PhalloBoards - An Online Community to Discuss Penile Girth Enhancement

Girther wrote:

Dr_Sullivan wrote: The approach to managing lumps or irregularities after Bellafill (PMMA) injections depends on their cause:

1. Uneven Placement, Pressure Areas, or Uneven Collagen Formation: If the lumps or irregularities result from factors like uneven placement of the filler, pressure areas created post-procedure, or irregular formation of collagen, it's advisable to wait approximately three months before taking action. This time allows for the natural settling of the filler and the body's adjustment, which can resolve many of these issues.

2. Granulomas Formation: If the lumps appear to be granulomas (inflammatory reactions that can form around foreign bodies like fillers), it's important to address this as soon as possible. Granulomas can be a more serious complication and require prompt attention.

Treatment approaches vary based on the scenario:
- For issues related to placement, pressure, or collagen, the treatment might involve injecting more filler to even out the area.
- For granulomas, the recommended treatment is usually intralesional, involving direct treatment of the granulomas themselves.

Is it easy to differentiate between the two - lumps and granulomas?

Very, especially for a Physician. One (i.e. lump or large nodule) is an aesthetic irregularity (clumping of filler and associated bodily fluids/tissue due to any number of reasons), and the other (granuloma) is an actual immune response that may require medical intervention well beyond "breaking up the nodule/lump."

That said, both lumps and granulomas don't appear to present any major issues with respect to penile function & health as far as I've seen (assuming of course, these issues are being addressed by a Health Care Professional, especially those with insight into these potential complications, like Dr. Sullivan).

(7.) How long can you wait before resuming intimacy or strenuous activity after girth injections?
After undergoing penile filler treatment, it's advisable to wait a week before engaging in any intimate activities involving the penis. Additionally, we recommend waiting at least three weeks before partaking in any strenuous physical activities. Prioritizing a proper recovery period is essential for optimal results.


(8.) Can you gain length from girth injections?
There is a possibility of experiencing a mild increase in length when opting for girth injections. While the primary focus of girth injections is to enhance thickness, some individuals may observe subtle gains in length as well.


(9.) Is there risk of Filler Migration in the penile shaft to other parts of the genitals or other parts of the body?
The chance of filler migration within the shaft is generally rare, but our skilled and experienced injectors strategically place the fillers to minimize this risk. There is no risk for filler migration to other parts of the body.

Let me start by saying that I love Voluma for its combination of safety, natural feel, and duration. In response to your question about Volux, know that it is also part of the Allergan family of fillers and known for having the highest G prime.

G prime is central to understanding the characteristics of dermal fillers. G prime, or G’, is a measure of a filler's viscosity and elasticity. This rating essentially tells us how soft and pliable the filler is, and how firm it is. The lower the G prime, the more fluid and flexible the filler; the higher the G prime, the denser and firmer but also less flexible it is.

I think of Volux as Voluma plus, a slight upgrade from Voluma so to speak, but with the with the benefit of increased G prime in Volux, note that it is slightly more prone to needing touch-ups and fine-tuning. However, if you are aware of this beforehand, it can be a very effective choice for penile augmentation. The increased G prime suggests that Volux could offer a firmer, more robust result, which aligns with your preference for a firmer filler.

Regarding the concerns about sponginess, especially with higher volumes of HA like 20 to 40 ml, it's important to note that individual perceptions vary. However, it's not necessarily a universal experience, most men love their Voluma.

Spreading the HA injections over multiple sessions can have an impact on the overall feel and integration of the filler. This approach allows for gradual adaptation and might mitigate the feeling of sponginess, providing a more natural result. Importantly it also allows for the smoothest final appearance. Volux, given its high G prime is a great choice if you are aware of the need for potential touch-ups.

Chip2th wrote: Wow thank you for such a great reply to my post. Very much appreciated.
I have another question if you don’’t mind.

The doctor I’ve been chatting with is concerned if more than 10-12 cc of HA are used the result can be considered too spongey feeling. I’m going with Volux, supposed to be slightly more firm.
However I’ve read quite a few posts in this forum by now and I haven’t really noticed any body complaining about it being too soft or spongey and some of these guys are getting quite a bit of HA often 30 ml or higher.
Is this sponginess something a woman would notice or just me since I’m so used to the previous feeling.
Is this notiion of it being too spongey overblown ?
Does spreading let’s say 20 to 40 ml over multiple sessions make a difference or is it just total voilume ultimately.

