PhalloBoards - An Online Community to Discuss Penile Girth Enhancement

karmaz1 wrote: So I was researching this some time back, but have we not had some disasters with grafts on this board?

Infections, grafts being rejected, shrinking a lot over time - the penis becoming twisted and consorted.

It seems super high risk to be honest. Because to be fair, if it were as good as claimed, with none of the filler downsides, plus permanent, why wouldn't more do it.

Yet there appear to be very few surgeons doing it, and the uptake is very small overall (compared to other options which don't cost 'that' much less)

Well yes, that's why I strongly recommended against multiple sheets of dermal graft matrices - the reason why these implants "shrink" (leading to shape irregularity) is because the graft itself failed to vascularize. This also happens with fat injections. When too much is placed in at once, the blood supply required to keep the graft alive isn't sufficient enough. This is why for example Dr. Solomon is very strict with how much he'll implant, based on these observations.

As for infection, this is a risk with all procedures in a clinical setting, no matter what you get done. People get infections in even the most cleanest of clinics undergoing the most benign outpatient procedures. That said, with a procedure like Surgimend which is surgical, you'll likely get an antibiotic course which will reduce these chances of infection. Again, anything that requires the breaking of the skin is going to have a risk of infection - this is why you don't go to back alleys for enhancement.

Few surgeons perform phalloplasty period. It's not a breast job or butt lift. This still remains an experimental field performed by few, and even fewer who are any good at it. Ask your Primary Care physician about penis enlargement and they'll turn their head in confusion. Dermal fillers for penile application didn't really pickup steam until about 5+ish years ago. Furthermore, most doctors who perform girth enhancement are not qualified Boast Plastic Surgeons and therefore CANNOT perform Surgimend on your penis either way. This may explain why you see very little of it discussed relative to non-surgical alternatives.

Dr. Solomon who has performed hundreds of repairs on penises from fillers to implants strictly prefers Surgimend for girth. In my opinion, that's quite telling because he's a Doctor who's seen some of the most repair jobs in phalloplasty, so I imagine he knows what works and what doesn't. Dr. Victor Liu is Board Certified and has performed every phallo-procedure under the sun, including fillers, and he too prefers Surgimend as his "best looking results."

Personally in my opinion, if you are looking for modest gains (not monster sizes), aesthetic contour, permanence, and avoiding the accordion effect if you're uncircumcised, Surgimend is very much a viable option. Of course no procedure is without risk; I implore you to lookup statistics on breast implant complications, you'd think having been performed 10,000x more than penis enlargement they'd have figured it out by now, but even those procedures aren't without risk. You are artificially enhancing your penis, something guys dream of being born with, and it isn't without risk or consideration. This is why I say only those who are in a sound state of mind ought to consider this procedure, that includes budget and alibi, and all.

jackets5 wrote:

Screen2584 wrote:

jackets5 wrote: This is my first post on these boards but been lurking for a while. I’m a triple board certified physician who is looking to have enlargement procedures. I found Dr. Carney’s email through the boards here and sent him an email, telling him my intention and that I was a physician. Dr. Carney, sent me his cell number and said “let’s find a time to chat”. We spoke for closer to 1 hour last night about phalloplasty procedures. He even spent time giving me alternative advice before even considering the lengthening procedure, including saying I could have it don’t by a local doctor and not him. We spent time discussing fat transfer and filler treatments, pro’s and con’s. My takeaway is that he really like the results the filler gives but dosent like how temporary it is and the cost to the patient. All in all super impressed by him. In my practice I come across surgeons everyday who cut because they can and not because it’s always in the best interest of the patient. I appreciate when surgeons say no to surgery or lay out very clear alternatives to surgery and that’s what I go from Dr. Carney.

If any of the moderators want to verify my identity/credentials so they know this is 100% authentic please DM me

Hello doctor, your conversion with Dr. Carney was interesting to read about, but it leaves a lot of unanswered questions. You mention what Dr. Carney thinks, but what do YOU think?

And you mention what Dr. Carney thinks are pros and cons, but what does he ultimately suggest?

Hi, first I want to state that all things Phalloplasty are outside my area of expertise. That being said I want to consider both length and girth procedures, I’ll go through what we talked about for both. Also, I’m 41, happily married and my wife is kind of against all of this.

