PhalloBoards - An Online Community to Discuss Penile Girth Enhancement

Ah I see. See answers in bold:

Whether you have any thoughts on botox as a means to prevent migration and whether it's safe.

I'm not sure how Botox would prevent migration, then again, the risk of migration with Hyaluronic Acid (HA) has never been discussed because it's a non-issue. Not only would a skilled & experienced practitioner know where to inject it, but the very filler itself is just a more cross-linked version of the compound that already occurs naturally in your body. Furthermore, a few Clinics have been using Botox in the penis for quite some time now, and just like its use in the face, it has been shown to be safe and effective for improved flaccid hang and/or mitigating retraction (i.e. turtling). The only thing you have to account for is how long it will last, since with any Botox application, routine maintenance (i.e. follow-up injections) will be required to retain its benefits.

Whether I should stick with the same filler, or I'll be fine if I have more than one filler in terms of maintaining a natural look.

If Dr. Tsay happens to offer the original filler you had, I'd go with that only because we already know this iteration of HA has a proven track record with you; if Dr. Tsay does not offer your original filler, I don't think there will be much in the way of significant differences if all you are doing is fixing aesthetics & symmetry. This will be a conversation you will need to have with him, but working with different brands of the same kind of filler (HA) is going to be easier to manage (I would imagine) than mixing different TYPES of filler in the penile shaft (example: PMMA + HA, or Fat + Ellanse, and so on). Not that other combinations aren't effective or safe, but rather, the same TYPE of filler is more likely to play nice with what's already there.

Regarding safety, are there any instances that you've seen of Dr. Tsay causing issues to penis functionality given that he gets closer to the urethra and goes on the top of the shaft as well where there's more vascularity?

No, Dr. Tsay has no reports that would warrant questioning the safety of his approach, especially with respect to the penis. Dr. Tsay was brought on board because of his prolific reviews involving facial injections, perhaps the most difficult area to enhance because it's the most seen part of a patient to the outside world (as in, contouring female facial beauty without looking "plastic" is a testament to his proficiency in filler technique). He wanted to venture into male enhancement a few years ago and has put out great work and has had positive reception since. While it is unfortunate you couldn't stick with William of PhalloFILL Dallas, I can understand why some may opt to remain local, and I have every bit of faith in Dr. Tsay with handling your work moving forward. Make sure you set realistic expectations, be clear & communicative with your goals, and trust his recommendations if you wish to optimize future sessions.

Timeline: This is not a "I did Ellanse in year 202X" and here's where I'm still at, because since the COVID years I've had multiple top-up treatment sessions to correct unevennesses and fill in gaps, so my most recent session was 1 mil done in August this year. But I will not have anothe top-up treatment.
Stats: I have sex with men. My erect length is 12~12.5cm, and before the procedures, my erect circumference was 10.5cm. My current erect circumference is around 14-15cm.
Appearance: When flaccid, I have this quite visible turtleneck effect, because the collagen can't shrink when my penis goes flaccid, so it just bunches up in the shaft, whilst my glans shrinks, so it's a very unnatural look, and I'm very self conscious to display my flaccid penis to other guys because they all know it doesn't look normal. For numerous times I was asked by other patrons at gay bathhouses if I had done a "dick-job" or a filler injection. And I don't know how to respond.
Erection quality/texture: I think because of the volume injected and therefore the collagen formed is too large, it adds a lot of weight and wears my penis down when I tried to have an erection. And unless I achieve a 100% erection (which usually takes me 2 weeks of abstenance and meeting a very attractive man who is completely out of my league), my erection rigidity and hardness can reach an 8 or 9 out of 10. Otherwise, if the blood in my penis is not enough to have my corpus cavernosum press against the collagen, my sex partner can feel the collagen under my penile skin and it's softer (like a layer of some substance rather than just human flesh) than how a normal penis feels to the touch.
Sensitivity (and in comparison to ADM/AlloDerm/MegaDerm): Ellanse only produces collagen, it may be vascularised but nerves don't grow into the collagen, which means the sensitivity in my penile shaft is almost non-existent, to achieve orgasm, my only option is to stimulate the head. In comparison, I have read that not only blood vessels grow into the AlloDerm/MegaDerm matrix as it's integreated into the surrounding tissues, but nerves also grow into the matrix and the new tissues, leaving the shaft as sensitive as before. I also don't know if the better vascularisation in the matrix makes erection stronger and more rigid.
Confidence on sex life: Initially, I went through the procedure to increase my sexual confidence, and to no longer be turned down for having too small a penis, but now quite often in a gay bathhouse, as soon as a guy has a feel of my penis, he walks off. I feel very frustrated.
Where to go from here/if I could travel back in time: I know that steroid injections can reduce the collagen formation, but I don't know whether the outcome will be even and smooth; I also know that despite Ellanse being branded as a semi-permanent treatment, the collagen is actually irreversable, and the only way to completely remove the collagen is to surgically remove it. As you can probably tell, if I could do it all over again, like if COVID border closures never happened, I would have flown to Korea or Taiwan (which has recently introduced the ADM procedure), or if the ADM procedure existed in my country, I would definitely have gone that route instead. But this would involve surgically removing the collagen without damaging my corpus cavernosum and nerves in the process, waiting for it to heal, then receiving the ADM surgery and waiting for that to heal. I'm just not too sure at this point. It seems that H-Acid is soft but reversable, Ellanse says its semi-permanent for up to 4 years but the collagen is really permanent and strips of my sensitivity and reduces erection quality, have guys here done the ADM and are happy with a combination of sensitivity retention, erection quality, evenness and the permanence of girth increase?

