rate pricing vs price-per-volume injected).

I also want to stress how reasonable rates have become despite inflation + being a very specialized niche & uncommon procedure. In the 90's and 2000's, $15,000 was a steal of a price with a strong forecast of depressing complications. I think at present time, my most expensive FILLER Sponsor is around $10,000, and that's largely due to overhead as he operates out of some of the most expensive real estate in the country and also happens to be highly credentialed. More importantly, think about the confidence-per-dollar you get with a fatter cock versus a coveted sports car. While I'm sure some of you have your own motivations, the vast majority of guys want the big dick no less than they want the Porsche, except now we live in a time where the big dick amounts to 5% of the cost of a luxury/sports car with comparable effect. Don't get me wrong, I enjoy promoting healthy competition amongst my Sponsors (while representing them fairly to the best of my ability), which in turn helps keep costs reasonable. I try to encourage seasonal promotions and such to ensure readership here can grab at whatever they can take off the top. At present time, PhalloBoard Members have a 5% Discount with Androfill (Ellanse & HA - United Kingdom) and a 10% Off any Male Enhancement Services from Jiva Med Spa (Which includes Bellafill PMMA). Find their contact info by clicking here and mention the PhalloBoards member discount prior or during booking.

Regardless of all of that, let us not forget that this is an aesthetic elective medical procedure that are performed by maybe 20-25 practitioners in the North America worth trusting your penis with (yes that includes some non-Sponsors)... this by very definition makes it a luxury... but perhaps the most inexpensive luxury for men all things considered.

Rybrad wrote: 2. How spongy does it feel? Does it feel like your natural penis, or is there an obvious softness to it that is easily discernable? I'd like to maintain stiff erections and not have a squishy feeling when hard?

This comes up a lot, and I think it has to do with earlier iterations of HA. As some of you may or may not know, HA is naturally created in the body (one of a few reasons it has such a strong safety profile), and medical manufacturers learned that they can make it in the lab through a technique called cross-linking. Older iterations of HA were used for soft areas (face, etc) and it wasn't until more recently that cosmetic medicine had expanded its use all over the body. Now there are cross-linked iterations much more robust and compatible for use in the penis.

This explains why some of the more recent HA reviews (either in a Progress Report or Directory Rating) have been generally positive. What has made PhalloFILL so popular so quickly is that they really put in the work to find the right brand of HA that would provide both the best kind of retention, and more importantly, "feel & naturalness."

It should also be noted that you don't want the penis to be too hard much like you wouldn't want it to be too soft. Even an erect penis has some "give" when pressed against the skin. I've been to an Adult Novelty store, and that's when I noticed that ZERO of the dildos (which are meant to mimic an actual penis) were ever as hard as vibrators (which are meant to provide stimulation as an electrical device).

Last advice here regarding the "feel" of HA. If you are the type that is hyper-critical then I'd strongly recommend being circumcised and starting with low-to-medium volumes. This way if you didn't like it, it's easy to manage and will eventually dissipate. If you can live with potential imperfections that only you will notice, then go with whatever the practitioner recommends. And by the way, the potential imperfections wasn't a knock on HA, all fillers have a degree of unpredictability, now matter how good the doctor or filler is.

Rybrad wrote: 3. They have locations all over the US and even one in my city, but I want to go with the practitioner with the most experience. Would this be the Dallas location?

So part of the affiliation is that PhalloFILL provided training (among other things) to these would-be affiliates, and so they are all in theory qualified to do a modest (or even great) job. That said, for me it would be Dallas 100%. They are the ACTUAL FOUNDERS AND COMPANY of PhalloFILL and they've also had a pretty good reputation with keeping patients satisfied (they have the most ratings in the Directory Listing section of this site).

However, if budgeting and logistics is of notable importance, then call your closest PhalloFILL Office, many of them being Urology practices, more than equipped and familiar with penile health & enhancement.

That would be interesting! I haven't heard of it myself. In our practice, we often will mix fillers to create a hybrid that provides the best of both worlds - the immediate bulking of HA and the collagen stimulating function of a biostimulatory filler like sculptra or radiesse.

This will be a pretty niched question so I might not even get an answer.

I know some have floated the thought of Ellanse being used after PMMA and vice versa. I also know any combination of anything could have unintended results. Does any one see any reason that a shorter term stimulatory filler like Radiesse wouldn't play nice with existing PMMA?

