PhalloBoards - An Online Community to Discuss Penile Girth Enhancement

aleksk wrote: Looks extremely good, Dr Oates. Do you think you have equal success aesthetically with uncut patients? I know for a fact that most Australians (especially under 40) are uncut. 

Also, think seriously about a clinic in East Europe - somewhere low cost and easy access to much cheaper high quality fillers (including Ellanse) and easy access to the whole European market. I\'d look into Bulgaria if I were you - super low cost, easy to establish a business, European Union laws. You\'d be able to offer these procedures 40% less than the price you are currently asking and will have huge success with British, German, Irish, Spanish etc. Bulgaria also borders Turkey and is very close to MIddle East so think about that massive market as well as Europe. You\'d get the best of both worlds. It doesn\'t even happen to be Sofia, you can establish yourself at a holiday resort with good flights to most European countries (e.g. Varna). 

By the way, I have an MBA and speak several Eastern and Western European languages if you need my help.

Hi Aleksk,

My trial Ellanse patient is really happy and wanting more (from the 4 ml we did). 

Waiting on Allergan to get back to me about pricing of Voluma in various places. One consideration is how easy/quick it is to get to from Perth/Sydney. I would like to train doctors in other countries (and will eventually) but think from a business point of view they would just drop any arrangement I have with them and just go it alone once they are trained up.

Restoration wrote: Dr. Oates,

If Radiesse is injected with a blunt tip cannula (like DermaSculpt) does that eliminate the concern around embolization?

Also, it seems to me that Radiesse is more like PMMA, in that it is particulate and will allow natural collagen ingrowth, whereas HA fillers are just blobs that are destined to move around as the penis moves... but that\'s just my theory on it. Also, Radiesse is in a suspension that does not dissolve for many months, unlike MetaCrill, whose carrier is gone in days. So, the suspension that Radiesse is in can get molded weirdly too, I suppose. I wonder how all of these non-MetaCrill patients keep their filler smooth when the carrier doesn\'t dissolve for so many days/months.

(PS - Anyone else can answer if you want - I just was initially replying to what he wrote.).

Radiesse would be safer with a blunt cannula - but not 100% eliminate embolisim problems. There have been cases of blindness with fat using cannula in the face. But they do it very fast and rough too. So technique may play a part.

The way I inject HA it is even distributed in long tiny thread. I dont think Radiesse is such an advantage in that way. All stimulatory fillers that use a carrier that dissolves probably have the same issues that they could clump. Sculptra is polylactic acid that is just dissolved in water with is rapidly absorbed. That deposits the PLA in the tissue to stimulate collogen. It was one of the original products I considered. It may be great - if any doctor has used it I would love to hear. But they have techniques that place \"threads\" of it in the face that supposedly contract and lift. I did not want guys coming back saying the skin of their penis contracted and is now shorter. There have been report of shortening with PMMA. Maybe Sculptra is a great option, but not on my radar right now.

As Aleksk keeps saying, Ellanse is probably a big step forward from Radiesse. I have 1 small experience with it but will take it very slow here. There are both potential benefits and negatives. more soon.

Resto- I went back and looked at your big thread. It\'s an amazing read - I can\'t believe how much you opened up about stuff.

I\'ve been thinking this over and over and over.. but something doesnt sit right. I\'m not sure the body wants this stuff in there.. the hardening happens to breast implant too after a while (a lot of the time anyway) - but the ladies can just change it out.

Us guys are stuck it seams.. The Elist implant on the surface seems like a better plan.. put it in, change it out if needed- but I\'ve read that thread too, so no thank you.

I\'m really in a quandry here. I was going to pull the trigger on Ellanse as you may remember then when I reached out to confirm it was no longer offered in TJ.

Wish there was a way to liquify and re-set the PMMA.

Smalljay, again- thanks. I\'m going to go back and read your whole progress thread too.

If it wasnt for you guys- I\'d probably have this done by now. Not saying I WON\'T do it- but at least you guys gave me pause to put in more research. I\'m having a really bad time right now, I\'m in a bad place mentally. Maybe I\'ll post the story. This Penis Dismorphic thing had never been an issue with me before. I\'m in my early 40\'s. Something with the current GF just set it off. I can\'t sleep sometimes. I obsess. I\'m miserable.

thanks again.

Smalljay I don\'t think it\'s only the \"older\" broads that are not bothered about what it is looking like. ED is so common now, even among the young men, that most women are really more focused on \"getting laid\" as buttercups put it, and maybe a little more than that, the hardness or EQ.

So for me, I\'d be damned if I care about nodules and ridges if they are not suppurating! However, not having gone down the road of PMMA, I think the thread is appropriate due to the statistics and I\'ve decided I\'ll go the \"temporary\" way (ellanse or HA).

@ Reklaw: So you\'ve had ellanse filler treatment; were you pleased with the results and where did you get this done?

