PhalloBoards - An Online Community to Discuss Penile Girth Enhancement

Texas wrote: Note: For readers and future searchers: Not very many of the doctors doing fillers are discussing penile webbing and how it affects the fillers over ability to migrate and conversely stay in place better. I absolutely mean no disrespect in saying this/the following: They ( the doctors) may not be mentioning this because they do not know much about two things being related, they do not want to deal with it or the questions, and or they do not offer the services to fix this in the first place. No slights here, only facts. No problems per say either, but food for thought.
* I was in fact told by Dr Morganstern himself ( on a recorded call that I am sure they have ) and then Dr. Carney as well that I should get my Penis Webbing fixed prior to getting any fillers to ensure a better outcome. And subsequently it could make my look bigger too. lol. Like damn near everyone else out there, lol, I said fuck it and proceeded anyway without listening. lol. In turn, see my above comment, I did have some migration of my filler and a swollen sack and achy nuts. Now: Could I have achieved a slightly better girth out come? Could my product have stayed in place more ? Who knows.

This is actually a really important thing that I feel I will mention in my next discussions with Sponsors; it's very easy for Doctors injecting these fillers to not realize or dismiss the importance of how the webbing can act as a hinderance.

I'm glad you mentioned this, much like the cut-vs-uncut topics, there are things that can impact the aesthetic outcome of a filler procedure.

Texas wrote: On my very fist round Ellanse , 10ml, my sack got really swollen and discolored. I feared that some product had migrated down into there. I was later told that it would not be uncommon or impossible for this to occur if I wasn't ALWAYS stretched out and downward. After a video chat and me explaining the feeling of a hardish squishy type "material at the bottom of my sack, it was more or less confirmed that i had lost a bit of filler. Nothing bad to worry about, only sadness, hahaha. My overall result still matched the math as expected.
anyway, due to this my balls were pretty achy ( as yours were @aaarthur for a few weeks until the swelling subsided. the "material" also eventually went away as well.

Note: For readers and future searchers: Not very many of the doctors doing fillers are discussing penile webbing and how it affects the fillers over ability to migrate and conversely stay in place better. I absolutely mean no disrespect in saying this/the following: They ( the doctors) may not be mentioning this because they do not know much about two things being related, they do not want to deal with it or the questions, and or they do not offer the services to fix this in the first place. No slights here, only facts. No problems per say either, but food for thought.
* I was in fact told by Dr Morganstern himself ( on a recorded call that I am sure they have ) and then Dr. Carney as well that I should get my Penis Webbing fixed prior to getting any fillers to ensure a better outcome. And subsequently it could make my look bigger too. lol. Like damn near everyone else out there, lol, I said fuck it and proceeded anyway without listening. lol. In turn, see my above comment, I did have some migration of my filler and a swollen sack and achy nuts. Now: Could I have achieved a slightly better girth out come? Could my product have stayed in place more ? Who knows.

Thanks Texas. This makes me feel less nervous. I am still experiencing the pain on day 12.
Because of the pain I kept a retracted penis and got filler accumulated on bottom webbing. It is so bad. Anyway, I do not care the webbing filler now I just want the testicular pain go away.

On my very fist round Ellanse , 10ml, my sack got really swollen and discolored. I feared that some product had migrated down into there. I was later told that it would not be uncommon or impossible for this to occur if I wasn't ALWAYS stretched out and downward. After a video chat and me explaining the feeling of a hardish squishy type "material at the bottom of my sack, it was more or less confirmed that i had lost a bit of filler. Nothing bad to worry about, only sadness, hahaha. My overall result still matched the math as expected.
anyway, due to this my balls were pretty achy ( as yours were @aaarthur for a few weeks until the swelling subsided. the "material" also eventually went away as well.

Note: For readers and future searchers: Not very many of the doctors doing fillers are discussing penile webbing and how it affects the fillers over ability to migrate and conversely stay in place better. I absolutely mean no disrespect in saying this/the following: They ( the doctors) may not be mentioning this because they do not know much about two things being related, they do not want to deal with it or the questions, and or they do not offer the services to fix this in the first place. No slights here, only facts. No problems per say either, but food for thought.
* I was in fact told by Dr Morganstern himself ( on a recorded call that I am sure they have ) and then Dr. Carney as well that I should get my Penis Webbing fixed prior to getting any fillers to ensure a better outcome. And subsequently it could make my look bigger too. lol. Like damn near everyone else out there, lol, I said fuck it and proceeded anyway without listening. lol. In turn, see my above comment, I did have some migration of my filler and a swollen sack and achy nuts. Now: Could I have achieved a slightly better girth out come? Could my product have stayed in place more ? Who knows.

aaarthur wrote: I got Ellanse 10ML on 11 days ago at Avanti.
Since Day 6, one of my testicle starts to pain and it continues to day 11 now.
It is dull pain if not touching. But it like been kicked if touch or shake. Sleeping would make it felt better.
I thought it was bacterium infection and so did my physician. But anti-biotics does not help. I did blood and urine test and ultrasound. It mostly said normal except cysts found in scrotum.