I should add to your original post that the "scar tissue," claim by the Dermatologist, especially with respect to Hyaluronic Acid (HA), seems a bit over-zealous at best. I think what they may have been trying to imply is the presence of fibrosis, which is definitely something more common with fillers that induce neocollagenesis (e.g. PMMA, Ellanse, Radiesse) -- and even in light of this, dermal fillers (especially HA) haven't presented any pervasive problem in regards to sensation that this Dermatologist seems to allege -- I should note that I'm not suggesting this Doctor is lying or is speaking ignorantly, but that even one instance of said-complications could warrant this kind of attitude from a physician, especially those who don't specialize in male enhancement to begin with.

Approaching 15 years of dermal filler reporting in the penile shaft on the PhalloBoards, sensation-loss is seemingly a non-issue in discussions over that same timespan. I hope I'm not dismissing any legitimate concerns. Those who are reading this (especially the many unspoken whom I continue to implore to post) who believe otherwise, your wisdom would be most appreciated. Otherwise I'm pretty confident in my assertions here.

Also, if I may recommend, if it is HA you'd like to revert, I would perhaps let the HA break down on its own than forcing the Hyaluronidase process if possible, assuming your concern is fibrosis -- any notable introduction of a needle or cannula in and out of your dermal layers can technically introduce "scarring," even if negligible. Also, depending on the volume & timespan that HA has resided in your shaft may also determine how effective the Hyaluronidase enzyme is -- I've been told on numerous occasions it doesn't necessarily eliminate 100% of the HA, but typically most. So if you can wait it out, this might be best (if possible).

Those who you have tagged may have a very different insight than my own, and I'm not a professional healthcare or medical expert -- instead I'm best seen as more-or-less a "patient representative" with ample knowledge in this area due to my role here. So please defer to the Docs, Sponsors, and your own Practitioners when it comes to making any ultimate decisions.

lateinse wrote: the info around ellanse is very confusing tbh. could you please elaborate what exactly you mean by very long lasting? it says "up to" 4 years everywhere, but indeed, i've seen some people reported here that it did not degrade even after the fifth year. do we have any case where it actually degraded? are the types of complication same with pmma or less dangerous? is it recommended for the newbies?

Ellanse and PMMA generate girth much the same way, the main difference is that the PMMA microspheres are permanent and not degradable by your body, whereas the microspheres found in Ellanse are. However, the 1 & 2 year Ellanse versions were reportedly lasting well past the manufacturer's date, forcing them to take the 3 & 4 year versions off the shelf. It appears that the collagen associated with Ellanse is more robust and longer lasting than expected (likely being similar, if not identical to that of PMMA-induced collagen).

This is great news for penile patients, but not such great news for people who expected temporary gains, like in the face in those who are aging. In other words, there are different types of collagen the body produces, and the manufacturer of Ellanse underestimated its life expectancy when used as a dermal filler.

The complication associated with Ellanse are likely comparable to that of PMMA, including aesthetic irregularities (especially in uncircumcised men), and the much more rare foreign born granuloma (which are treatable).

I have a penile implant and considering filler, either HA or ellanse. Penile blood flow is slightly reduced for me because I have solid plastic tubes in the middle of my shaft. Do fillers tend to somewhat reduce blood flow in the penis or is it unaffected? Or even enhanced?

jaumzaum wrote: Hello. I would like to know what are currently the most effective procedures/surgeries for penis enlargement today. I know there are a lot of different surgeries and procedures, including lipoplasty, skin reconstruction plasty, V-Y and Z plasty, flap reconstruction, suspensory ligament release, ventral phalloplasty or scrotoplasty, penile disassembly, total phalloplasty, sliding elongation, fillers, grafting, biodegradable scaffolds and PENUMA. I would like to know from patients and doctors which ones are the most effective and secure (i.e. provides more elongation/girth as well as less complications). I'm considering doing a penis surgery this year, and this will guide me finding the best doctor.

