PhalloBoards - An Online Community to Discuss Penile Girth Enhancement

In all my years reviewing every bit of literature that has come through the PhalloBoards (and elsewhere) as it pertains to these procedures, I haven't found anything alarming with respect to penile enhancement + PMMA.

The only (hardly) note-worthy matter is when men have had large volumes (we're talking hundreds and hundreds of cc's/mL's) injected intramuscularly that later go on to deal with rare systemic granuloma issues (which in turn can cause other & lesser known rare issues to occur). It should be noted these studies involved silicone oil, but due the involvement of granulomas, it's plausible any permanent or long-term filler injected in heavy volumes intramuscularly could plausibly have some type of late onset risks.

However, keep in mind PMMA in the penis is injected in 10-20 cc's/mL's at a time, and seldom (if ever) exceeding 100 cc's/mL's in total over multiple rounds, all injected inter-dermally (not inter-muscularly). Also, granulomas in this regard are exceedingly rare and typically much easier to manage or resolve because of how localized it is (versus having a foreign material injected in hundreds of cc's/mL's in different areas of the body, like the buttocks, etc.). I make this clear because it does not have the same parameters as the aforementioned study, with significantly less volume, not silicone related, and skin injections (not muscle).

In a nutshell, I haven't seen a report, study, or former patient who has had strictly PMMA enhancement of the penis show any adverse sexual and/or life impacting events, and I've been monitoring the PMMA bit since nearly the inception of this site. It should be noted, however, no procedure is without risk. If you are highly risk-averse, you may want to consider Hyaluronic Acid (HA) alternatively. That said, I've had PMMA in me (through Avanti Derma in fact), with the next month marking 13 years post-op of my first appointment, with no complication to date.

You just have to weigh the pros & cons of what is known.

quantity wouldn't cause an embolism; an absolute muppet going Leroy Jenkins on your dick with a needle would. Whether they use a cannula or needle, HA shouldn't be going into your vasculature at all. HA is a dermal filler, and will go between two dermal layers in your dick's skin.
As a non-doctor, my minimally-educated opinion is 10ml is neither absurdly aggressive nor overly conservative given your starting dimensions. If you were already swinging an amazonian eggplant it would be too little, if you had a micropenis it might be too much, but you're bang-on average and that's a bang-on average volume.

For aftercare the doc SHOULD be providing you guidance. There's a whole heap of info on it here phalloboards.info/forum/progress-reports...54190-aftercare.html
The PhalloFill people, who use a different HA, have guys wear a sleeve for a couple of weeks almost around the clock to force the filler into a good shape before it sets. I don't think any of us could guide you through mimicking that sufficiently online. My guy had me wrap and massage - when i wasn't massaging, i had it lightly wrapped to stay elongated. Periodically I'd unwrap, heat it up with a hot rag, try to get hard, and manipulate any bulky or clumpy spots, then let my erection subside and rewrap - in hindsight using a weight to stay extended would have been helpful, too.

@girthseeker98
I look forward to hearing and seeing more about this device. I assume you went through a physician. The entry price is steep but if it really works it might be the best option at least for length regarding cost, safety and hassle/time. I know some of the members here have spent greater than 20k on fillers or dermal graft/lig cut surgery. My question is the permanence after stopping. Most people who have made gains with PE lose some once they stop.

As a precautionary measure, it's advisable to avoid dental work or immunizations for four weeks after filler injections and one week prior. This strategy aims to minimize the risk of adverse reactions associated with filler procedures. Invasive dental procedures can lead to bacteremia, where bacteria enter the blood and may attach to dermal fillers as biofilms. Biofilms are clusters of bacteria that form a protective barrier, making them hard to eradicate and potentially causing inflammatory reactions around the filler. Over the years I have seen individuals who underwent dental cleaning immediately after filler injections were more prone to experiencing adverse reactions. Similarly, a filler reaction can occur following a vaccine administered shortly after the procedure. These responses are well documented in the medical literature. I would strongly advise you to space these procedures. Not what you wanted to hear but better safe than sorry.

I'll preface with this. When I finally pulled the trigger back in 2019 to get dermal fillers, in the back of my head I knew my end goal would be something substantial so long as it was safe and functional.

I took a break from PMMA due to logistics, COVID and because I wanted to be a bit patient with watching options develop. All of a sudden, HA practitioners began popping up with pleasing results, rumours of practitioners using other fillers began swirling (such as Ellanse, Scultpra, Radiesse, etc) and I wanted to just wait and see.