So I guess it's filler related. Dr.
Morale said it could be swelling. But I have no swelling on penis now.

Any folks got the experience of testicle pain?
Many thanks. Now I am more nervous than painful and hoping it's not chronic.

I'm sorry to hear that, and I too hope it won't become chronic and probably won't be once you get a chance to read some of the links I posted below.

It sounds like these cysts are the culprit. However I've never once read a report connecting penile fillers to testicular cysts (or cysts in general), and I suspect it's a coincidence that you're experiencing them so close to a male enhancement procedure.

The reason I suspect this is because the filler gets injected into a dermal layer of the shaft and encapsulates; so my next line of questioning would be (1) why would it migrate to the testicles and (2) create cysts? Is it possible they are related, sure. However given that this would be the first time I've read of ANY filler leading to cysts in the testicle (or anywhere for that matter), leads me to believe this is coincidental.

I wonder if a biopsy can be taken of cysts in that location? If there were no traces of Ellanse, perhaps it could rule that out? Otherwise, testicular cysts are ailments men do experience independent of any surgeries they've had: here's something you can check out:
https://patient.info/mens-health/scrotal-lumps-pain-and-swelling/epididymal-cyst

https://www.nhsinform.scot/illnesses-and-conditions/sexual-and-reproductive/testicular-lumps-and-swellings#:~:text=injury%20or%20infection.-,Epididymal%20cysts,sometimes%20ache%20or%20feel%20heavy.

Honestly any filler will do, it's a matter of communicating your desire to your practitioner on what you're trying to achieve: for example, those with "baseball bat" style penises will likely want most of the filler at the base, tapering upward toward the glans. This can be achieved with Hyaluronic Acid (HA), Radiesse, Renuva, (your own) Fat, Ellanse, or PMMA; in other words, all viable penile fillers.

penningbooks wrote: Hi there,

I'm someone whose Teosyal Ultimate has produced quite temporary results, requiring an expensive and unrealistic amount of maintenance. I am torn between waiting for complete dissolution before internationally seeking Ellanse OR receiving Teosyal Ultra Deep (TUD; the hardest HA) locally.

Has anyone had TUD? Has anyone heard any evidence that it would have superior longevity to softer fillers? The surgeon said it might, but I can't find any evidence that hardness = longevity. The Androfill site rates its longevity the same as any other HA fillers.

Curious thoughts, thank you!

I've noticed varying degrees of product dissipation; some guys see HA last a year while others 2+ years. A lot of it has to do with one's own physiology (the mechanisms by which your body breaks down and absorbs foreign bodies), otherwise these fillers would last the same for everyone. I'm sure other factors play a role like age, smoking, lack of collagen supplementation, those which I don't know. That said, I'm of the belief that the "formulation" (a.k.a. cross-linking) of the filler brand also plays role in structure (i.e. firmness) & longevity, and part of this forum's mission is to monitor which brands of HA present the best penile application (as opposed which brands are best for "wrinkles in an aging face").

Would you mind if I asked how long yours lasted? If I were you, I'd consider low volume of the Ultra Deep evenly along the shaft to test it out; there is no doubt the difference in "formulation" I spoke about will play a role in a better outcome, just how good I don't know. If worse comes to worse, then proceed with Ellanse.

I'm interested Doc. I had 3 rounds of Ellanse, the first round in June '19 and so far its still holding strong. Do I need to wait for this filler to dissipate or can I have the lengthening procedure done before then?

Free Fat Transfer (FFT) is a surgical method in which your own fat is harvested for girth injections. However, not all candidates are ideal --> lean men, etc.

The evolution of FFT is based similarly to the advancements in dermal graft matrices --> you cannot overfill because if you do, the implant will not vascularize and integrate into the surrounding tissue, and thus will be absorbed/broken down over time, eventually leading to lumps and bumps. If you are to take a conservative approach and layer incrementally, you can extend the life of the fat implantation considerably, thus requiring less top-offs. It's also your own tissue making it relatively safe.

As for their contention of permeance, I simply have to take them at their word but I cannot say I know for certain its actual lifetime when "done correctly."

However one thing worth noting: Hyaluronic Acid (HA) and Ellanse are showing longer lifespans than indicated by the manufacturer. A circulating theory behind this is that the layer in which you get fillers injected into the penis have less lymphatics versus a place like your face, where dermal fillers are popular. These lymphatics are the pathways and mechanisms by which your body dissipates foreign material, and it could explain why fillers last longer in the penis than in the face (and faces are largely where the manufacturer's get their data from). One could possibly extend this theory to fat (when done correctly), but I can't say for certain as far as the physiology is concerned. In other words, this is just a theory/musing. This would be a question best aimed at Dr. Carney.