Length: my current length is about 5.75”. I do have a decent sized fat pad and even when I was very lean I still had a decent sized pad. Dr Carney suggested I take the next few months to work on losing weight then getting liposuction of the fat pad (which he said he would recommend someone close to where I live). He also talked about doing manual stretching and extender work, where he thinks you can get an inch in “natural length”. He said with the procedure you can get on average about 1.5 inches in flaccid length with MAYBE 50% of that being erect length but that would only be with a dedicated 6 months of stretching. Our plan was to lose weight, extend/stretch for 6 months or so, get lipo and I still want the procedure we can do it. I thought his plan was exceptional and it’s a surgeon talking me out of surgery that he would make money on.

Girth: discusses FFT and injectables. Explained the FFt procedure in great detail. Personally I’m much more on the side of doing injectables probably starting with HA filler. We discussed how he does it staggered in 2 seperate procedures of about 10ml each time. He thinks fillers get very good and predictable results but said for a lot of patients cost is an issue. Said would recommend a top off every 18-24 months or so and that filler in the penis seems to last much longer than in the face. Safety profile is also very good. My girth now is 4.7 mid shaft with a bigger head than shaft. Hoping to get mid-shaft to maybe 5-5.25 inches with manual exercises before doing filler with a goal of 5.75-6 inches girth wise.

So for now the plan is diet, stretching/manual PE, pubic lipo in the next 6 months or so. Then re-eval the desire for length. This will depend on my wife as she is petite and has an inverted cervix so getting some manual gains and pubic lipo maybe all she can tolerate and she does get pain sometimes in soggy style right now. Then go to Carney for HA filler.

This is actually some really good advice! And based on my own knowledge, it is exactly what I would have recommended.

1. FFT or HA: I say go with HA. FFT is a safe choice, but it seems the fat can often be unevenly distributed. Doctors seem very comfortable to perform this procedure, because it is safe, and if the results end up dissatisfactory it is not hard to fix.

There are certainly many examples on the board where the results of HA were not satisfactory, but the big advantage is that it is possible to dissolve it, so in that sense it is the safest of all alternatives.

Like Dr. Carney said, you need to come up for a "top up" after 1-2 years. Supposedly FFT can retain some fat, but the result is most definitely not permanent.

I had a tear-through procedure, where my own fat was injected under the eyes, and it got absorbed in 4 weeks! So obviously fat is very unpredictable. The result was however supposed to last for 1-2 years.

2. Ligamentolysis: I had this procedure, combined with dermal fat graft, and I could not do stretching using a penile traction device because of phimosis that I developed post-surgery.

I also feel some lingering pain in the incision area. It is not something that I feel ordinarily, but I noticed that when I use the penile traction device it starts to look swollen at the incision site, and then it feels a bit painful.

The hardest part however, which supposedly make most people give up, is that you need to use the penile traction device daily for 8-12 hours for 6-12 months.

I believe that I had some flaccid gains, and probably they could have been greater if I started using a penile traction device, but I think this procedure is too demanding for most people.

Besides, there are some supposedly very rare possible complications that I think are too worrying to risk for what is likely to be minor flaccid length gains. I do not think that I had any of those very rare complications myself, and everyone on the board wrote the same, but I would still worry about it.

3. Liposuction: definitely this is something you should do. It is very noticeable to have a fat pad when looking at the penis. It will of course not make your penis longer, but it will probably make you feel that your penis looks longer, and maybe your wife would even perceive it as such.

Skeptical_One wrote:

SolLhilll wrote: I’m close to pulling the trigger and getting 8 or 10 ml (to start) of HA filler but I’m wondering if it stays in place or if you can kind of “feel it?” Does it feel like it’s an integrated part of your shaft or does it feel sort of disconnected or suspended?

The filler will eventually integrate with the surrounding tissue overtime, and thus will provide the connectivity you seek. The first few days post-op recovery, you may find the product malleable and mobile, but this is to be expected and is relatively true for most fillers injected into the penile dermis.

The advantages of HA are its strong safety profile, making any future girth or revision very manageable. I hope those who've spent a lot of time with their HA chime in, we got hundreds of lurkers on at a time but few ever register to post. Remember guys, it's an anonymous forum for like-minded men

Would love to hear from these people. I know that a lot of men get the procedure.

I’ve seen studies that report long term satisfaction with the results, but these were always ratings from the person who got the procedure, and not necessarily from people who are experiencing the results as a third party. As someone who’s actually been on the receiving end of girthy men I’m just worried that it doesn’t feel natural.

SolLhilll wrote: I’m close to pulling the trigger and getting 8 or 10 ml (to start) of HA filler but I’m wondering if it stays in place or if you can kind of “feel it?” Does it feel like it’s an integrated part of your shaft or does it feel sort of disconnected or suspended?

