PhalloBoards - An Online Community to Discuss Penile Girth Enhancement

Dr_Tsay wrote: srogers

You are correct about the Renuva. Great for top offs or add ons after a fat transfer.
As for HA, I used to use primarily Juvderm Voluma XC in the past because it was one of the highest G prime fillers meaning the firmness and amount of lifting capacity (lifting the skin creating enhanced girth). Since Juvederm Volux came out in early 2023, Ive really enjoyed this more due the an even higher G prime. For example, in the face when Im using Voluma to create a strong jawline in a man, I would typically need 6-8 syringes of product. When Volux came out and is FDA approved for Jawline, I noticed I would need as many syringes for the same effect. So even though the product was more expensive, the patient didnt have to use as many overall to get the same effect in the jawline. Regarding GE procedures, there is also this phenomenon that a small amount of filler creates more "POP" compared to Voluma, although the volumes required to get to a larger size are still about the same overall. Another advantage is that the Volux is less "squishy" compared to other HA products Ive experienced (i.e. Versa, Juvederm Ultra, Restylane L, etc).

I have been patiently waiting on Ellanse to get their FDA approval in the United States. I have heard great things about its utlity in GE procedures anecdotally, but will hold off on using this until they get FDA approved here in the US.

Dr. Tsay

@Dr_Tsay any idea when Ellanse will be approved in the US?

srogers

You are correct about the Renuva. Great for top offs or add ons after a fat transfer.
As for HA, I used to use primarily Juvderm Voluma XC in the past because it was one of the highest G prime fillers meaning the firmness and amount of lifting capacity (lifting the skin creating enhanced girth). Since Juvederm Volux came out in early 2023, Ive really enjoyed this more due the an even higher G prime. For example, in the face when Im using Voluma to create a strong jawline in a man, I would typically need 6-8 syringes of product. When Volux came out and is FDA approved for Jawline, I noticed I would need as many syringes for the same effect. So even though the product was more expensive, the patient didnt have to use as many overall to get the same effect in the jawline. Regarding GE procedures, there is also this phenomenon that a small amount of filler creates more "POP" compared to Voluma, although the volumes required to get to a larger size are still about the same overall. Another advantage is that the Volux is less "squishy" compared to other HA products Ive experienced (i.e. Versa, Juvederm Ultra, Restylane L, etc).

I have been patiently waiting on Ellanse to get their FDA approval in the United States. I have heard great things about its utlity in GE procedures anecdotally, but will hold off on using this until they get FDA approved here in the US.

Dr. Tsay

Yes, first and foremost, go with trusted providers. That isn't to say "Thicken" isn't a good brand, but there are Clinics up popping up left and right who already use fillers off-label, and upon learning that this (penis enlargement) is an option, offer it because they can. Truth be told, most of the worst work I see are by non-Sponsors.

I know that's easy for me to say, but the fact remains that the VAST majority of traffic never posts even once. Even among Registered Members (you don't need to register to read, only to post, or to purchase Premium Membership to view attachments), I believe on PhalloBoards 2.0 it was like 15% ever posted once or more, it's considerably less here. Most guys do their research, book, and go about their lives. I really wish more guys would pay it forward like the pioneers before them.

The reason I cite those statistics is to explain that there is a lot of back channel information I'm privy to. Emails and Private Messages come my way seeking advice that simply choose not to post publicly. They know with my work here that I treat anonymity like HIPAA (despite not being a Healthcare Practitioner), so I see a lot more than just what goes on publicly. Suffice it to say, most of the worst work (in terms of aesthetic appeal) come from "no-namers."

Also, the Sponsors here not only have been vetted, but have demonstrated a desire to be leading innovators in the field, and that's reassuring. Furthermore, putting their face on this forum takes guts because substantiated negative reviews are permitted (there is no censorship or shilling here). So if someone is willing to embrace Sponsorship of the PhalloBoards, it tells me they want to be a big player in the industry, and not some Family Practitioner-turned-Botox Spa side hustle (no offense to any who may fall under that category, I'm sure there are some who are indeed good at their craft). Sponsorship isn't terribly pricey by a Doctor's/Clinic's standards (I do not disclose financial-specifics other than acknowledging that they are Sponsors, which means exactly that) so if they don't have the guts or pocketbook (i.e. low volume whether because they are extremely new to the scene which implies inexperience or because they put out bad results) to promote themselves on the only site anywhere on the web dedicated to the topic of surgical & non-surgical elective medical male enhancement, why put your one & only penis in their hands? Stick with the "Big Guns" if you want a "Bazooka."

I cannot vouch for the Newport and Los Angeles PhalloFILL Providers (It's only the Headquarter Dallas Location that is an Official Sponsor here), but they have been trained by the PhalloFILL team so you certainly aren't dealing with slouches. On the other hand, Avanti Derma primarily employs Ellanse and Linnea Safe (PMMA) which if you are not comfortable with, I'm not going to try and impose on you other than to say that they have been demonstrably efficacious in the penis long-term (nearly 15 years-ish following its use).