Speaking of which, here is his direct take on the matter:

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I was rather surprised hearing that the sentiment on the PhalloBoards is that an FFT is not a permanent girth enhancing procedure. Fat tissue that survives the transplant process is a permanent outcome. However, as I thought more about it the next day and realized why lots of people might not feel that way.

Surgically-speaking, a penile FFT is considered to be a fairly simple procedure. However, as you’ll soon discover it’s deceiving in that regard.

I regularly perform organ transplants in the hospital that are considered dangerous and overwhelming to some surgeons. I can tell you with assurance that an FFT penile procedure is far more challenging to achieve a successful transplant than most doctors and patients realize.

An FFT is a “transplant”, and like every other type of human transplant procedure, there’s a lot of places it can fail since we’re trying to move a living organism from one location to another. When a patient gets an FFT and ends up eventually “losing it all”, that simply means the transplanted tissue eventually died and was reabsorbed into the body as waste.

To succeed in this procedure, your doctor must get six points just right. Shortcomings with any aspect will affect the final outcome.
.
The Right Patient: Not every man is a good candidate for an efficacious FFT. A patient has to possess the right proportion of height and weight. He needs to be fairly healthy as patients addicted to potato chips and comparable junk food usually have fat that won’t transplant with success. Significant obesity usually triggers a poor outcome. Men who’ve had a previous girth enhancing procedure utilizing a permanent man-made injectable like PMMA or Silikon are not good candidates for FFT unless that material is first removed since the injected agent blocks the tiny blood vessels in the penile shaft necessary to ensure the transplanted fat cells stay alive. Likewise, men beyond the age of sixty-five will almost never get a good result – regardless of overall health – as human fat rapidly degrades to a more viscous state after a certain age. Such fat tissue simply won’t survive a transplant. Finally, this is a surgical procedure that requires mild anesthesia. If a patient has health contra’s for anesthesia, this procedure won’t be a viable option.

The Right Harvest: Improper attention to delicateness during the adipose tissue harvest is another source of failure. The fat cells must be extracted in a quantity that will provide a size increase worthy of a surgical investment AND they must be kept flourishing during that substantial withdrawal. Fat cells are rather fragile and although damaged cells can be transplanted, few will survive over the long term in such cases. Exactly “where” the tissue harvest occurs is another source for disappointing results. You can’t extract fat from just any location and expect it to succeed as there are variations in the quality of fat tissue in different parts of the human body. Likewise, some fat material has characteristics more akin to subcutaneous penile tissue compared to other more pliable fat that can leave patients with a distinguished “squishy” outer finish.

The Proper Treating of the Fat: Once harvested, the fat must be reconstituted in a manner that will make it suitable for subsequent reimplantation. We use an FDA cleared fat transplant filtration system to optimize purity, but I credit Dr. Morganstern and his many years refining these procedures with developing a novel shaping technology that optimizes the reimplantation procedure. Again, during this particular process within the treatment is yet another incidence where the fat cells can become damaged and/or die.

The Fat Injection & Placement: Finally, the harvested fat tissue gets transplanted into the penis. The most common mistake I’ve seen in this aspect of FFT is with doctors using the wrong needle for a particular patient. There’s no such thing as a “one size fits all” in any aspect of phalloplasty. Also, there’s an art form to the distribution technique that when poorly executed usually results in unevenness or lumps within the shaft several months down the line. Another common error is when the surgeon attempts to add too much fat into a singular procedure. We understand most men want the biggest possible outcome in a singular procedure but if you add too much at once, it increases the likelihood you’ll eventually end up relinquishing almost all of the transplant. One other mistake I’ve seen is where the doctor agrees to perform too many congruent procedures along with an FFT. Certain procedures are notorious for triggering excessive hematoma which prolongs any healing process. Living tissue transplants stand little chance of long-term viability if the time window for healing is overextended.

Survive the 72-hour “Tissue Vulnerability” Window: Assuming everything I just discussed was performed to perfection, the number one reason most fat tissue transplants will fail to live up to expectation is because of a 72-hour post-transplant assimilation period. For about three days after post-procedure, the transplanted cells will be unable to access any life-essential blood supply. Some of the cells will almost always die during this nutrient-starving phase. We pre-treat the penis before each procedure with a patented device that Dr. Morganstern developed that triggers endothelial cell production for healing penile trauma / Peyronie’s disease. We found this technology bridges the lack of blood flow nutrients immediately following surgery to a level that minimizes the loss of viable fat cells.


Following Prescribed Aftercare: Given the delicateness of the vulnerable cells during transplant and variations in how quickly healing occurs between one individual and another, it’s crucial to follow any prescribed aftercare program indicated by your surgeon to ensure long term success. Regardless of how capable your surgeon and how well your particular transplant procedure came out, it can fail quickly if you don’t follow recommended post-operative care.