To give background on why I'm asking. I have existing PMMA and had no issues. I've since had HA added, with no issues.

I know that previously we all encouraged no mixing, but there are multiple providers now doing this. For example, some are using Bellafill and HA in tandem. Some are using a more typical HA with Radiesse. Some are using only one of the above. There's a lot going on out there now.

I know a lot of American and Canadian practitioners are very leery of existing PMMA because many of them either had bad experiences themselves or saw it happen with Bellafills predecessor years ago. I've never seen any granuloma, abscess, etc issues with Linnea patients (or frankly now with current Bella or any quality providers using it correctly). Some view PMMA as a sleeping dragon you don't want to disturb. But others who have had experience with Bella or Linnea are fine with adding more pmma or using HA in addition to it.

This is kind of all over the place but I'm basically asking for any real experiences with any type of combination fillers.

Momoney

Fasting such as intermittent fasting by itself does not necessarily harm Renuva placement or your own fat production from Renuva placement. However the fat that is made from injecting Renuva will behave just like your own fat, so any significant weight loss will affect the size of the adipocytes by making them smaller. On the contrary if one were to gain significant weight after receiving renuva, one should expect to see some girth increase due to the weight gain because the adipocyted now would have gotten larger.

It’s hard to give an exact quote for Remuva based on a 0.5-1 inch for girth improvement because each person has a different size starting out. 0.5 inch gain for someone that is 3 inch circumference will be a lot more significant in improvement than someone that is starting out at 4 inch girth size. Another variable would be baseline length. I’ve had patients that were very well endowed naturally with 8-10 inches length flaccid and 20 ml product did very little for their girth improvement. In general fat transfer is more cost effective if one has the fat to graft. If not then Renuva or HA fillers would be the only nonsurgical option.

Price per ml Renuva is more cost effective than HA fillers.

Hope this helps.
Dr. Tsay

Boinkers

Yes top offs are to either add more if someone has already had a fat transfer and would like more girth, or to address any unevenness from either HA filler or fat transfer. As much as we try to shoot for absolute perfection this is not always possible and so top offs can help to even things out. Grossly abnormal unevenness (“deformed”) is definitely not the norm and usually due to poor injector/doctor technique.

Hope this helps.
Dr. Tsay

Jess81 wrote: Many men’s clinics on TikTok are claiming permanent enhancement using collagen stimulating fillers. There’s also a few men’s clinics here in Denver that claim the same.
Is this true? Or is their definition of “permanent” flawed?

This is often the language I see associated with silicone injectors -- stay FAR AWAY!

Silicone oil is permanent and can even yield aesthetic results, but this is all very deceptive because silicone is also prone to migration and has a higher severity of complication if & when things go wrong. I've actively turned down prospective Sponsors who primarily inject silicone due to ethical concerns.

Of course you can always call and ask, but if they are dodgy with responses, simply hang up and move on. With so many viable options available for injectable phalloplasty (Hyaluronic Acid, PMMA, Ellanse, Radiesse, Renuva, and Fat Transfer), why even risk it?

Stay safe out there, start with PhalloBoards/Community-vetted Practitioners and peruse the Physician Directory, and don't settle for questionable practices with your one & only manhood!

Leoncios wrote: Thanks everyone for the responses. On this androfill page here ( www.androfill.co.uk/how-much-filler-to-take/ ) it says that you can put up to 30ml, which would give 3 cm of girth, is that true too or is it just propaganda?

30mL of filler can certainly yield 3cm of girth. My first ever session of filler was 20mL yielding a full 1-inch in erect circumference (girth) gains. That said, everyone's body's response to the filler varies, so all things equal, two men may achieve varying degrees of size with the same doctor & filler. In light of that, the vast majority of men can expect modest gains with 30mL of filler.

I should also note this is probably more so true for fillers that rely heavily on neocollagenesis for gains (e.g. PMMA, Ellanse, Radiesse).

MoMoney wrote: Any evidence that things like fasting will be detrimental to Revuna?

I see that the cost of FFT is $6500. what is the expected cost of Renuva for .5-1.0 girth range? Sounds more affordable than yearly HA top offs.

As of January they charge $2150 per 3ml of Renuva. So to get the increase you are looking for of like a 25% increase in girth, doing the math you are looking at like $30,000. Correct me if I'm wrong.