Spend some time looking around. Here’s a quick synopsis:

Avoid at all costs the penuma implant, silicon injections (ie the Loria method), and strongly advise against having this done by a non sponsor.

Natural methods:

P - long : combines PRP shots with a daily stretching and pumping protocol.
Phalback: Daily pumping protocol with new technology for length and girth (4x the cost of p long)

Fillers:

Hyaluronic acid - safest , but expensive and don’t overdo it
Ellanse - firmer and longer lasting than HA, but not approved in the United States
PMMA - higher risk than HA because it is not reversible like HA. Also chance of granulomas. Considered permanent .

Surgeries - I would avoid but you’ll need to dive deep on the forum for that info.

There’s a mountain of info here. Read the progress reports here and on the 2.0 board learn from others best practices as well as what to avoid (there are some horror stories). Best of luck

Hi Saltypirate,
I know FFT is quite common for some doctors in Thailand, the advantage is low cost and the free and safe supply of own body fat! They will fill 40-50ccs in one time. I have seen some photos and initially it is really overfilled to allow for the body to absorb the fat and leave some behind. Dr told me the disadvantage is softer feel and the unpredictable results on aesthetics and the body will eventually absorb the fat. Patient has to undergo general anesthesia.

My Dr prefers HA due to safety predictability, less complications and ease of the procedure for patient. I believe there is a certain amount of customer satisfaction for HA vs FFT and some Doctors have personal preference on one procedure over the other because of that. The disadvantage is cost of HA.

However, the choice is yours and if you do opt of the FFT, please share with us, it would be very interesting to hear from a patient.

Personally, I have been to HE clinic and saw Dr Chayut, Yesterday was my 3rd visit but at his own clinic. The doctors in Thailand usually operate or are attached to several clinics and shuttle between the clinics depending on their specialty. The reason I brought this up is to inform of the fillers available. The Korean filler they use is either Neuramis or Dermalax, The patient has a choice of fillers and I think there is an ongoing promotion, Baht 68000/cc or USD 188/cc for Korean filler. The other filler available is Juvederm. On my 1st and 2nd visit they gave me Juvederm Ultra4, on my 3rd visit they now have Juvederm Voluma and I was injected with Voluma. I feel the Voluma is firmer than Ultra4 and I hope it will be longer lasting, I guess they have updated their filler supplies. the Juvederm is price B15,000/cc or USD416/cc. So don't worry if you just go in for a consult and shop around. It seems nowadays penile enhancement with HA and availability is very plentiful in Bangkok. Different doctors use different brand products, so you need to ask but most have options from Korean, European brands Mesoestetic and Juvederm.

My first visit I had filler on the shaft only and the second was to top up the shaft and enhancement to the glands. I was expecting the filler in the glands would disappear fast but it still had volume after 6 months so I went to get more yesterday. Since my experience was good, with almost no swelling and no discomfort, I'm a very happy customer. I always see how the Dr does the procedure and I feel his skill and technique is very good. For glands enhancement he is very careful and only has one entry point at center and will fill the corona ridge all around from that entry point.

I hope eventually Doctors in Thailand will have access to longer lasting fillers like Ellanse and offer that as another option.

Wantingbigger wrote: Did they not say why it's not available anymore in their London clinic?? That sounds abit Sus to me.

Nothing sus about it; they have a new Provider since Dr. Horn has decided to relocate (although in my understanding at present time, he's still Androfill associated) to Brussels, Belgium. The moving may have been personal or professional, I honestly have no idea, but I have every reason to believe all parties are on good terms, and that Dr. Horn is very much their Ellanse provider moving forward.

The new provider is not comfortable using semi-permanent or permanent fillers (Ellanse applies to the former), and thus sticks to Hyaluronic Acid (HA) only. This isn't unusual, there are reputable Clinics in the U.S. (PhalloFILL for example) who also choose to stick to HA exclusively. Every Practitioner has a preference, for any number of reasons/factors.

The one filler unanimously rejected by all ethical Practitioners are large volumes of silicone oil to augment penile girth. Otherwise, there is nothing "sus" (i.e. "suspect" to those unfamiliar with the lingo) about this policy change.