Many thanks

Elanse Trial

Members we have the opportunity to do 2 guys with Ellanse at a discounted trial price. It is the 3 year version and we can do it at $450/ml. See Subtle77\'s thread for how it has gone. It may be the Ellanse is the best product available for injectable phalloplasty and we are keen to get a couple more guys while the company is supporting us.
So it will be in our Perth or Sydney clinic.

www.calibreclinic.com.au

Dr Oates wrote: Stimulatory fillers have much more tendency to be lumpy. I have used Ellanse (but much less than HA) over about 4 yrs. It tends to feel harder to start with but over all patients are happy. I have had 1 patient with an auto-immune reaction and granuloma (lump) formation. It was in the face - I really dont think someone would be happy with that in the penis. But women are much more likely to have that issue.

I\'m researching safety and negative reactions to ellanse. I found this, which said it was the first reported case of a granuloma from PCL worldwide:

www.ncbi.nlm.nih.gov/pubmed/29757038

Then I recalled reading something from Dr. Oats in this thread. Guess that makes two. Wealth of info on this site for sure

aleksk wrote: Esteban Sarmentero.

Hello Aleksk,
Have you heard any reviews from Dr Esteban Sarmentero? or do you know anybody in PhalloBoards that have had a treatment with him? I have a friend who went for a consultation with him recently to have HA but wants to know a bit more about other patients results with this doctor.
Thanks in a advance,

Dr Oates - correct me if i am wrong. You may think - why do this twice in such small quantities? Well, it fits into my goals, as simple as that. Apart from a modest gain, my goal is primarily preserving aesthetic and looking natural. My other goal is the filler not starting to disappear as soon as I leave the doctor\'s office, but rather last long as such without the need of top-ups in the meantime (perhaps the 3-year version of Ellanse?).

Hi Aleksk,

I reviewed the patient with 4 ml of Ellanse on the weekend. He was very happy. He thinks it feels better - firmer (flaccid mainly) than the Voluma. This is the guy who got a lot of swelling with having big volume HA (in a training session).

So we went ahead and did another 10 ml of Ellanse. It goes in nicely with a cannula. But even though it is about 4 weeks from his first treatment I am not sure the carrier volume has dissolved away yet.

But promising. I have about another 20 ml saved to trial on a \"virgin penis\" if his keep settling down well. I am not too concerned about vascular occlusion (comfortable with using the cannula after all these cases) but developing lumps over the next few months would not thrill me. But the carrier seems to hold the product in place well - I need to go back and see what the carrier is for PMMA.

Nemeckova emailed me back saying she offers Metacrill and Voluma and that she can order Ellanse two weeks prior to your appointment if you opt for that as she currently doesnt have any in her clinic.

Thank you aleksk - good suggestion. I just sent her an email. Will post if I get an answer.

aleksk wrote: What do you all think about my low quantity approach given my goals? Or should I just stick with HA and accept that it\'s expensive as hell, will need frequent touch ups and will start dissolving as soon as I leave the doctor\'s office

I think it sounds like a good idea. I\'m looking for the same myself. 3-year Ellanse with small quantities at a time is the way to go at the moment as I see it. Does anyone know a good place to get Ellanse in Europe? Everyone seems to say that the product is much cheaper in Europe.

I agree with Hoddle, I could go into detail about how bad it is waiting for this shit to wear off but there\'s no point because it\'s beyond most people\'s comprehension.
And it was well beyond my comprehension prior to having the procedure.

Johnson wrote: I must say I do see the point in Ellanse. The main problem with PMMA is that you don\'t really know the health risks 5+ years down the road. You don\'t have that problem with Ellanse. The thing that makes HA unattractive in my opinion is the fact that is dissolves gradually. I just cant imagine dating someone and have my penis become smaller month after month. Also, we have the financial and time consuming aspect (+ psychological stress) of having to get refills/touch ups frequently. Then there is firmness. Wade told me via mail that HA is less firm than Ellanse. In my opinion the most important aspect really, as size is really just a means to an end. You could be very big but if you\'re not firm its not worth a lot. If you have a good practitioner I cant see why you should be very disappointed with an Ellanse injection given that you can always get touch ups if it isn\'t perfect the first time around.

But you are just outlining the appeal or incentive for doing a long term temporary procedure that isn\'t reversible. It\'s easy to demonstrate the appeal of any procedure. But it\'s really only experience that can allow for some to empathise with or fully understand the possible downsides. It\'s easy to imagine being able to mentally cope with a unsatisfactory result, with the knowledge it\'s only temporary. But the reality is usually pretty different.

I suppose analogy would be if you went to prison for 4 years you tend not to sit there thinking \"at least it wasn\'t a life sentence.\" But rather you think \"4 fucking years!\"

If you end up with a lumpy penis, that you are embarrassed about, a year will seem like a very long time, let alone 4 years. Also don\'t forget people report permanent issues with temporary particulate fillers.

Kinda what I was thinking too Johnson, although I see Hoddles point too. Looks like it\'s Radiesse for me, and hope I squeeze out 2 years. Should be calling today or tomorrow to make my appt.
I am hoping, that after Radiesse, if some kind of new super PMMA gets released or Ellanse comes back I can switch fillers. Nervous about two different compounds not agreeing with each other under the skin. I\'m not a chemist, so I have no idea if what I just said is even a valid concern.