Thank you

Depends on the brand of Hyaluronic Acid (HA) he's using. HA is a naturally occurring substance in our body that medical device manufacturers have cross-linked to behave more like dermal fillers. Some iterations are used for the face, hence their softness, but newer iterations have taken into account HA's versatility in many areas of the body, proving to be both more natural feeling and longer-lasting.

Do you mind sharing with us the Doctor you've chosen? I believe Volux should be fine, the bigger issue is a lack of consensus among injectors in the field on which is best for penile application -- an ongoing area of discovery & trial. That said, HA possesses the best safety profile among all fillers, so don't think for a second you're a guinea pig in this regard.

Chip2th wrote: I'm getting stated gathering info to make a decision.

I saw on Dr Shafers in NY website Volux is listed as an HA filler.

It's the most expensive and they claim its the firmest and longest lasting HA filler.

I am I going to notice a big difference compared to Voluma for example?

Which doctors and HA filler do you all recommend? Cost is not a primary concern for me.

Does anybody happen to know how much it costs to have the HA dissolved if needed?

The consensus seems to be HA is the safest and also good because its reversible.

What should I know about PMMA ? I see its permanent. What are the other negatives?

How does the feel of HA vs PMMA compare. I'm really concerned how my penis is going to feel after getting the filler.

Do you still maintain all the same amount of feeling, sensitivity.

I see avanti derma gets a lot of love on this board. Is it primarily price driven because they are in Mexico? I see they have been around a while, I noticed they did not have the HA Volux though. Would they get some special order?

Here is some more info about me that maybe could help you guys better point me in the right direction.
43 yrs old
6ft
175lbs
I am in excellent shape, eat very well, do all the healthy stuff, the fish oil, vitmamins etc, lots of exercise
I take growth hormone ( for anti aging) which i speculate will really help with healing, results, etc. Maybe even more so with PMMA for collagen production.
My penis is very healthy, rock hard erection never fails.
Excellent blood flow, vascular, grower doubles in size from flaccid to erect.

I guess I'd be happy with 5.5 girth, but I notice a lot of guys looking to be in the 6" plus range.
I'm guessing 6" plus is when you can be considered big??

How many many ML's do you guys think I need to get to 5.5" girth ? How many sessions?

Many thanks

My stats:

7.5 BPEL
Neck 4.25"
Mid shaft 4.5"
Base 5"

Dr. Shafer's Clinic is on 5th Avenue, let's just say in order to cover that kind of overhead, you have to be World Class levels of Plastic Surgeon. He's mentioned in a number of major Publications and Blogs and is the only Doctor I know of that is conducting a full-blown study on Hyaluronic Acid (HA) as well as possible mini-documentary in the near future. Despite the stereotype of the big shot Plastic Surgeon, my discussions with himself, his Staff, and his former patients, I get the impression he's quite likeable and goes the extra mile to make it as smooth a process as possible.

As for PMMA, Dr. Shafer offers Bellafill (the American iteration of PMMA) if you prefer. That said, I'd recommend starting with Hyaluronic Acid (HA) first. HA comes in a variety of versions depending on its application. You see, HA is a naturally occurring substance in your body, and what medical manufacturers have done is cross-link them to behave like dermal fillers, and thus create volume in the dermis. In the past, most iterations of HA were used mostly for the face in small volumes, thus their relative softness. Now that HA has been demonstrably effective in many other areas of the body, these same companies are creating more robust, longer lasting versions of HA which can yield quality results.

As for dissolving HA, my recommendation is to get low volumes injected first for a modest gain in girth, especially if cost is not an issue as you mentioned in your post. This way you can tell whether or not you like it, which will allow you to add more if it's a success, or have it dissolved if you aren't totally satisfied (the enzyme called Hyaluronidase is likely most effective in the earlier stages, but I'd give it at least 3 months minimum before passing judgment). Sometimes not all of the HA will dissolve, but not to worry, since it is temporary, you'll likely have to wait out a short time after Hyaluronidase to see your penis return to its normal look. HA is a temporary filler, but the rate at which your body will break down this filler varies wildly person-to-person it seems (I've seen men detect reduction in size as early as 6 months and even anomalies as long as 2 years, and for this reason many companies assert 12-18 months to be on the safe side). It's kind of like how some people heal faster than others, grow hair or fingernails quicker than others, and so on -- despite similar physiologies, many processes that aren't essential to our vitals seem to vary person-to-person.