Finally, in fairness to the skilled phalloplasty surgeons out there performing FFT, I’ve had more than one patient show up in our clinic claiming to have “lost all his previous FFT” with another doctor. However, upon close examination, we discover many of them actually retained a life-lasting portion of transplanted tissue.

How does that happen?

Following any FFT surgical procedure, there’s going to be a good bit of swelling and bruising. It takes months for all that swelling to completely subside. Some men confuse this loss of fluid – which can double the girth of the penis – with loss of fat tissue and lose sight of their pre-procedure width.

We very recently introduced a new non-surgical fat-tissue transplant procedure that will result in most patients adding about a half-inch of girth from a treatment. One of the reasons I was particularly excited to develop this new technology was so we could provide a less invasive and affordable pathway for patients to achieve that “post-surgical swollen girth” that many men adore and get depressed over losing once all healing is complete. It’s worth mentioning that this new procedure is NOT well suited as an initial procedure for men already over seven inches as we’re restricted in the amount of transplant tissue we can successfully collect from this pathway.

Another FFT complaint we sometimes encounter is patients were left with palpable fat “bumps or nodules” in their penis in the months or years following surgery. It seems some of you are aware that our clinic is able to redeploy the same technology we use to break up fibrosis and plaque in the penis that’s commonly associated with Peyronie’s disease to resolve these nodules since we’ve had a number of patients visit from around the globe for such repairs who indicated they heard about us on the PhalloBoards. However, I want to be clear that 98% of such nodules associated with an FFT are not from “fat tissue”. Rather, they’re pockets of excess edema which became trapped during the post-surgical healing process.

Most FFT surgeons recommend massaging the transplanted tissue for a period of time following your procedure to help reduce the likelihood of this unsightly outcome.

I've heard from both Avanti Derma (MX) and the Androfill Clinic (UK) that Ellansé L and Ellansé E have been discontinued - however, Ellansé M and Ellansé S are still available and are not going to be discontinued anytime soon.

As you'll see, the news is surprisingly good because it pertains to the reported longevity of this filler; this makes it more economical which means less top-offs (thus less visits and less costs). However, if you are the type who prefers things that aren't long-term or permanent, Hyaluronic Acid (HA) remains the best filler in this regard (even so, HA too has exhibited a longer-than expected lifetime in the penis).

I will use this topic to continue posting updates as they arrive. Here are some current information that has been more-or-less confirmed:

The text exchange with Francis from Androfill, and I'm transcribing his message with his permission:
S and M are lasting longer than their 1 and 2 year ratings, at least in the penis.

We have an S patient from 2019 who has had no reduction in size. He originally chose S because he wanted to be safe (knowing it would be gone in 1 year), but not.

I understand from the Sinclair Rep that one of the main reasons for pulling L and E was that they were lasting far longer than anticipated. This can cause headaches to doctors using the substance in long term shifting / sagging areas such as the face (where the product is intended for).

Dr. Casavantes of Avanti Derma also discusses the 2022 Ellansé update in his Doctor's Forum thread (the following is a copy & paste from www.phalloboards.info/forum/dr-casavante...co-avanti-derma.html ):
At the end of 2021, our supplies announced that Ellansé-L would be discontinued and reassured that the shorter-lasting versions (S, one year and M, two years) would remain in the market.
The obvious response/request was to know the reason why.
Their decision came from the fact that we have known since we followed our first patient's evolution: Ellansé (any of the variants) is way longer lasting than the initial research showed.
Additionally, those observations came from patients who received the product for facial rejuvenation. The expected longevity of Ellansé is even longer for penile implants since the penis has a less active metabolism and dynamics; also, its exposure to the elements is minimal compared with the face.
The face has significant structural changes over the years, and most injectors do not support the idea of having very long-lasting or permanent fillers there. The penile structures remain pretty much stable.
The most enduring versions of Ellansé (L, and especially E) became less and less popular, to the point that they didn't make financial sense to both the manufacturer and t he end-user.
The longevity of Ellansé depends on the length and cross-linking of the polycaprolactone chain in its different versions, which determines the speed of biodegradation and biosorption. Safety is identical in any of them; the byproducts of degradation are water and CO2.
At Avanti Derma™, after many years of using Ellansé L, the only reported problems have been strictly cosmetic (imperfections); we have no reports of local or systemic complications or damage, which coincides with the findings of some investigators (doi.org/10.1111/jocd.13518 , journals.lww.com/dermatologicsurgery/Abs..y_of_Forehead.4.aspx )
Ellansé-E was never available in Mexico, but as the largest consumer of Ellansé-L in our country, the company gave us notice of the withdrawal of version L by the end of last year, so that we had the opportunity to stock-up.
We will continue to offer the versions of Ellansé-S and M.
Ellansé-L will be provided while supplies last.
DrC / DrM

@donwfree

Here is a response from Dr. Carney himself:

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Good question!


I’m going to go the long way around the barn responding to your inquiry to address other questions I receive regarding lost size following installation of a penile prosthetic.