In early 2023 I stumbled across two HA practitioners in the greater Toronto area. The consult at one just was not for me. The second seemed more cautious about my PMMA and his bedside manner seemed agreeable to me. I went a couple of times for HA. His approach was a bit rudimentary compared to my prior experience at Avanti. Topical numbing only, small amounts of HA (to be cautious, which I totally agreed with, this is not a knock), product placement always seemed to be in line with the trend some practitioners have of just placing it on top. It gives it a pronounced appearance flaccid but that's about it. Not ideal in my mind. I wasn't overly thrilled with the aesthetics and still wanted more but I was kind of told to wait. Of course nothing changed.

Fast forward several months and I randomly did a Google search, scrolled and found Leonardo Medicine. Never had seen the result before in a search. I checked out his site and did some digging, doctor seemed quite accredited. His results pictures were also excellent. So I finally reached out and he did a virtual consultation. Initially it was for his Hybrid Filler, which is a blend of HA for bulking and Radiesse to promote collagen growth more akin to the sphere based fillers like PMMA and Ellanse but not as permanent. He wanted to wait while he talked to other doctors who have come across PMMA patients and talked to Radiesse's manufacturer to get their input.

We decided to not try Radiesse at the time.

But he was willing to add size and do an aesthetic correction with HA. I was stoked. Lol.

Arrived at the clinic. It's in a building that was once residential it appeared but has been fully renovated. I'd compare his suite to a large two bedroom apartment. There is also a physiotherapy office, some type of medical testing clinic and I think a family practice and his independent office. Clean bright procedure room, secondary room and office, washroom, consultation and waiting area. I honestly love his practice. You feel private and comfortable. For anyone who has seen Avanti's office, similar clean and comfortable space. Parking is easy, highway access is easy.

Anyway. Topical numbing. Then an injected nerve block. Then for most patients an injection to induce an erection (Trimix I think it's called?). This never worked for me so we stopped using it and I had more luck just inducing one without for whatever reason. He prefers to inject erect or at the very least see it erect so he can have erect aesthetics in mind when filling. He uses some type of light that shows veins etc to make it even easier to work with the cannula or other syringes. Whole thing usually takes about an hour and a half from going in until leaving, give or take.

After my first fill, I was very happy with my aesthetics. At no point beyond that was it really to overly correct anything. Most guys would have been very happy at that point honestly.

So full disclosure, I have had quite a bit done. I am extremely happy with it. He can definitely do a very natural looking minor enhancement for those that want it, I've seen many of his results like that and talked to guys here in PM and on Reddit who ended up going and were very happy with half an inch or an inch.

Here's all of my appointments and volumes excluding this week. The attached pics are one comparison from when I first went to him and then prior to my most recent appointment (I was there for a hair treatment study a couple weeks ago and offered for him to take a pic).

August 7, 2023: 10 syringes of Revanesse Ultra (1.2mL for each syringe)
September 18, 2023: 8 syringes Revanesse Ultra
October 10, 2023: 8 syringes Ultra
October 30, 2023: 6 syringes Revanesse Contour
November 28, 2023: 4 syringes Contour
December 18, 2023: 5 syringes Contour
January 19, 2024: 6mL PRP

Not shown in pics below is what I am now, I went in yesterday for:

April 1, 2024: 8 syringes Contour + 6mL PRP

I will update and share more pics if the interest is there.

All summarized, I've been very happy. The addition of the PRP to the filler layer seems to have also helped keep things feeling very nice. I can't really say enough good things.

Just keep following your post-op instructions, it's too early to say anything about it short of any complications (which from what you describe sounds like a normal part of the process). When it comes to dermal fillers, you're almost always inevitably (like 99% of the time) going to have a subsequent appointment to touch-up, revise, and/or add more girth anyways.

It's a process, a marathon even. Let your body do the work, the massaging is typically for the short-term to ensure the filler stays evenly spread (or conversely, to prevent filler from clumping and creating nodules). You'll likely feel some unevenness with your fingers, but that's because you know your penis better than anyone else. Don't allow that to alarm you, and try not to obsess over very small matters, especially if they are not complication-related (which with Hyaluronic Acid a.k.a. HA is uncommon).

Teosyal is more common Internationally if I'm not mistaken, do you mind if I ask where you got yours injected?

cwhite235 wrote: Hello everyone,

I've been considering getting fillers for a long time now, since maybe 2.0 or 3.0 forums, back when the big discussion was allografting vs fft - so I've been following these injectables for a long time.