The filler will eventually integrate with the surrounding tissue overtime, and thus will provide the connectivity you seek. The first few days post-op recovery, you may find the product malleable and mobile, but this is to be expected and is relatively true for most fillers injected into the penile dermis.

The advantages of HA are its strong safety profile, making any future girth or revision very manageable. I hope those who've spent a lot of time with their HA chime in, we got hundreds of lurkers on at a time but few ever register to post. Remember guys, it's an anonymous forum for like-minded men

otis wrote: If you're wondering if getting a large volume of silicone injected is a good idea, check out the most recent post by HugeCockAce on his OnlyFans.

Unfortunately I am dealing with several medical issues at the moment which continue to prevent me from posting. Im not at risk of sudden death or anything like that, however, my organs are showing some pretty bad warning signs that something could be wrong / needs to be corrected...

I have a quite enlarged spleen, abnormal looking / damaged liver, liver enzymes are all off, several issues with persistent pain and swelling in my left side. Plus I have several areas on my head that will not heal / continue to leak product (months after doing anything).

Guys this stuff is dangerous.

Again, I don't think I'm at risk here of going away anytime soon or anything like that, however given what is going on, I am trying to sort this all out and determine what it means.

I have a urologist appointment next week, then likely some MRIs and we'll go from there.

I'll try to post something soon. Sorry guys.
Ace

Now AFAIK he hasn't said what he had injected but based on his size (you can search his name to find videos) and his current situation, it's very likely silicone. We also have no indication he went to Loria and based on just how big he got I suspect he didn't. My guess is he was injecting it himself or going to some shady doc in Mexico. Still, it shows the serious, life-threatening complications that can come from large volumes of silicone. The complications from other fillers are mostly aesthetic and correctable with touch ups.

There is a place in Mexico which I won't mention by name, notorious for silicone injections. If you travel to MX for penile PMMA enhancement, Avanti Derma is the only place I'd recommend, a place you won't be secretly pumped full of silicone oil.

Sad to hear, more guys need to know this stuff shouldn't be taken lightly. Do your due diligence and get this performed by a credible and experienced practice!!!

Flyskatatypes wrote: Skeptical, thank you so much! I would love to set up a time to speak very briefly with you. I have done a lot of in-depth research on the topic but I would love to here from someone such as yourself, who has had much more exposure to this topic over a longer period of time.

I can make room in my schedule almost any day/time that works best for you.

As for what I wanted to say, where do I begin?

Dr. Loria was making a career as a hair restoration and nutrition specialist. As a forum lurker, Dr. Loria had been a registered member of my site and was one of the first aspiring medical "professionals" to see the potential of dermal filler girth enhancement, especially having read all the PMMA reports coming out of Mexico (circa 2012ish ?).

Soon enough he started offering his own "permanent" solution for men in the U.S., touting that it was a proprietary filler that contained PMMA (Lie #1). However, given our skepticism, we had members of this site contact Dr. Loria to inquire, but he'd often refuse sharing the ingredients of his filler because we weren't privileged to that information (Lie #2). The idea that a medical doctor can inject you with something and not tell you what it is makes no sense, but I digress.

As time went on and cracks began to show, it was apparent Dr. Loria was using silicone (likely Silikon 1000, but who knows). This can filler can be used off-label in a micro-droplet technique to help spot correct small areas on the skin, like on the face. Dr. Loria decided instead to use this filler in large volumes in the penile skin. Due to silicone oil's propensity to migrate, he would have patients wear a tight band at the base and have their shafts wrapped for as long as a month (sometimes longer), in hopes to prevent as much migration as possible. You shouldn't have to worry about migration to this degree with modern techniques and fillers, and should be done with your wrapping in no more than 7 days.

The problem with silicone oil is that it is highly deceptive. You see, silicone oil can provide instantaneous permanent girth, usually with very aesthetic results. However on the flip side, it is not only prone to migration, but its complications are typically much more difficult to manage than that of other fillers, and often times much more severe in nature. Dr. Casavantes once used Silikon 1000 in small volumes to correct aesthetic irregularity, and later discontinued it out of concerns for long-term health. Dr. Liu offered Silicone oil as one of his many options, but now has opted to veer away from it.

A more recent concern has arisen regarding the large volume injection of fillers into the body and its association with kidney conditions exacerbated by foreign body granulomas. In my readings of this, silicone was especially prevalent in the case studies. While the penis doesn't typically involve large volumes, silicone oil (as used by Dr. Loria) can be injected with as much as 60, 70, or 80 cc's in a single-go, which is quite significant. I'm not suggesting this would create a granuloma condition capable of inducing hypercalcemia, since most of those case studies involved hundreds of cc's, but being that it is silicone oil prevents me from ruling it out.