Some History Regarding Penile Implants


The first working prototype of an inflatable penile implant for severe erectile dysfunction was introduced by a urologist at Baylor named Brantley Scott, MD at the American Urology Association convention in New York City in 1973. It took another ten years for Dr. Brantley’s innovation to gain clearance from the FDA and become widely available.


Four urologists were recruited to initially train other urologists on how to successfully install inflatable prosthetics for ED, including Rejuvall founder Steven L. Morganstern, MD. I’m including a photo from a TV talk show of this group including Dr. Morganstern, Brantley Scott, MD, John Mulcahy, MD, and Drago Montague, MD of the Cleveland Clinic.


The biggest problem with early penile implant procedures was higher-than-expected rate of infections and formation of scar tissue. Renowned Urologist John Mulcahy, MD (seated third from the left in the attached photo), published what’s considered the gold standard for urologic surgeons regarding how not to trigger significant scar tissue or infection following implantation of a prosthetic. His solution was rooted in a tandem of key procedural insights plus accepting the fact a post-prosthesis erect penile would end up being about an inch shorter than it was before the implant was installed.


Let’s fast forward to today’s times.


The company Dr. Scott co-founded (AMS) is still the primary provider of inflatable implants in the world. Although various improvements have been made through the years, the core design is still fundamentally the same, which speaks volumes about Dr. Scott’s innovation.


Two independent events helped shape the recent increase in patient complaints regarding lost size. Insurance companies began cutting the allowable reimbursement for penile implant procedures. It’s now less than one-third of what it used to be. Congruently, hospitals became more rigorous regarding the amount of allowable time for each procedure in their OR’s. The result seems to be that when an implanting urologist encounters a more complicated prosthetic case, the tandem of lower pay and hospital pressure triggers him/her to complete the operation based upon medical standards vs. penile length optimization. We encounter patients who claim they lost over three inches of erect length following installation of their implant.


About eighty percent of the hospital procedures I personally perform for the university are repairs of failed surgical procedures. Thus, I’ve performed several replacements of penile prosthetic implants to regain lost length and learned a bit about what can be done to improve matters and what can’t.


The unfortunate reality is that if a patient doesn’t get a new penile implant installed within six months following their initial procedure that resulted in significant loss of erect length, nothing can be done to reverse that outcome. An implant becomes firmly seated within the corpora over time and builds small amounts of scar tissue as it heals. This makes any further penile lengthening impossible. If we somehow added length to the penis through repositioning, the improved length would be floppy at the end of the penis and unable to penetrate.


What can be done to improve lost size following a penile implant?


The girth of the penis can be enhanced after the installation of a prosthetic implant.


One pathway is non-surgical injection of a select hyaluronic (H/A) dermal filler. The other is transplanting your own fat within the subcutaneous tissues that surround the organ, assuming you’re a good candidate for fat tissue transplant. (Under the age of 63 (adipose cells begin to die as we age and won’t successfully transplant after a certain point); if diabetic, you must have an A1C of 7 or below; and you must be a non-smoker or have been completely off cigarettes for at least 90 days before your procedure). The hyaluronic pathway faces no health or age constrictions but has less longevity (usually about two years).


Regarding your original question regarding using Ellansé as the bulking agent to improve girth, I don’t think that would be a good idea. The primary components of Ellansé are about 80% hydrocellulose and 20% polycaprolactone. Polycaprolactone is a fairly strong inflammatory agent that triggers production of Level I, II and III collagens about 24 hours after its first injection. The polycaprolactone could damage the walls of the inflatable implant and open the door to a host of medical complications.


Given the fact your inflatable prosthetic can be damaged during a girth enhancement, I would recommend having a urologist perform the procedure because of their familiarity with the inner prosthetic design. It’s a somewhat time-consuming procedure to safely navigate around the implant when adding thickness.


Another procedure some implant patients get is adding H/A to their glans to help restore lost rigidity. During installation of the prosthetic, about half of patients must have the unique blood supply to the glans severed during installation. This results in significant atrophy to the glans, hindering penetration. I always add about 3ML of Juvéderm Voluma to the glans during an implant enlargement for this reason.


Finally, unlike a penile prosthesis, enhancement of a penile implant is considered a cosmetic procedure (elective) procedure and is never covered by insurance.


Hope this information helps a bit for those looking to improve lost size following installation of a prosthetic penile implant.