My stats:
BPEL: 5.1" when I'm really turned on, but usually around 4.8-5"
EG: 3.8" head, ~4.25-4.5" mid to base
FL: 2" (but it retracts to almost nothing frequently)
FG: 3"

The main thing I'm worried about are the aesthetics because I turtle/retract so easily into almost nothing and my girth is really small when I'm flaccid, I'm worried about partners seeing it flaccid and looking weird/donut like I've seen described in some threads, and whether someone who's a true "grower" but also genuinely on the small size girth wise would be a good candidate for this?

I've seen a lot of discussion about the P-long protocol and gaining length with it, so I'm wondering if that would be a good route to take before I go with injectables. Ideally I'd like to gain about an inch of length, and be around 5-5.5" girth - is that possible? Would it look okay on someone my size?

I'm tired of having to buy smaller condoms and even just getting to a point where I can fill out a normal one would be great

If aesthetics are your concern and you're a big retractor like me, dermal grafts like Alloderm performed by the likes of @PhalloplasticSurgeon_DrLiu are still very much viable as they've come a long way since iterations of this procedure early in PhalloBoards' 2.0 era. Since it is custom tailored to fit your shaft, you'll likely face less aesthetic irregularity; the trade-off is that it is surgical so will have longer downtime.

I also think injectables can work but I'd start with small volumes, perhaps Hyaluronic Acid (HA) to see how much retracting you do with the presence of filler. As a fellow retractor, you can probably do 0.5"ish in circumference (via graft or filler) while surviving the donut effect but that's just a guestimate on my part.

Thank you for the introduction. I feel honoured to be included in this forum to provide the best care possible to those seeking improvement in their size, function, and self-esteem.

My undergrad degree is in Engineering Science with a Fine Arts minor. I feel I bring both sides of the brain to the table when it comes to medical sexual aesthetics. Your outcomes should be natural-appearing with real-feel texture and enhanced performance. I have managed to engineer my own protocols and continue to fine tune my technique using nonsurgical minimally invasive commonly used aesthetic techniques such as Botox, Dermal Fillers, and PRP.

My Moto is “You Only Bigger. You Only Better”. That’s what I’m looking to deliver as an official P-Shot® and P-Long® provider and innovator in GROTOX®  (Penile Botox) and SCROTOX™ (Scrotal Botox) in Canada, along with the P-GIRTH™ male augmentation procedure in both the U.S. and Canada.

Sexual enhancement can be a very embarrassing topic to discuss with your doctor but my staff and I are here for you. Many consider me to be very personable and easy to talk to. I invite you to contact the office for in-person (preferred) or virtual consultation and consider visiting us for treatment. We are conveniently located just about 10min from Toronto Pearson’s International Airport (YYZ). We look forward to hearing from you.

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!

Leonardo Medicine Penile Augmentation
Contact Form (Website)


Leonardo Medicine
Sexual Medicine
Dr. John Leonardo


Services of Interest to PhalloBoard Members:
P-Girth - Non-surgical penile augmentation treatment using a choice of dermal fillers with or without PRP
Grotox - Botox for Growers to relax penile retraction (shrinkage), improve erectile function, and increase endurance
Scrotox - Scrotal Botox treatment to provide Scrotal Relaxation and to decrease excessive sweating
P-Shot/Priapus Shot to improve size and function using PRP


Location:
3826 Bloor St. West, Unit 2
Etobicoke, ON M9B 1K8
(Toronto)


Other Forms of Contact:
Phone 647-223-4436 -or- 647-526-5596
Email info @leonardomedicine .com -or- This email address is being protected from spambots. You need JavaScript enabled to view it.

I am sorry to hear about your ordeal. For those who have followed this forum long enough know my opinions about Loria (I refuse to call him "Dr.") as well as his deceptive "proprietary filler." If you hear those words, run for the hills! I actually took at a look at Dr. Malik to see if he'd be a viable Sponsor to reach out to, but once I learned he was injecting this crap, it was a no-go for me. I'll say it for the newcomers, but avoid silicone oil injections for penis enlargement, especially in high volumes!