Many start with HA, some like it and don't mind its annual maintenance (every 12-18 months or so, depending on your body's propensity to breakdown foreign bodies), usually requiring less and less volume, making costs manageable (and well worth the investment because its effects are life-changing). Others may prefer the Ellanse or PMMA route afterwards if they were either unsatisfied with HA or found the maintenance to be costly long-term. A lot is to be considered, weighing pros & cons, there is no perfect option, some like the safety profile & non-permanence of something in their penis, while others like to get it one & done and never have to worry about it again. As long as you aren't getting a rigid silicone implant or high volumes of silicone oil inside of you, and stick to the PhalloBoards friendly fillers, you'll be alright (i.e. HA, PMMA, Ellanse, Radiesse, Fat Transfer, and Renuva).

That said, just as I praised Ellanse & PMMA, I will equally praise HA and confirm your understanding that it has the best safety profile among all fillers, because it does. It's already naturally occurring in your body, it's only been cross-linked in a lab to behave more like a dermal filler, somewhat if not mostly reversible (depending on how much volume injected and how soon after you choose to do it), and will EVENTUALLY dissipate in the event you don't like it, meaning you won't need any invasive procedures to remove it surgically (that said, again being as impartial as I can be, it's exceedingly rare for people to get PMMA or Ellanse completely removed when having it originally injected by a legitimate practitioner).

Personally, if it was HA I truly desired, I'd hit up Dr. Tsay ( Additional Link ) in Orange County or fly to the PhalloFILL Office in Dallas ( Additional Link ). Again, not a knock on the Newport or Los Angeles locations, I just can't personally vouch for them, but if it were them vs. Thicken, my bets on the PhalloFILL locations. That said, if you are going to spend what you're spending, I'd take a look at some of the options I mentioned.

Good luck and keep us posted!

Thank you, I am very happy with the result, both on erect and flaccid measurements. One under-appreciated effect for me was the movement along the grower to shower spectrum. Very satisfying psychologically and in addition to my partner’s reactions to the larger size, which have been both notable in her reactions and own admission. For those on the fence, it really does make the impact you are seeking in performance.

On the product decision, my understanding is that Renuva is really there to top-off prior fat transfers. I think it is fairly costly per ML and you more total MLs when using fat transfers or Renuva such that building up solely using Renuva would not be recommended. I wasn’t considering a fat transfer based on my research on the forums (although I understand they have come along away from where they were 10 years ago). Ultimately, I liked the safety profile offered by HA given the non-permanent nature, reversibility if was very dissatisfied, etc. In terms of which filler, I think Dr. Tsay would steer most people towards either Voluma or Volux. Volux is supposed to provide a better, firmer result that lasts longer all things else equal, but is more expensive. Dr. Tsay does perform fat transfers but I was pretty sold on HA before contacting him and steered the conversation down that route.

I asked Dr. Tsay if he would ever consider using Ellanse in the future if and when approve by the FDA and he seemed excited about the opportunity, but he doesn’t seem inclined to consider Bellafil/PMMA as I think he has had experience with people who come to him for HA after receiving PMMA they are not happy with.

That's a thick, aesthetic end result, and I know you mentioned you weren't sure you were going to Progress Report (hence the lack of Before photos), but I'll tell you that it's most appreciated. Keep us posted if you can!

Dr. Tsay has high marks for bedside manner and is known to be accommodating when answering questions. Mind if I ask how you both chose on HA versus Renuva or Fat or any other alternative (since I know he offers a plethora of fillers)? I know with some other Clinics they usually assess the penis before deciding, or was it you who decided ultimately?

After lurking on this forum for quite some time, and waffling over PMMA and Ellanse on the one hand (was considering Avanti Derma given I am in Southern California) and HA in the other, I decided to go with HA. I still may consider them in the future for reasons I mention below, but so far, I am extremely happy with my decision on both the HA route and Dr. Tsay. I mainly saw the discussion around Dr. Tsay on the forum related to another product he offers, Renuva, and didn’t see any in-depth discussion on his HA procedures, but I chose him based on location and the general recommendation of the forum.

I received a total of 25 ml of Volux over three rounds between September 2023 and March 2024 (Round 1: 10 ml, Round 2: 5 ml, Round 3: 10 ml). I believe 10 ml is the max he will do per round, but can’t recall if he said that exactly. 10 ml is a good increment and provides a noticeable difference, but my guess is most people will ultimately want multiple rounds unless they are already on the bigger side.

My initial stats:
FL: 4.0”
FG: 3.5”
EL: 6.0 “
EG: 5.0”

6 days post 3rd Round:
FL: 4.75” – 5.0”
FG: 5.0”-5.25”
EL: 6.0”
EG: 6.125”

Dr. Tsay’s office is located in Tustin, CA, which is about an hour outside of LA. The office is clean/modern and comfortable. From what I saw, all of the staff are great, friendly, and professional young women who assist all the way from scheduling through post-care. They mainly communicated through text which was very convenient, and they are very responsive to your messages including through post-care.