At the end of 2021, our suppliers announced that Ellansé-L would be discontinued and reassured that the shorter-lasting versions (S, one year and M, two years) would remain in the market.
The obvious response/request was to know the reason why.
Their decision came from the fact that we have known since we followed our first patient's evolution: Ellanse (any of the variants) is way longer lasting than the initial research showed.
Additionally, those observations came from patients who received the product for facial rejuvenation. The expected longevity of Ellanse is even longer for penile implants since the penis has a less active metabolism and dynamics; also, its exposure to the elements is minimal compared with the face.
The face has significant structural changes over the years, and most injectors do not support the idea of having very long-lasting or permanent fillers there. The penile structures remain pretty much stable.
The most enduring versions of Ellanse (L, and especially E) became less and less popular, to the point that they didn't make financial sense to both the manufacturer and the end-user.
The longevity of Ellanse depends on the length and cross-linking of the polycaprolactone chain in its different versions, which determines the speed of biodegradation and biosorption. Safety is identical in any of them; the byproducts of degradation are water and CO2.
At Avanti Derma™, after many years of using Ellanse L, the only reported problems have been strictly cosmetic (imperfections); we have no reports of local or systemic complications or damage, which coincides with the findings of some investigators ( doi.org/10.1111/jocd.13518 ,
journals.lww.com/dermatologicsurgery/Abs...y_of_Forehead.4.aspx )
Ellanse-E was never available in Mexico, but as the largest consumer of Ellansé-L in our country, the company gave us notice of the withdrawal of version L by the end of last year, so that we had the opportunity to stock-up.
We will continue to offer the versions of Ellansé-S and M.
Ellanse-L will be provided while supplies last.
DrC / DrM

alextest4646 wrote: Had 8 ml of Voluma in the shaft 2 months ago

costed me 6000 canadian

voluma is expansive

the physician was not known by the forum and did about 30 guys before me

Girth gain was very modest, especially considering the price and the non permanent apsect of HA ( around 0.5 to 0.5 inch at the base and 0.25 mid girth )

aesthetic wise it's not perfect but dont expect to win a beauty contest !

I am going to get 3 rounds of ellanse in the next year when this covid thing calms down : )

I don't mean to hijack to the topic at hand, but would you mind sharing your provider? I've been keen on finding a quality American Midwest and/or Canadian Clinic to broaden accessibility to my readership and not have to make them rely on uncertainty with regards to penile surgery or injections.

Honestly from what I've been gathering these past few years, temporary fillers are a lot more long-term than short-term than originally believed.

The manufacturers of these fillers give their product retention rates based on facial injections; however, the retention in the penis could be much longer because of the layers the filler is injected into, which to my understanding has less means to absorb and dissipate (i.e. lymphatics) as quickly, thus reports of longevity.

Our Ellanse reports on the site have been pretty strong despite it being a "temporary" filler, and some Clinics have reported to me that HA too has become more of a "long-term temporary" than thought before, at least as far as penile application is concerned. I'd be really interested in getting up-to-date opinions in early 2022 regarding this matter.

I say this because permanency at your age in light of how robust the current temporary market is makes me want to reiterate what I said above. I don't want to be mistaken though, permanent isn't "bad" (heck, I have permanent in me), but if I knew what I do today, I think I would have reconsidered my approach (that is in NO WAY a knock on PMMA, or that I would have done something different, just an honest hindsight).

Again, good luck either way.

Androfill wrote: I would be interested to know what patients are thinking about in regard to the HA and Ellanse procedures.

I agree some of our updates are from years ago now, geological timeframes in penis enlargement as one member put it.

I will share a couple of things I have come to conclusions on over the past couple of years. I am not a doctor, so these are conclusions based on patient results and feedback rather than medical science. Regardless I think some of the conclusions can help guide people.

Too much HA is being injected per patient.
We have stopped this at Androfill as far as I am aware and have had warnings on the website about injecting too much filler for over 2 years now.

However, almost every other clinic and doctor doing HA (even the good doctors) still inject far too much filler. There is no other way to explain it aside from greed overriding patient care, assuming the doctors in question know that injecting too much is an issue.

Why is it bad to inject too much HA? (this means over 30ml, but probably over 20ml in many cases).

1. Stretching the tissue
The tissue in the penis is stretched irreversibly, including the skin. If too much HA is injected it means that a reversible procedure has led to an irreversible outcome.
Put simply, if you increase your girth from let's say 4.5 inches to 6.5 inches, and then decide you don't want HA anymore, you will be left with loose skin.
Picture an obese person that loses a lot of weight. Injecting too much turns a reversible temporary procedure into a permanent change.
If you increase your girth by 2 inches with HA, you can not go back to your original penis.

2. Natural feeling / slushiness
HA wasn't designed to support such a large increase in size. With too much HA the penis will feel very soft, particularly if you are not fast at metabolising it and so are left with filler in the late stages of isovolumetric degradation a year or so later. A penis with 40,50,60ml of HA is likely to feel slushy after 18 months.
If you have just 10 or 20 ml you are more likely to metabolise it all before it turns to slush.

Putting to one side the isovolumetric degradation issue, when the filler is freshly injected even fillers with the most structure (Volux, Teosyal UD) cannot support 2 inches in girth increase. The maximum increase with HA should be 1 inch for this reason alone (to feel normal), and also so as not to stretch the skin (point 1. above).