Regarding Avanti Derma, their popularity stems from a multitude of factors, including (but not limited to) being the first Clinic deemed a success in an industry that goes back 3 decades, full of botcheries and nauseating complications. They were really the only name in the game as far as the use of PMMA (or any dermal filler really) in the penis while being the first to demonstrate the efficacy of this methodology to the North Western Hemisphere (I specify this because its origins came from Avanti's founder Dr. Casavantes being trained in Brazil where penile bioplasty was seemingly invented, as well as Dr. Casavantes' relationship with Professor Lemperle, the world's leading expert on PMMA at the time). Dr. Morales now performs the procedures, but she was trained by the now retired Dr. Casavantes and she seems to have been able to uphold the standard of quality after Dr. C's departure. Of course, value likely also plays a role, Medical Tourism is huge around the world. I went to Mexico for a teeth cleaning + two wisdom teeth extraction + medication + free taxi to and from the border all for $300. In some U.S. cities, that could have easily been $3,000! When it comes to medical cosmetic/aesthetic work, there are many really top notch Surgeons, Dentists, Hair Restorationists all over the world, including Mexico, Brazil, Spain, Turkey, and some others.

Regarding how they feel (PMMA vs HA vs Other Options), I have a simple rule of thumb: just don't go overboard. With your length, you're an ideal candidate, you can easily acquire 5.5"+ without sacrificing natural aesthetics. It's usually when you begin getting a lot of filler that it can become more palpable (this is true for all fillers). That said, the vast majority of partners won't notice, only you will since you are accustomed to your own penis. Since penises come in different shapes, sizes, veiny/non-veiny, colorations, glans proportions, curvatures, among other things, most people won't be bothered to question it, especially since male enhancement of this type is still relatively low-key (i.e. not mainstream). The nice thing with HA is, that if you feel it becomes too palpable to closer you reach 6", you'll know it will eventually dissipate back to 5.5" and you can go in to touch up any minor unevenness from the filler breakdown.

Sensitivity, form, and function of your phallus will not be affected by filler injections. These fillers go into layers of your dermis and are not injected into any of your erectile or urethral tissues, thus posing no risk to erectile or urinary function. However, some men have reported very subtle changes in sensitivity, both "more" and "less" sensitive post-op, but I've never seen any account that had any significant change in this regard either way. More sensitivity makes sense to me since you'll have more surface area than you had previously; the even less common reports of subtle loss in sensitivity I chalk up to early stages of collagen growth, because I can't think up of any physiological reason why this would occur, and suspect most these guys who have stated as much likely regained full sensitivity many months later (unfortunately, a lot of guys will update their Progress Reports less and less frequently with the passing of time because they've got what they wanted, happy, and want to move on and not dwell on size anymore because in their minds, the weight is off their shoulders; that said, anyone reading this, I implore you to at least do yearly updates if you choose to Progress Report, after your initial first few months of posting).

HA's Pros: arguably the best safety profile for a filler; somewhat reversible, and whatever isn't completely dissolved will dissipate in short time; newer iterations of HA are having positive reception/reviews in the penis.
HA's Cons: requirement of maintenance, and somewhat unpredictable what that timetable might be for a person. I will say however, this is a minor "con" since if you choose to top-off once a year, you'll only need much smaller volumes to sustain your size goal, and at lower volumes it should be lower in cost in theory; the other only con I can think of is a lack of consensus on the best brand of HA for penile application. Given Dr. Shafer's many years doing this procedure, I would take his recommendation, he has too solid of a reputation to push you in one direction just because "he got a deal buying a certain brand of HA in bulk." Besides, he's conducting an ongoing HA study, which would make him even more privy to the qualities of each brand of HA filler.

PMMA's Pros: its permanence means once you've completed the number of appointments required to get your final end result/goal, you are set for life. This is a good value proposition. The microspheres are bio-compatible and biologically inert, non-carcinogenic, and has been used in a variety of medical applications outside of just dermal fillers for many decades.
PMMA's Cons: albeit rare, complications may be more challenging to treat (not impossible, but may require multiple appointments involving one or more therapies to resolve the issue). The most known (again, still rare) complication is a foreign born granuloma (which can happen with any filler by the way) which can end up creating a larger than usual lump that will require a few sessions of corticosteroid injections and possibly anti-inflammatory medication to treat. Fortunately, FBG's do not effect the functionality of your penis, the granuloma itself is a localized area of inflammation due to the presence of a foreign body in the shaft skin, and to be frank isn't something I'd consider alarming, but absolutely necessary to treat. In the 13 and a half-ish years the PhalloBoards has been around, I can probably count on one hand the number of irrefutably diagnosed granuloma's being reported. Sure, there are a lot of people who don't post (the vast majority of traffic don't are mostly visitors who are researching with no interest in discussion, which is fine), so it could be a bit higher than I'm lead to believe, but I also know the sample size I'm provided is unparalleled in terms of overall reporting, so I'm sticking to my belief that (major) complication stemming from PMMA in the penis are very rare.