Granted, it is true that infections are an associated risk with most medical procedures that involve any breaking of the skin (like injections and incisions) where pathogens can enter your system, albeit very low when proper measures are taken, especially in non-surgical procedures. It is indeed a risk nonetheless, remember that these are elective procedures; once in a blue moon things can and do go wrong. It's a small gamble, even smaller if you deal with reputable, experienced, and mindful practitioners (Loria isn't someone I'd describe in that vain). Furthermore, some Practitioners will provide you a dosing of antibiotics post-op as a preventative measure, even if the procedure is an outpatient non-surgical dermal injection.

While it is technically possible for even a reputable, highly skilled Doctor to have a patient acquire an infection from a procedure, it's something so uncommon that I can't recall the last time any Sponsor here has had a case so bad that it required this level of treatment. In addition to this observation, Loria is notorious for having complaints of all types, and with his proprietary filler, who's to say that it hasn't been tainted during the compounding/manufacturing process? While I can't know or say for certain, the very fact that he just won't offer Hyaluronic Acid (HA) or Bellafill (PMMA) tells me there is something fishy about this filler of his. I don't know of any other cosmetic practitioner who uses THEIR OWN mystery injection cocktails; if they choose to mix two or more fillers, they'll simply tell you what it is they are injecting and you can decide against any one of them. The same can't be said for Loria's filler.

How much of this was just bad luck (that small percentage of patients that will end up with an infection after a simple, non-surgical outpatient procedure) -OR- how much of this was due to poor product quality (e.g. tainted) and/or negligence or incompetence on the part of the Clinic's sterilization protocols, DOES NOT MATTER with respect to Loria and his cronies, because if it wasn't an infection, it'd probably end up being some other ridiculous issue.

Hang in there man, per our discussion in private messages, take my suggestions seeking out Doctors who have dealt with Loria complications -- those who haven't, simply don't know what they are dealing with and may actually exacerbate the situation unintentionally (you'd be surprised to learn how often I hear about people telling me that their ER Surgeon, Urologist, or Family Practitioner had no clue what they had done to their penis). Penis enlargement is still very niche & experimental technically-speaking and therefore specialists are vital in acquiring the best care.

Do you mind if I ask what Loria or Malik said with respect to your situation, or if they offered to help? Were they at all at least trying to offer help, whether to you or your treating physician?

I would give Hyaluronic Acid (HA) some time to integrate. Despite it not being a conventional collagen filler like PMMA or Ellanse, it still stimulates some collagen and elastin by virtue of having been injected inside of you, inducing a mild inflammatory response. In time it will better mimic your shaft, both flaccid and erect. I wouldn't pass judgment until a minimum of 6 weeks post-op. Also, it carries with it the best safety profile among manufactured dermal fillers, making it at the very least a good test filler, and for many, a sustainable filler (since you won't have to inject nearly as much in subsequent rounds to retain size/gains). Food for thought

(10.) Are there any circumstances in which a patient cannot undergo the P-Long Protocol?
Those with a penile implant are not a candidate for P-Long. It is rare for a patient to not be a candidate for the P-long protocol, since everything that is injected is from the patient's own body. However, this is why we have our provider assess you prior to any procedures to ensure candidacy.


(11.) Is it possible to undergo the P-Long Protocol after having received girth injections? How will the Doctor know how deep to inject the PRP if there is dermal filler present?
Yes, since we follow strict disinfecting and sanitizing protocols prior to procedure. The depth of the injection will be aided with ultrasound, which our providers have been trained in.


(12.) Will a detailed set of instructions be provided to the patient? And for how long will the patient need to remain prescribed to this regimen in order to see benefits in both length and girth?
Yes, prior to treatment a consent form will be provided to review and sign, which lists important information for the P-Long treatment. Post-care instructions will also be provided. The P-Long is a six month protocol that does require dedicated effort and consistency for the entire duration of the six months. For optimal results, we recommend following the full length of the six month program.

(19.) Do girth dermal filler injections adversely impact blood pressure or increase risks of hypertension?
Dermal fillers absolutely do not affect blood pressure or increase risk of hypertension. They are strictly placed underneath the skin of the shaft and have no systemic effects whatsoever. The only rare issues are granulomas which can happen with any product and cannot be predicted or prevented. Sometimes the body's immune system can get activated which then attacks the dermal filer causing a granuloma or inflammatory nodule. Almost all of these issues are easily treated with local steroid injections.