Any evidence that things like fasting will be detrimental to Revuna?

I see that the cost of FFT is $6500. what is the expected cost of Renuva for .5-1.0 girth range? Sounds more affordable than yearly HA top offs.

I appreciate your take but I'm going to have to respectfully disagree.

Again, take into consideration that despite all the companies you call who claim they fix one another, none of them choose to opt for silicone oil injections (with the exception of a handful of dunces who were "trained" by Loria). Think of it this way: those who do Hyaluronic Acid (HA) don't care for PMMA, and those who do PMMA don't care for HA, and those who do Surgimend don't care for fillers at all... but they ALL unanimously agree that silicone is bad news. The vast majority of qualified injectors will not do large volume silicone in the penis, many of them Urologists, Dermatologists, and Plastic Surgeons. Dr. Loria claims to be a cosmetic surgeon, he is not.

And yes, other practices do use Silikon1000 for other procedures, namely in very small volumes via micro-droplet technique (which the Manufacturer insists on), typically in superficial areas like the face. It's a completely different ballpark when doing body contour and penis enlargement via high volume injections.

Secondly, decades plural? That implies at minimum 20 years. Yea... no. Dr. Loria only started doing penis enlargement after his failed Hair Restoration & Nutrition practice wasn't picking up much steam, slightly less than 10 years ago (not even a full, singular decade). He has shills on his payroll, and this can be confirmed if they actually make anyone believe it was decades plural.

The PhalloBoards forum was shilled on numerous occasions with fake accounts all with IP addresses from his Boca Raton location, all of them first-time posters acting like they seem interested in this new Dr. Loria guy. When the shill was pressed for photos, they provided pictures that already existed on the web and had nothing to do with a procedure. Once they were outed, I got very obscene messages that I rather not repeat. Furthermore, around the same time, someone impersonated me with a Skeptical One username on the old PEGym forum, and I have an itching suspicion on who would have been behind it. If Dr. Loria were involved, it would be quite an embarrassing way for a medical professional to conduct himself, no?

---

Moderator Alumni Hoddle10 once wrote on the 2.0 forums:
On his website, Dr Loria says:

"This highly specialized procedure may be presented at the American Academy of Facial & Plastic Surgeons, American Academy of Phalloplasty Surgeons, American Academy of Urological Surgeons, and the American Academy of Cosmetic Surgeons in 2013."
penisenlargementus.com/

Hoddle10 goes on to say:
There are a few problems with this idea though. Sadly "The American Academy of Facial and Plastic Surgeons" doesn't actually exist. More bad news is that the "American Academy of Phalloplasty Surgeons" disbanded some years ago, so despite their website still being up, he wont be able to present to them either! The "American Academy of Urological Surgeons" is also going to prove a problem, as regrettably they don't exist either. However, the good news is that American Academy of Cosmetic Surgeons does exist. Again though, as far as Dr Lorias presentation goes there is going to be a problem - he's not a member!


Obviously the site has gone through some changes over the years, but it's nice to see a time capsule retain some of the questionable practices and sales pitches used by this Clinic.

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Dr. Loria is performing the LEEP procedure and from what I can tell, it is a medical device without FDA approval. Isn't this illegal? It is.

Dr. Loria had a patient who was in the ICU with sepsis and he refused to giving the ICU physicians information on what was injected inside his patient. What's he have to hide? Imagine if this patient died, it would have sent phalloplasty back to the stone age because of one quack. This account can be found (and confirmed with photo evidence) on the LPSG Dr. Loria thread. Sickening to be honest.

Lastly, sure, some (not all) complications that can arise from silicone could theoretically occur with other fillers; however, if & when complications arise with silicone, they are known to be more severe. It also has a higher propensity to migrate, hence why Dr. Loria requires patients to wear a band at the base of their penis for a month (or however long he does it now). For example, men might get 60-80cc's MAXIMUM of Ellanse (or PMMA) over the course of many appointments over a lifetime, whereas you can get 60-80cc's of silicone in ONE-GO! This means it's plausible to have in excess of 150cc+ of migration-prone oil in your dick for the course of your lifetime!

For me, it's just that I know men who have confided in me regarding the severity of the experiences with silicone, even at smaller volumes. I simply haven't had that same kind of interaction with people and HA, PMMA, and so on. I've been monitoring men get fillers injected into them on the only website devoted to this specific topic of discussion, for a decade-and-a-half and I can say with certainty that the frequency & severity of filler complications correlated with silicone the most.