*Note- these are elective procedures and aren't without risk of complication(s). That said, having a qualified, skilled, and experience practitioner using medical grade products ensures that complication rates stay relatively low; This forum has over a decade of progress reporting and complications stemming from patients who have been to any of the Doctors who have Sponsored this site are uncommon and typically get resolved over time. Most major complications you may hear about come from Doctors & Clinics that I have turned away Sponsorship opportunities to, as they presented a well established history of severe and/or frequent reports of complications & botcheries (e.g. large volumes of silicone oil, rigid silicone implants, or any procedure that is both very experimental & extremely invasive).

I'd go with your gut, Dr. Shafer is a Sponsor here for full transparency, but I wouldn't have brought him on board if I thought he didn't put out good work. As I've said before, he's also highly esteemed and you don't work on 5th Avenue Manhattan without being a stud in his field of Medicine. His Patient Coordinator Luc is a really nice guy to chat with and their Staff are peak professionalism. I hope this information helps. Good luck!

ajay1861 wrote: I am having some issues with the softness of the filler too. Thiough I had 40ml done in 4 10mL increments over 5 weeks and got the last one done a few days ago.

I believe it was too much too soon now. Is the process to have it all removed easy?

Seems like getting circumcised first is the way to go to keep a hard dick when getting fillers done.

I’m considering removing it all, getting circumcised then going again

I'll take every opportunity I get to remind this for those who may not have seen me say it elsewhere -- if you are going to get dermal fillers as an uncut guy, get circumcised first. If you have some personal reason for why you wish not to get circumcised, then just KNOW that men with uncircumcised penises see a notably higher rate of aesthetic irregularity (i.e. not favorable results) than those who are circumcised. This has been reported to me by Clinics with some of the highest volume of penile enlargement patients. Furthermore, any cosmetic issues that do arise in uncut men are more challenging to correct.

Ask yourself, would you like a thicker cock with no foreskin, or a thicker cock with a significantly elevated risk of unsatisfactory results? But please don't misunderstand, it is possible that men who are uncircumcised can still achieve great results, my Public Service Announcement is only to point out that those patients were lucky quite frankly. It's too well documented (both here and by Clinics) to think otherwise.

(4.) How many sessions can a patient expect to achieve an ideal result?
The increase in girth during each session is influenced by the amount of filler administered. Typically, the best results are achieved after 1 to 3 sessions.


(5.) How long will filler injections take? What kind of anesthesia or sedatives are used?
Penile filler typically takes 30 minutes to prepare and inject, making it the quickest way to see an increase in girth. A topical anesthetic is applied to the penis prior to injection and the fillers are blended with lidocaine, ensuring a comfortable experience for patients.


(6.) Can girth injections affect the function or sensitivity of the penis? What complications are there to consider?
Girth injections maintain the natural feel and sensitivity of the penis, preserving its functionality post-fillers. While complications are rare, it is advisable to refrain from any self-pleasure activities for the first week following the injections.

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.

Bigmster wrote: Hi,
I am wondering whether previous HA filler is a contraindication for surgical enhancement, like Alloderm?

Completely at the discretion of the Surgeon. *Note* - the term Surgimend found below is basically like Alloderm, and I believe Alloderm is what they are primarily using now.


Bay Area Penis Enlargement (Dr. Victor Liu) says the following in his FAQ:
(Q5.) If I had other treatments for penile enlargement (fat injections, Penuma, Surgimend, etc.) and am not happy with it, can I have still get filler injections?

Dr. Liu's Answer:
Generally, filler injection after a person had surgical insertion of Penuma or Surgimend for penis augmentation is safe and do-able. However, it is not advisable to do surgical insertion after the person had filler injection because of the adhesions resulting from the surgery making it very difficult and even unsafe to perform. One of the problem with Penuma is that it is firm and sometimes it is palpable on the skin surface and does not look natural. One way to treat this would be with filler injection.
Some patients had fat injection for Girth enlargement and complain that the penis feels too soft and look uneven. This is a common problem with fat injection because some of the fat may be absorbed unevenly and of-course fat feels soft. This can be improved by injecting filler intradermally (inside the skin) to give a "shell" and also inject sub-dermally (underneath the skin) to even out.
It is best to see and be examined by the treating surgeon before a final decision on what is best for you.