(20.) Why are high volume silicone-oil injections into the penis regarded as the least safe or least ethical option as a girth filler by the PhalloBoards Moderation Team and many of its Sponsors? Have you ever dealt with patients who have had botched silicone injections from another Clinics come to you for revision?
FDA had issued warning in 2017 and again in 2021 against use of injectable silicone for facial or body contouring. In fact silicone has never been approved by the FDA for any dermatological condition. This "ingredient" or "product" is not very predictable in the skin and have known to spread and cause systemic side effects years later such as pneumonitis, ulcerations, migration, hyperpigmentation of the skin overlying the silicone. I have never seen a GE procedure from another clinic with a complication but I have seen it in the buttocks and lip, where the treatment of the complication required invasive procedures that left the patients with many unsightly scars.


(21.) Despite complications from correctly performed dermal injections being rare, foreign born granulomas (FBGs) are often regarded as the worst-case scenario complication. Have you experienced FBGs in your Practice? How would you go about treating this issue in the event a patient experiences signs of an FBG?
Granulomas can happen with any substance injected or implanted into the skin. By definition anything except for autologous grafting can cause a granuloma. An example would be if you suffered a viral infection such as the flu and the body mounted an immune response that decided to attack the substance that was injected. We advise avoiding any dental procedures or vaccinations 2 weeks before or after dermal filler injections to prevent this. Depending on how severe is the granuloma, I would typically inject a steroid such as triamcinolone into the granuloma and majority of the time this would resolve the issue. Not super common but I have seen a couple and indeed were mild. Sometimes if the granuloma was not even visible and we decided to leave it alone.

This is a question frequently arises in consultations: Can patients who have had a satisfying experience with HA fillers transition to polymethyl methacrylate (PMMA) for a more enduring result?
The most common scenario is : a patient tries HA and is happy with the results and now they seek a more permanent option with PMMA. Is this transition feasible? The short answer is yes.
Some doctors suggest it is problematic and want you to dissolve all your HA before proceeding with PMMA. Their concerns are as follows:
1. Risk of Complications:
They argue that the presence of HA might interfere with the PMMA integration process, potentially leading to unevenness, granulomas (inflammatory reactions), or even more severe complications due to the unpredictable interactions between the two substances.
Response:
There is no inherent reaction between HA and PMMA that would preclude their sequential use. It is important to remember that hyaluronic acid is a naturally occurring in the skin's dermal matrix. When PMMA fillers are injected into the dermal or subdermal layers where natural HA resides, they typically do not provoke adverse reactions. This is because PMMA microspheres are designed to be biocompatible and, when used correctly, should not interact negatively with HA or other dermal constituents. Injecting PMMA in areas previously treated with HA-based fillers should theoretically be as safe as injecting it into the untreated dermis, which already contains HA. The key is the technique used during the procedure:
2. Unpredictable Outcomes:
The concern is that the temporary HA filler could alter how the PMMA settles, potentially leading to asymmetry or dissatisfaction with the aesthetic outcome.
Response:
The injector must employ precision when injecting PMMA to ensure the microspheres are evenly distributed and to avoid the formation of granulomas or nodules just as they would when injecting into a penis with no HA. PMMA should be carefully injected to avoid disrupting the uniformity created by the HA fillers
4. Gradual Transition:
Some practitioners advocate for a gradual transition from HA to PMMA, allowing the HA to partially metabolize naturally over time. This approach can provide a smoother transition and reduce the risk of complications associated with immediate layering.
Response:
I fully agree with this. If you are at a size, you are happy with why not just slowly replace your HA with PMMA over time. It allows you to have more precise placement of the PMMA.

5. Time Interval: It's sometimes advised to allow sometime between the HA filler dissipation and the PMMA injections. This gap can help the practitioner assess the natural anatomy of the penis without the influence of the HA filler.
Response:
This not necessary if the original HA filler was well placed and has been well integrated into the tissue. This might be desired however if the original HA was poorly placed.

Why Not Dissolve the Existing HA?
Dissolving HA is not cheap, hyaluronidase is expensive, and a significant amount is needed for full reversal. Why incur this expense if it is not needed. Also why reverse the gains that you have already paid for? Dissolving the existing HA just seems like an unnecessary expense.

Conclusion
From a biochemical standpoint, there's no reason to expect that PMMA cannot be safely injected into areas where HA fillers have been previously placed.
Through my clinical experience, I have found that both hyaluronic acid (HA) and polymethylmethacrylate (PMMA) fillers can be safely employed for penile augmentation, whether they are used together or in a sequential approach, to meet the preferences and objectives of my patients.

getmoregirth.com/blog/