Capo710 wrote: Hey guys I’m looking for recommendations for a good dr to gain some permanent girth in California. I’d love to go to Avanti but my partner can’t leave the country for a while so I’m looking at other options. Thank you

Contact Dr. Tsay (Orange County) , Dr. Luis Lee (Northern California), Dr. Victor Liu (Beverly Hills and Bay Area) , and Dr. Brandeis (Northern California, P-Long Protocol) to consider your options.

Avoid any Clinics that offer penile implants to augment your penis if you are NOT suffering from ED, as well as large volumes of silicone oil filler (i.e. not using micro-droplet technique consisting of volumes of 10 cc's/mL's or less), or really anyone not vetted by the PhalloBoards and/or its Community.

If it's your first-time, you may want to consider more temporary options, especially if you can't travel abroad; Hyaluronic Acid (HA) has a strong safety profile and is offered by the vast majority of (vetted & screened) PhalloBoards Sponsors. Many end up liking it and continue to pursue it, while others may prefer less lifetime maintenance and opt for Ellanse or PMMA. You won't know until you try.

Just be sure you have realistic goals in mind, sufficient funds to accommodate subsequent visits, and a sound state of mind and sound motivations moving forward.

Good luck.

I second Avanti Derma's take on Ellanse. Many recipients of the filler are reporting much longer retention than originally projected by the manufacturer, which is actually great news for penis enlargement patients. Of course, Hyaluronic Acid (HA) is a good starting point and it isn't unusual for some Clinics trial HA first to see how well your penis acclimates to fillers in general. You may also find you like HA and stick with it, especially given its healthy safety profile if you come across a version/brand with better overall retention.

Truthfully I'm not sure what brand of HA Moorgate uses, and depending on the nature of its cross-linking & quality, may not be the most ideal iteration of HA for penis enlargement (pure speculation on my part if you've seen such a dramatic loss in a month's time @Kara101349 ). Typically you don't start looking at topping off any reductions until about a year (give-or-take a few months) post-op, so either you're a rare outlier (someone who breaks down foreign bodies rapidly on the extreme end), or the quality of the HA isn't ideal for penile application. This is open speculation on my part because I have no knowledge of what brand of HA is being employed, how/where it's being sourced, etc.

Fat transfer is an option as well, but I cannot vouch for the efficacy or quality of Moorgate's FFT work, I've only heard/seen their dermal filler results.

If you wish to remain in Europe, Androfill of U.K. or Dr. Horn's own Independent Clinic in Brussels, Belgium can provide HA, and Ellanse is available in the U.K. (I am awaiting on word about Ellanse's availability in Belgium). The only other options for Ellanse that are trustworthy are the aforementioned Avanti Derma in North America, as well as a Clinic or two in Australia, but I haven't been in touch with the Aussies in a bit so don't know the current status there.

Through my clinical experience, I have found that both hyaluronic acid (HA) and PMMA fillerpolymethylmethacrylate (PMMA) fillers can be expertly and safely employed for penile augmentation, whether they are used together or in a sequential approach, to meet the diverse preferences and objectives of my patients.

Hyaluronic acid fillers are particularly valued for their temporary and reversible attributes, presenting a less risky proposition for individuals exploring penile girth enhancement without a long-term commitment. These fillers deliver instantaneous results in girth expansion and are generally well-accepted by the body, exhibiting a minimal likelihood of adverse reactions. One of the standout benefits of VolumaHA fillers is their adjustability, allowing for fine-tuning to achieve the desired aesthetic and tactile outcomes.

In contrast, PMMA fillers are recognized for their enduring results and are chosen by those who desire a more permanent augmentation. The robustness of PMMA is attributed to its microscopic spheres that maintain their position beneath the skin's surface, thus offering a sustained enhancement in penile circumference. However, given the non-reversible nature of PMMA fillers, it is imperative to engage in a comprehensive consultation to ensure that patients have a clear understanding of the long-term commitment and are well-informed of the potential risks and implications.

While each type of filler has distinct characteristics that might make one more suitable than the other depending on individual circumstances, there are no intrinsic contraindications to using them in a sequential manner. This flexibility allows for a customized treatment plan that can evolve over time to align with the changing desires or satisfaction levels of the patient.

Hello @Abc123
Low and tight is the ideal circumcision in preparation for a nonsurgical phalloplasty. All of the others are secondary but better than no circumcision at all.
The difference between loose and tight is the amount of penile body's skin left and how relaxed it is.
Tight skin helps keep the filler in place; low scar allows the injector to place the filler as close as possible to the corona of the glans.
As mentioned by @hyperbol , it is a good idea (for cosmetic reasons) to leave a small area of the tight mucous membrane (where the cannula cannot go under) to maintain a neck.
If your surgeon is open to suggestions, you should go for low and tight.
DrC Avanti Derma

evolution10wrx wrote: better written, I want to increase the thickness of the penis in the healthiest and most FDA approved way.