Dr. Solomon says the following in his FAQ:
(11c) Is it possible to undergo surgical augmentation (e.g. Surgimend, and/or lengthening) even if prior work has been performed on the penis, namely dermal fillers?

Dr. Solomon's Answer:
It is possible to perform grafting after prior procedures have been performed. However, the risk of complications is increased after prior procedures. Prior procedures, both surgical and non-surgical (such as fillers or fat grafts) will disrupt normal blood supply to the skin and make healing more challenging for the patient, with increased risks of wound breakdown and infection, among other things.


The only two I'd recommend consulting with on this specificity of your question.

Good luck.

The following questions are in bold followed with answers authored by Dr. Sullivan:


How much girth/circumference can you achieve with girth
enhancement injections?

Basics:
The average flaccid girth: 3.5 to 4 inches and erect 5 inches. Most men are
looking to gain 1-1.5 inches.

Results:
A single session typically involves the injection of 5 to 15 syringes. Best results
for most patients come after 15 to 30 syringes over 1 to 4 sessions. After each
session, you can expect an increase in girth ranging from 1/4 to 1/2 inch. After
several sessions, total enhancement ranges from 3/4 to 1.5 inches. Some patients
may wish for more than 1.5 inches but be aware that as the girth increases the
naturalness of the look decreases.


How Many Sessions can a patient expect to achieve ideal results?

Most patients have great results after just one session, but 2 to 3 sessions may
be required depending on your goals. Some patients, thrilled with their initial
enhancement, opt for additional treatments. Spreading treatment over multiple
sessions allows for more fine tuning of the symmetry. It is important to avoid
over-filling during a single session. Stacking enhancements across multiple
sessions seems to produce the best results. Fifteen to thirty cc or syringes is
usually the optimal number for significant girth enhancement for the average-
sized penis. Remember your starting point matters. A man starting with a girth of
3 inches and achieving an increase of 1.5 inches has a 50% enhancement, if you
start with 5 inches and gain 1.5 inches there is a 30% improvement.


How long can filler injections take and what kind of anesthesia is used?

Typically, the procedure is completed within 30 minutes. The initial visit may be
an hour. This extra time is essential for completing patient intake paperwork and
conducting a comprehensive consultation.

I use a combination of topical numbing and a dorsal penis block. The dorsal penis
block involves administering a local anesthetic to the base of the penis, rendering
the entire penis numb. Patients experience almost no discomfort during the
procedure.


Can girth injections affect the function or sensitivity of the penis? What
complications are there to consider?

This is an important question. Most patients report either unchanged or
enhanced sensitivity with girth enhancement. Where does the enhanced
sensitivity come from? I believe some of it is from being more confident. So much
of sexual pleasure is mental, and feeling good about yourself is key to good sex.
Importantly with increased girth there is increased friction thus improved
sensation for you and your partner.

Potential Risks and Side Effects:
Bruising/Swelling - It is common to experience bruising and swelling post-
procedure. This may last for 1-2 weeks.

Discomfort - When the anesthesia wears off, there may be mild discomfort. This is
treated with over-the-counter anti-inflammatory medication.

Infection - Infections are rare, but as we are breaking the skin barrier and
introducing a foreign substance it is a potential risk.

Lumps/Unevenness – There may be lumps or unevenness especially in the first
few weeks. This usually resolves on its own. If it does not HA fillers can be
corrected using a small amount of hyaluronidase. Occasionally unevenness may
require an additional syringe or two. Some men have natural folds in their penis
due to how it is positioned in their underwear. This can cause the filler to kink or
crease. To mitigate this, we use dressings in the first week, but despite our best-
efforts creases can still form, necessitating a touch-up.

Delayed-onset Nodules - Delayed-onset nodules have been associated with both
PMMA and HA fillers. With HA fillers, these nodules can be dissolved entirely, but
PMMA nodules may prove more difficult.

Vascular Necrosis – This is where the filler is inadvertently injected into a blood
vessel. Although most affected individuals make a full recovery without lasting
scars it is an important possible serios complication. Girth enlargement is a
medical procedure and all procedures have possible serious complications.


How does a newly girth enhanced penis feel?