3. Uneven reabsorption. This is made worse when the layer of filler is thick.

Cheap filler
The use of cheap, counterfeit / made in China, parallel imported filler, or even completely contraindicated filler (Genefill / Hyacorp) is common in the UK.

I am not sure how a doctor can read a warning pamphlet inside a box of Genefill which clearly says "contraindicated for use in the genitals" and still proceed to inject it.
There is a case we are dealing with today in which a well-known doctor on Harley St, with a big Andrology practice, told the patient he was injecting Voluma, showed the patient the box of Voluma (for the first syringes) and then proceeded to inject some other type of filler for the remaining 20ml (later discovered to be Genefill upon investigation).

If patients do not get better at asking for the stickers from the box of filler, and observing and counting every syringe that goes in, they will continue to be a) ripped off, and b) injected with who knows what.

Men seem much less likely than women to check on what is being injected.
I have come to form a view from talking to patients and support staff at other clinics that around 70% of the product being injected is not what the patient thinks they are getting.

It annoys me because for a few reasons. Aside from the ethics of patient consent (if you agree to have one thing injected and it is another product, then you have not consented), and aside from commercial fraud, it also makes the clinics using authentic filler seem more expensive.

The only way to compete with another clinic advertising 40ml of HA for £2,000 is to also use a lower grade filler.

For a 40 ml procedure using Genefill filler, it will only cost us £200 in raw filler.
For a 40 ml procedure using Volux it will cost more than £4,000 for the raw filler alone.

I have been tempted to name the doctors and clinics in the UK doing this.

Ellanse
Long term followers will remember how hesitant we were at first to inject Ellanse.
It took years before we were routinely offering it and usually only to repeat patients who had an idea of what they were getting into.

I still feel it is very risky for first-time patients.

1. Consider, what if some aspect of the patient's penile anatomy is not suitable for filler generally (for example loose pockets into which filler wants to migrate), or tight bands of skin that pinch in and cause an uneven shape. Patients are better to discover that are not suited for penis fillers with a reversible substance like HA.

Otherwise, if they are given Ellanse and discover they are anatomically a poor candidate, they can do nothing to fix the situation for years if the shape is wrong, the filler has migrated to the underside or any other issues.

2. Overall, despite Ellanse being a higher risk product (mainly the fact it can't be reversed), the results are generally better than with Hyaluronic acid, and will unlike HA support a larger increase in girth, to maybe +1.5 inch, without compromising on hardness.

My ideal pathway into penis enlargement with dermal filler would be:

1. To begin with a small 6-10ml HA procedure (to practice moulding and to make sure the filler sits well in the penis / the penis is anatomically well suited to filler without the higher likelihood of issues such as migration).
2. Then 10-20 ml of Ellanse (over 2 or more visits) to bring the maximum gain to something like 1 - 1.5 inches.

One issue to consider with Ellanse. It can become difficult to inject more using a cannula after around 3,4 months. The cannula simply can't break through the new tissue stimulated by the Ellanse / PCL.

I am not sure which other information is useful to patients. Perhaps what I am sharing here is already known.

Hallo Francis, Reading again your post, a couple of questions raised to my mind, here they are:
1. Too much HA is being injected per patient.
We understood your explanation about all possible short and long term issues using too much filler, so that your suggestion is to go with 6/10ml of HA first and see how it goes, then move to Ellanse.
Question: based on what we see on your website regarding thickness increase estimate, 10 ml of filler would give 0,3 inches on a 7" penis or 0,4 on a 6" penis.
Is that erect girth gain?
2. After the first 6-10ml of HA, and realized that moulding has been successful, and all swelling subsides (in some cases after one month, is it immedialty possible to go with Ellanse or you should wait for HA to reabsorb or dissolve it before going with the new filler? Let's say 18 months?
3. "anatomically a poor candidate: some aspect of the patient's penile anatomy is not suitable for filler generally (for example loose pockets into which filler wants to migrate), or tight bands of skin that pinch in and cause an uneven shape. Patients are better to discover that are not suited for penis fillers with a reversible substance like HA."
Question: is this something that can be expected/observed before the treatment during a visit, or it's somehting that cannot be foresee?
4. For foreing travellers: "The earlier you start moulding the filler the better, by day 4 or 5 the filler is almost ‘set’ and becomes very difficult to mould."
Does that suggest that it's better to plan 5 days in London after the treatment to be sure everything is going ok and have supevision?

Thank you in advance

Androfill wrote: I would be interested to know what patients are thinking about in regard to the HA and Ellanse procedures.

I agree some of our updates are from years ago now, geological timeframes in penis enlargement as one member put it.

I will share a couple of things I have come to conclusions on over the past couple of years. I am not a doctor, so these are conclusions based on patient results and feedback rather than medical science. Regardless I think some of the conclusions can help guide people.

Too much HA is being injected per patient.
We have stopped this at Androfill as far as I am aware and have had warnings on the website about injecting too much filler for over 2 years now.