The procedure itself goes like:
1) Arrive and fill out forms.
2) Go into the exam room, undress from waste down and put on paper gown, apply numbing cream to the base.
3) Dr. Tsay and staff come in and start sterilizing the area, which involves cleaning and some liquid that feel pretty cold when applied (which actually kind of helps for next step).
4) This is the only unpleasant part of the whole process, which is the numbing. It’s really not that bad and takes about 90 seconds I would guess. Initial poke is actually fine because of topical numbing, but you will feel a deep aching kind of sensation at parts. It’s over pretty quick.
5) Dr. Tsay layers the product in. He is very focused on you being comfortable and good with the progress and service. Both he and the staff have great bedside manners.
6) You get bandaged up and get post-care instructions.

Post-care: No working out for a couple days, keep it bandaged four 2-3 days, no sex/masturbation for minimum 7 days. Massage as appropriate.

I am extremely happy with the results. The only downside with HA as I can see it is that you have to continue it indefinitely. Volux was said to last 12-24 months, but highly variable based on each person. I don’t think I’ve observed any loss to date, but it’s hard to tell given the spread out rounds.

*All my pics as of 6 days post-3rd round. I wasn’t planning on writing a detailed review so didn’t take my own before pictures. I was ultimately so grateful I ended up pulling the trigger, I wanted to post what I could to hopefully convince whoever is considering Dr. Tsay to just book.

Endolift effect is around 2 years?

So like on the instagram-link - you would do it on the shaft, right? This is what you meant by mircroneedling? Or this is called only Endolift, right?

- Is it a problem that I have there Pmma now in the meantime … ? I m very happy with the optical result of my Pmma (what I have since 2019) - but an unsuccessful FFT the year before (2018) (all absorbed) gave me a lot loose skin - so my Pmma has too much space to move around. In 2023 I already did a very strict tight cut revision circumcision- but this does not help. The filler still moves left/right while touching. Also in erection.

- What are the costs of the surgery on the shaft?


I m happy to hear your feedback !

I answered the question earlier. Bodytite and Renuvion are basically used during surgery for body skin tightening. They both require incisions and are overly aggressive for a small are such as the shaft. Now that you mentioned it, I have used endolift (see link to my instagram below) to tighten the skin of the shaft because a client complained about too much loose skin on the shaft from swelling after excessive masturbation. That could also theoretically could be used for melting fat see link below but RF microneedling is way safer. Remember safety should be a top priority for any cosmetic procedure.

www.instagram.com/reel/C0iTsbxL2QR/?utm_...gsh=MzRlODBiNWFlZA==

RF microneedling stands for Radiofrequency microneedling. It tightens skin and at certain depths depending the location of the body and skin thickness, it can also destry fat cells..

Update to FAQ (always educational) --> phalloboards.info/forum/dr-tsay-ask-me-q...wers.html#1308716255

@Dr_Tsay

- Is it smth like Shockwave Therapy what also women use to burn fat?

- Or can it be more compared to BodyTite/Renuvion ?


Maybe additional question
Also: I do not expect an exact answer but do you think RF needling would be a risk / or reduce my Pmma (what I got in the meantime)

@Dr_Tsay
Thank you for your qualified answers in that forum.

What is „RF“ microneedling?

PmmaFan

Sorry to hear you are not satisfied from a prior FFT. There are also different levels of unsatisfaction with some complaints more difficult to address than another. Sometimes i use Renuva (filler that grows your own fat) to blend in any discrepancies or unevenness. I would not recomnend using Kybella or anything similar because the chemical can diffuse to either Bucks or Dartos fascia and cause problems there or worse case fibrosis and scarring. the good news is that the fat will eventually dissolve over time. If it were me I may consider RF microneedling at 0.5-1 mm depth and over several sessions. This can cause a mild fat melting and at that depth you are not going to deep to affect any of the important underlying structures and connective tissue.
Hope this helps and good luck!
Dr. T

Viable options still in discussion, in a nutshell:


Non-Surgical (Injectable Dermal Fillers):

• Hyaluronic Acid (HA)
• PMMA
• Ellanse (not available in the U.S.)
• Radiesse
• Renuva

Surgical:

• Fat Injections (FFT)
• Dermal Grafts (e.g. Alloderm, Surgimend)
• Ligamentolysis (lengthening surgery)

Protocols (neither surgery or filler injections; primarily relies on a prescribed enlargement routine and possible supplementation over a period of time:

• P-Long
• A soon-to-be-announced Rejuvall Protocol

Also worthy of note* -- rigid silicone implants for the purposes of augmentation are still just as bad as they were in 2011, and large volumes of silicone oil as dermal filler injections are arguably just as bad -- avoid both!

Check out the Phallo-Guide for a refresher, then hit up the Physician Directory to see which vetted & screened Practitioners are in your area who may provide the kind of services you are looking for.

And of course, there is a lot to catch up on, so find an hour(or more) every week and brush up on the last couple years of discussion and progress reporting. Good luck!