Great! It’s like driving a new car. The enhanced girth offers a sensation that is
amplified for many men. There's a subtle difference in how the penis feels
compared to before, but it remains discreet, detectable mostly only to yourself.
The injected area might be marginally softer, usually if larger volumes are used.
Usually, partners don’t notice a change in firmness; they do notice the change in
girth.

Consider many intimate toys have trended towards a softer exterior, for
enhanced comfort, a little bit of softness may be more comfortable for partners.
Also consider, the penis doesn't just gain in volume but also in weight, giving a
more noticeable hang when naked and in clothes. Most men really enjoy this
heavier feel and get a great boost in self-confidence.


How long can you wait before resuming intimacy or strenuous activity?

To prevent infections, it's advised that patients wait between 5 to 7 days after the
procedure before engaging in sexual activities. This period allows for adequate
healing and reduces potential complications. After 7 to 10 days sex and
masturbation are okay and might even assist in reducing any post-procedure
lumps. Physical activities such as the gym can be resumed after 3 days, but
caution should be taken to avoid any pressure to the penis.


Can you gain length from girth injections?

Unfortunately, no. However, there is the feeling that it is longer because the
increased weight of the penis makes it “hang” more. Girth injections increase the
thickness of the penis, not its length.


Question of Filler Migration?

After the filler is injected, a compression sleeve is provided to ensure the penis
remains extended. However, since the penis is not a static organ and can change
shape during various activities, some filler movement is normal. For the first 2-4
weeks post-procedure, any uneven distribution of the filler can be adjusted
through gentle massages. After a few weeks and after couple months, the filler
integrates substantially with the tissue, making migration very rare. One
advantage of using Hyaluronic Acid filler over other treatments like PMMA or fat
transfers is its adjustability. If any irregularities occur, Hyaluronidase can be
injected to dissolve the undesired filler areas, and additional filler can be added if
needed.

Although PMMA fillers, like Bellafill have the potential to move, following
aftercare guidelines can significantly reduce this risk. Abstaining from sexual
activities for a minimum of one week, using the provided dressing and avoiding
kinking greatly reduce this risk. As PMMA becomes part of the tissue and collagen
production, migration becomes highly unlikely.


Granulomas:

Granulomas are inflammatory reactions by the body to foreign materials. They
can occur when certain substances, like silicone, are injected into the skin. While
PMMA injections can cause granulomas, they are rare. If they do occur, they can
be treated, though they might not fully disappear. The chances of getting
granulomas are extremely low with HA dermal fillers. If granulomas do form from
HA, they can be easily managed hyaluronidase, which dissolves the filler if
required.


What to expect on the Procedure Day?

Before the Procedure:
- I will examine you and we will discuss your goals. Once we decide on the both
the filler to be used and the amount I will perform a dorsal penile block to make
sure you are numb for the procedure.

During the Procedure:
- I will carry out a series of dermal filler injections. The total volume injected will
range from 5 to 15 syringes on average (although some men may do more), based
on your individual anatomy.

After the Procedure:
- A dressing will be applied to the injection area, which you'll need to wear
continuously for the first 5-7 days. During this time, avoid sexual activities. We
will guide you on dressing care and provide the necessary supplies for a smooth
recovery at home.

Follow-Up:
- A follow-up appointment will be scheduled for you three to four weeks after the
procedure.
 

Blunt-Tip Cannula vs Needle?

Both the Blunt-Tip Cannula and Needle methods have their own advantages.
However, I prefer using the needle technique. The reason for this preference is
that I believe the needle provides more control and allows for precise fine-tuning
during the procedure. Additionally, by employing a nerve block during the
process, the procedure becomes extremely comfortable for the patient, reducing
any potential discomfort.


What makes a good candidate?

The best candidates are circumcised individuals without pre-existing scar tissue,
primarily interested in girth enhancement, and have realistic expectations about
the results.

While both circumcised and uncircumcised men can undergo the procedure,
those who are uncircumcised might need follow-up touch-ups.
 

Use of Platelet Rich Plasma (PRP) to Aid Gains?

While I perform this procedure for aesthetic purposes this will not increase girth.
If your goal is girth, you are better off investing in a filler procedure. If the
question is where to spend your money PRP or filler, filler wins every time.


 Best Circumcision for Girth Enhancement (Filler)

You do not need to be circumcised. We treat both circumcised and uncircumcised
patients. Male Enhancement injections can be performed regardless of
circumcision status. Patients need to understand that if uncircumcised they may
require a touch up and if they are looking for larger girth enhancement, they
would benefit from a go-slow multiple treatment approach.