I appreciate you sharing your experiences, but I will remind you that any instance where I see an advocacy or promotion (even if that isn't the intention) of this Doctor or methodology, I'm going to speak up for the sake my readership. There are plenty of more viable options including HA, PMMA, Ellanse, Radiesse, Renuva, Fat, and Dermal Grafts for girth enhancement, why chance it with the least popular option (i.e. silicone) out there?

Furthermore, I have no trust in Dr. Loria's ethics, or the expertise of anyone willing to learn his methodologies. Their office reached out to me for Sponsorship and I declined what would have been a modest amount of revenue if we had decided to agree on terms. If I'm willing to let all these other Doctors and techniques compete against each other on my platform, why not let him join? It ought to tell you that I value the integrity of this site and respect the community that has built it.

That all said, I want to reiterate that this isn't necessarily a cause for alarm for those who already have it, but it definitely warrants taking my advice (that comes from a place of experience & sincerity) on avoiding any further high volume injections, and focus on touch-up/revision instead, especially if you're in the 6-7" girth range.

We can resume the original topic now.

EricPig wrote: I agree. 8 is a lot and I don’t want to overdo it. I wonder who on here is 7.5 or above. Love to get their thoughts on this

It isn't just entering 8inches that increases the risk for potential issues, but its the injection of silicone oil that I've been warning against for many years -- at that volume you're really putting your skin under a lot stress AND I have to imagine the risk of migration goes up (especially with a filler like silicone).

I don't want to alarm you, but I know first hand of an old forum veteran who went MEGA overboard with silicone and now he's experiencing health problems. Granted, he's likely bigger than 8inches but suffice it to say there is no reason to push your luck. I know of other cases where skin grafts were involved because of complications stemming from silicone oil. Sure, all fillers aren't without risk, but some are considerably more acceptable than others. You just don't really hear about this kind of nonsense with Hyaluronic Acid (HA), Radiesse, PMMA, Ellanse, and Fat -- certainly not to the same extent.

Most guys are lucky to acquire 5.75"-6.0" of circumference after all, which is why I would strongly recommend focusing on any minor touchups and moving on while you still have a (presumably) healthy penis.

And to all others who may be reading this, let me reiterate for those who aren't entirely sure (since it is my responsibility) --> there are currently 11 Sponsors that use filler injections, all of which have access to the same silicone filler Dr. Loria uses. Many of these are career injectors and/or innovators in the field of male enhancement. However, all of them refuse to use it, if not outright condemn its application in the penis in high volume. That doesn't include numerous non-Sponsors who feel & practice the same way.

And I'll iterate one more fact --> certain Doctors (who won't be named) will almost always tell me via monthly phone-calls about "the new Loria patient they had to see and fix" as if it were routine. It stands out because it outnumbers any other filler by a wide margin. Again, no intention of alarming anyone who's already undergone the procedure, it's already water under the bridge. It's my responsibility to PSA certain topics when they come across my proverbial desk.

Anyways, without getting too off topic, as I stated before, my sincere and very stern recommendation would be to address any minor touchups (if necessary) and to retire from penis enlargement altogether. You're easily the biggest most people will ever come across in person in their lifetimes as far as girth is concerned, why push your luck? Take whatever victories you get in life! Food for thought.

uncuthero wrote: so dr loria uses silicone oil for glans

Is this still true? For the love of all that's holy, keep silicone oil away from your glans gentlemen... it's bad news.

Hyaluronic Acid (HA) in low volume remain the most effective solution for glans enhancement. I know PMMA and Radiesse have been attempted in the past as well, but I get the impression by many phallo-docs that HA remains their preference (probably to do with safety). There are two major problems with glans enhancement in general:

1. The layer in which the filler is injected is incredibly thin, limiting how much can be injected safely in one go (and by extension, capping how big you can get).
2. Also, due to the anatomy and physiology, the filler doesn't last nearly as long in the glans as it would in the shaft skin, where there is much more areolar space for filler & connective tissue.

I'd venture to say glans enhancement may be worthwhile if:

• You possess notably undersized glans
-OR-

• Budget is of no concern, because glans enhancement will likely require the highest frequency in follow-up top offs.

Super appreciate the info! Thank you.

Are top offs generally to address if fat fails in certain areas and creates unevenness?