As Dr. Sullivan pointed out, there is no FDA approved penis enlargement filler (or method) per-se. These dermal fillers (Hyaluronic Acid, PMMA, Ellanse, Radiesse, and Renuva) are used off-label into a layer of the penile shaft skin to create volume (simplest way of putting it). These fillers however, have been FDA approved for other specific reasons, none of which indicate girth enhancement, hence the off-label use (which is legal). I should note that Ellanse is still not FDA approved in the U.S. and is only available abroad.

In my personal opinion, Hyaluronic Acid (HA) is arguably the safest filler given that it already exists naturally in the body -- medical device manufacturers have cross-linked them to behave as dermal fillers to increase the volume of the skin. They are temporary in nature and somewhat reversible too with the use of a special enzyme to breakdown the filler if necessary. The trade-off with temporary fillers is that you will have to periodically top them off, and the rate at which HA breaks down/reabsorbs varies person to person. A safe bet is once a year, and you'll often times not need nearly as much volume to get back to your size-goal because not all of the HA will have diminished by then. I call this a trade-off because while you wish to seek out the safest option, you'll have to accept that maintenance comes along with it.

A counter example would be something permanent like PMMA (Bellafill in the U.S.). Due to its permanence, it can be very difficult and invasive to remove all of the PMMA in the event you have an undesirable result or complication. The trade-off here is that while it isn't as manageable as HA in terms of reversal/complications, you won't have to top it off periodically once you've achieved your final size goal. I should note that Bellafill is FDA approved and by and large is a safe filler too, relatively speaking.

So as you can see, some people prefer the peace of mind of HA in the event that they have undesirable results or complications because they are easier to manage, or would like to trial girth enhancement due to HA's temporary nature. On the flip side, permanent options like PMMA or dermal graft surgery offer a sort of "one & done" solution (with some potential subsequent touch-up appointments) which is a life-long convenience but can come with unforeseen challenges, despite complications being uncommon. You have to assess your own risk threshold, size goals, and what trade-offs are more compelling.

Hello @mantas ,
Can you elaborate on your statement about having your foreskin retracted for the last five years?
My response could differ depending on your response, but this is what I can say at the moment:
Avanti Derma physicians qualify prospective patients using a self-assessment table (see attachment).
As you can see, being uncircumcised does not disqualify patients but makes them "less than ideal."
It may look simple, but preserving the function of the foreskin is complicated. On the one hand, we need to keep it free of the filler; on the other one, we don't want to create a visible transition between the enhanced area and the foreskin.
Also, the foreskin gives a natural sliding function to the rest of the penile skin. This sliding capability of the skin is restricted in the circumcised individual.
In the uncircumcised individual, the bundle skin/soft tissue filler creates abnormal volume that slides towards the base during penetration or when pulled, creating the accordion effect.
So, even if you keep your foreskin retracted, its mere presence creates the same limitations.
Uncircumcised individuals are at a crossroads: either they undergo a moderate approach with a low volume of fillers, or they undergo circumcision to limit skin movement and thus be able to use a more significant amount of product.
The clinical results of PMMA and Ellansé are identical since both products are made of microspheres and promote collagen I and III formation. Remember, the only advantage (for some patients) is that Ellansé disappears over time, returning the tissues to their basal condition.
Please look for our eBrochure where you will find more information about all the topics in this thread. Please ask for it at This email address is being protected from spambots. You need JavaScript enabled to view it.

Wantingbigger wrote: Yes technique is key and also wanting the best possible outcome for your patients. In the UK from what I've that isn't the case. They inject a big lump of filler and then they'll send you, on your way to mold it. And with Ellanse that's not a good Idea.

Technique is not the key in this circumstance, but certainly helps in improving your chances for a good result. In the end, being uncircumcised increases the chances of aesthetic irregularity, reported by the most high-volume injecting Sponsors (and by extension, some of the highest-volume penile girth injectors in the world).

The U.K. has multiple practices (Sponsors & Non-Sponsors alike) that employ their own technique(s) and it doesn't matter if it is the U.K., U.S., Australia, or Mauritania, or anywhere in the world for that matter -- if being uncircumcised wasn't such an issue, why would these Clinics report their findings? Some of these Clinics that support adult circumcision don't necessarily provide circumcisions themselves, so they aren't exactly benefiting from turning away uncircumcised customers monetarily.