Preference of filler and/or brand?

Juvéderm Voluma XC and Juvéderm Volux XC are the longest lasting HA fillers in
the U.S. They also have a firm feel. HA’s are safe and have been around for
decades. The results are very consistent and predictable. I also use Defyne, Lyft
and RHA-4 however Juvéderm Voluma XC and Juvéderm Volux XC are my
preferred fillers.

If a patient is looking for a more long-term option especially if they have already
had HA filers. I choose to use the bio-stimulatory dermal filler Bellafill. Bellafill
provides immediate, long-lasting results and can last 5 years or more.


Can Filler cause ED?

No, not routinely. However as with any medical procedure extremely rare
complications can occur. The likelihood of the girth enhancement causing ED is
extremely rare. This is because we do not enter the corpora cavernosum which
holds the blood for the erection, nor do we inject anywhere near the nerve
bundles that affect the erection.


Can girth enhancement injections be performed on a penis that uses an
inflatable implant?

In most cases yes. Rarely, it would not be possible. For example, if an implant was
inserted and there were complications such as infection or scar tissue then girth
enhancement with filler might not be optimal.

Why are silicone injections regarded as the least safe option as a girth
filler?

Even when medical-grade silicone is used and even with the correct technique
(the microdroplet technique) its use is complication prone. The mechanism by
which liquid silicone works involves the formation of foreign body granulomas,
which can lead to firm nodules. These nodules may not only be challenging to
remove but can also erode the skin, resulting in ulcerations. This complication can
occur immediately or years later. It is unpredictable. I have seen this complication
many, many times and for this reason I do not use silicone. It is also very
important to consider that many providers using “silicone” are not even using
medical grade silicone. There are so many safer options that are very long lasting
so why take a chance?


Are there any solutions for glans enlargement?

Hyaluronic Acid (HA) fillers like Vollure can safely be used to increase the size of
the glans (head) of the penis. I take a go-slow approach here only injecting a
limited volume at one session. I keep the number of syringes injected here to a
minimum (I only inject a maximum of 2 mL of HA) and ask the patient to come
back to add more product later. Although I know it is said that the results are not
long-lasting due to the vascularity of the glands, I do not necessarily believe this is
true. Consider the lips another very vascular area, filler typically lasts 1.5 years
here if the correct filler is used. Filler may not last as long in the glands as the
shaft, but it is certainly long lasting.


Can you describe your experience with cosmetic medicine and the
importance of injection technique? How does this benefit girth
enhancement?

Injection technique is extremely important. I have been using dermal fillers since
they first became available in the U.S. two decades ago. I have used all filler types
including hyaluronic acid (HA), PMMA (Bellafill), calcium hydroxylapatite
(Radiesse), poly-lactic acid (Sculptra) and silicone. I have injected almost every
anatomical location including the face, lips, hands, neck, chest and of course the
penis. I have used both needles and cannulas. This experience allows me to safely
inject for girth enhancement.


Do girth dermal filler injections adversely impact blood pressure or
increase risks of hypertension?

No.


If I had other treatments for penile enlargement (fat injections,
Penuma, Surgimend, etc.) and am not happy with it, can I have still get
filler injections?

Yes. Filler injection after a person has had surgical insertion of devices such as
Penuma is safe and do-able. It can even be used to correct problems with the
device. If the device is visible or palpable, its appearance can be improved with
filler injections. Unevenness after fat injections can also be improved by injecting
filler.



getmoregirth.com

itgoesthud wrote:

MoMoney wrote: Thanks for the input. My suspicion is that it serra/nattokinase would not mess with the fillers, and its nice to some some anecdotal evidence.

Yeah I mean I've read people mention it ameliorated the breakdown of scar tissue but collagen, near as I can tell/read, is not the same nor affected the same, as scar tissue.

MoMoney wrote: You are almost at 2 years with what seems like a decent amount of your HA left. Have you been happy with it and when/if you do you plan on a re-up?

I went with such a conservative amount (15ml) based on my starting size that I think it's spread super thin, and indistinguishable from my penile tissue. I don't know how I'd like it if I would have gotten more, so my feelings are mixed, and I can't overly enthusiastically "endorse" it. I very much love my dick, and yet, I paid more for HA (from a non-sponsor, before i joined the boards) than I would have going to e.g. Avanti and getting something permanent. Knowing what I know now, if you put me in a time machine, I'd have gone the PMMA route. If money were no object, and adding more HA up to my goal size felt as natural as I do currently? Absolutely I'd be happy. But I suspect that's not the case, as it would be for PMMA.