However, almost every other clinic and doctor doing HA (even the good doctors) still inject far too much filler. There is no other way to explain it aside from greed overriding patient care, assuming the doctors in question know that injecting too much is an issue.

Why is it bad to inject too much HA? (this means over 30ml, but probably over 20ml in many cases).

1. Stretching the tissue
The tissue in the penis is stretched irreversibly, including the skin. If too much HA is injected it means that a reversible procedure has led to an irreversible outcome.
Put simply, if you increase your girth from let's say 4.5 inches to 6.5 inches, and then decide you don't want HA anymore, you will be left with loose skin.
Picture an obese person that loses a lot of weight. Injecting too much turns a reversible temporary procedure into a permanent change.
If you increase your girth by 2 inches with HA, you can not go back to your original penis.

2. Natural feeling / slushiness
HA wasn't designed to support such a large increase in size. With too much HA the penis will feel very soft, particularly if you are not fast at metabolising it and so are left with filler in the late stages of isovolumetric degradation a year or so later. A penis with 40,50,60ml of HA is likely to feel slushy after 18 months.
If you have just 10 or 20 ml you are more likely to metabolise it all before it turns to slush.

Putting to one side the isovolumetric degradation issue, when the filler is freshly injected even fillers with the most structure (Volux, Teosyal UD) cannot support 2 inches in girth increase. The maximum increase with HA should be 1 inch for this reason alone (to feel normal), and also so as not to stretch the skin (point 1. above).

3. Uneven reabsorption. This is made worse when the layer of filler is thick.

Cheap filler
The use of cheap, counterfeit / made in China, parallel imported filler, or even completely contraindicated filler (Genefill / Hyacorp) is common in the UK.

I am not sure how a doctor can read a warning pamphlet inside a box of Genefill which clearly says "contraindicated for use in the genitals" and still proceed to inject it.
There is a case we are dealing with today in which a well-known doctor on Harley St, with a big Andrology practice, told the patient he was injecting Voluma, showed the patient the box of Voluma (for the first syringes) and then proceeded to inject some other type of filler for the remaining 20ml (later discovered to be Genefill upon investigation).

If patients do not get better at asking for the stickers from the box of filler, and observing and counting every syringe that goes in, they will continue to be a) ripped off, and b) injected with who knows what.

Men seem much less likely than women to check on what is being injected.
I have come to form a view from talking to patients and support staff at other clinics that around 70% of the product being injected is not what the patient thinks they are getting.

It annoys me because for a few reasons. Aside from the ethics of patient consent (if you agree to have one thing injected and it is another product, then you have not consented), and aside from commercial fraud, it also makes the clinics using authentic filler seem more expensive.

The only way to compete with another clinic advertising 40ml of HA for £2,000 is to also use a lower grade filler.

For a 40 ml procedure using Genefill filler, it will only cost us £200 in raw filler.
For a 40 ml procedure using Volux it will cost more than £4,000 for the raw filler alone.

I have been tempted to name the doctors and clinics in the UK doing this.

Ellanse
Long term followers will remember how hesitant we were at first to inject Ellanse.
It took years before we were routinely offering it and usually only to repeat patients who had an idea of what they were getting into.

I still feel it is very risky for first-time patients.

1. Consider, what if some aspect of the patient's penile anatomy is not suitable for filler generally (for example loose pockets into which filler wants to migrate), or tight bands of skin that pinch in and cause an uneven shape. Patients are better to discover that are not suited for penis fillers with a reversible substance like HA.

Otherwise, if they are given Ellanse and discover they are anatomically a poor candidate, they can do nothing to fix the situation for years if the shape is wrong, the filler has migrated to the underside or any other issues.

2. Overall, despite Ellanse being a higher risk product (mainly the fact it can't be reversed), the results are generally better than with Hyaluronic acid, and will unlike HA support a larger increase in girth, to maybe +1.5 inch, without compromising on hardness.

My ideal pathway into penis enlargement with dermal filler would be:

1. To begin with a small 6-10ml HA procedure (to practice moulding and to make sure the filler sits well in the penis / the penis is anatomically well suited to filler without the higher likelihood of issues such as migration).
2. Then 10-20 ml of Ellanse (over 2 or more visits) to bring the maximum gain to something like 1 - 1.5 inches.

One issue to consider with Ellanse. It can become difficult to inject more using a cannula after around 3,4 months. The cannula simply can't break through the new tissue stimulated by the Ellanse / PCL.

I am not sure which other information is useful to patients. Perhaps what I am sharing here is already known.

Having had 40 ml of HA since last March, I wish I had known this before I did it. I didn’t realize the more layers the more it would turn to slush . No clue what the right out is for me knowing this now. I wonder if I should get it dissolved and hit reset ? Ugh

I do appreciate that you took time to make this update especially in light of the fact you’re not looking for new patients .