MoMoney wrote: Lastly, why do you take serra/nattokinase?

Familial hyperlipidemia coupled with me being on TRT and being the type who loves lifting and hates cardio.
Keeping my blood flowing is going to keep my dick hard, and keep me from croaking young. I figured fibrin clots are not conducive to this, and that regardless I'd end up with an improvement in blood pressure.
Generally any supplements I take are specifically targeted at endothelial function - good for the is good for the penis, so...yeah. I'm a tall, wide dude, left ventricular hypertrophy is almost a certainty, so any advantages I can get, I'm going to take. L Citrulline, nattokinase, niacine, baby aspirin, fish oil, I slam all of them.

I did actually learn a LOT from the holistic covid remedy guinea pigging people did; that's also how I discovered lactoferrin, which, turns out it's a great way of raising ferritin without wrecking your gut.

All very interesting man. I'm going for my second round of Ellanse with AD, likely stopping here, will be 25cc's total between the two rounds. Still interested in HA in the future if I want to experiment higher girth then.

I think the blood flow improvement I felt was possible fibrin clot busting. Cant wait to try it again and see if i notice the same thing years later.

I use to supplement with citrulline malate, gave me crazy endurance.

Every experiment with raw garlic? Shit gave me crazy energy and crazy wood.

MoMoney wrote: Thanks for the input. My suspicion is that it serra/nattokinase would not mess with the fillers, and its nice to some some anecdotal evidence.

Yeah I mean I've read people mention it ameliorated the breakdown of scar tissue but collagen, near as I can tell/read, is not the same nor affected the same, as scar tissue.

MoMoney wrote: You are almost at 2 years with what seems like a decent amount of your HA left. Have you been happy with it and when/if you do you plan on a re-up?

I went with such a conservative amount (15ml) based on my starting size that I think it's spread super thin, and indistinguishable from my penile tissue. I don't know how I'd like it if I would have gotten more, so my feelings are mixed, and I can't overly enthusiastically "endorse" it. I very much love my dick, and yet, I paid more for HA (from a non-sponsor, before i joined the boards) than I would have going to e.g. Avanti and getting something permanent. Knowing what I know now, if you put me in a time machine, I'd have gone the PMMA route. If money were no object, and adding more HA up to my goal size felt as natural as I do currently? Absolutely I'd be happy. But I suspect that's not the case, as it would be for PMMA.

MoMoney wrote: Lastly, why do you take serra/nattokinase?

Familial hyperlipidemia coupled with me being on TRT and being the type who loves lifting and hates cardio.
Keeping my blood flowing is going to keep my dick hard, and keep me from croaking young. I figured fibrin clots are not conducive to this, and that regardless I'd end up with an improvement in blood pressure.
Generally any supplements I take are specifically targeted at endothelial function - good for the is good for the penis, so...yeah. I'm a tall, wide dude, left ventricular hypertrophy is almost a certainty, so any advantages I can get, I'm going to take. L Citrulline, nattokinase, niacine, baby aspirin, fish oil, I slam all of them.

I did actually learn a LOT from the holistic covid remedy guinea pigging people did; that's also how I discovered lactoferrin, which, turns out it's a great way of raising ferritin without wrecking your gut.

I can't speak for PhalloFILL Florida (only Dallas, TX), but I've spent sometime reviewing @Dr_Sullivan and you can't get better than a Dermatologist (skin expert) who injects dermal (skin) fillers in the penile shaft dermis (i.e. skin).

Dr. Tory Sullivan Directory Listing (FLORIDA)

I have been on these forums for a few years and never pulled the trigger. But now it seems the procedure is becoming more commonplace, the fillers are getting more advanced, and more providers are coming online.

I am interested in HA. I am in the South Florida area.

Who is the most experienced doctor in my area?

I see Dr. Tory Sullivan and PhalloFILL has several operators in South Florida. Also there may be other providers I'm not mentioning.

Also what is the most popular/advanced filler brand that is being used right now for penile HA, and why? Is there one that is vastly superior to the others when it comes to realistic, even results?

Your response means a lot. Some of you veterans with PMMAs and years of HA fillers may consider this a walk in the park, but making changes to my dick is super nerve-racking as I am concerned about safety and outcome (even if HA isn't permanent).

P.S. Is there a HA provider that clearly outshines the rest in the USA that it may be worth flying out there to see him?