Silicone-born granuloma:


Now what happens to someone if they do experience a major complication stemming from silicone oil? You could of course visit Dr. Loria, because according to his website (not sure if it's still there), he claims to be a cosmetic surgeon (Lie #3). This is not true, he isn't a surgeon and if you have any major complications stemming from his procedure, he will not be able to fix it. This isn't a big deal normally, but if you were lead to believe he was more qualified to deal with anything beyond injecting your penis, then you'd be in for a harsh realization. It's just something about constantly lying as a medical professional that is both disheartening and disturbing.

Then there are forum politics, like how he created multiple shill accounts (with the same IP address) pretending to be former patients and eventually got busted for it many years ago. That was its own entire episode that can be saved for another time but feel free to ask about it in the email if you'd like.

Now I'm hearing his filler contains both Hyaluronic Acid (HA) and Silicone, but who knows anymore. I do have firsthand knowledge that his former patients have biopsies that indicate silicone oil and I know a number of physicians who cite Dr. Loria patients as a common repair job..

Lastly, for now (since I'm sure we'll exchange more info through email) I present this eye-opening consideration: If Dr. Loria's filler of choice and technique were so desirable, why hasn't any well-established/reputable plastic surgeon or urologist attempted to replicate this in their own Clinics? If they all have access to Silikon 1000 off-label, why aren't they also using this method if it has such "successful" results. In addition to this, a marketing representative of Loria's reached out to me for Sponsorship. As you may or may not know, I value the integrity of this site as it has been a life-long project well over a decade in age. I could in theory delete any negative mention of him and hope that any newcomer wouldn't be the wiser -- take thousands in compensation and move on. I flatly refuse to not only jeopardize this site's integrity, but I refuse to have this site or its community associated with his practice. Food for thought.

Good luck, and if you wish to reach out via email, feel free to do so.

Texas wrote: Although it is recommended to start stretching as soon as possible for many reasons, I think that as soon as you are ready you will be able to hang and stretch and work to get your gains still, Especially if you havent and are not retracting. Due the ligaments having been cut and the penis pulled out - you have new penis and tissue waiting to be pulled on. So dont beat your self up yet, Even though i know it sucks to think about, I think you will ok once you get to doing it all.

Thank you for the encouragement, and I also like to think that once I can start stretching, I will still be able to have good results. The surgeon who did my surgery used techniques to prevent retraction. Second, the phimosis has improved a lot, so I might not need a circumcision to resolve the phimosis.

Dekachin wrote: I had my lig cut in 2018. Looking back I have no regrets, but I also do not think it's a very necessary surgery to undergo.

The flaccid gain can be obtained via manuals and stretching and I'm not sure if it caused any flaccid or erect gains in length to be faster as a result of the surgery.

Erection angle was not really affected, just a very small change of angle when erect.

Other then that, my opinion is if you can save some money, there is no need for this surgery. Girth fillers like Ellanse with Dr Oates on the other hand are a game changer.

I do not want to discourage anyone either, but I think your advice is very good. Girth enhancement will make a huge difference in perception, but it is likely that the persons interested in ligamentolysis have too high expectations. Even surgeons admit that this is a big problem. Not so much the result of the surgery, which seems to be as expected for most everyone; instead, it is the problem that people have too high expectations, whereas their expectations when it comes to girth enhancement can be fulfilled. This is something that I often read that dissatisfaction from ligamentolysis is not because the surgery was bad, but because those people who underwent it had too high expectations.

I want to add one thing that I read: after having combined ligamentolysis and filler, it will NOT be possible to use the penile traction device for 15 days post-surgery for those who are circumcised, and for those who are uncircumcised until foreskin swelling has gone down. The foreskin swelling might be so severe that it is phimosis, and in this case the delay will be even longer, until the phimosis is resolved either by healing or circumcision.

I found three huge studies where people had undergone both ligamentolysis and fat transfer:

Composite augmentation phalloplasty: personal experience after 275 patients: parjournal.net/article/view/58#B15

Cosmetic penile enhancement surgery: a 3-year single-centre retrospective clinical evaluation of 355 cases: www.nature.com/articles/s41598-019-41652-w

These studies do not make it out to be a problem to combine both procedures, and the results seem very good, with few complications. Even so, based on what I read, I have a better impression of hyaluronic acid.

As for myself: the dermal fat graft that I had seems to have had a rather acceptable aesthetic and functional outcome, but in retrospect after having done more research, I think the procedure is too invasive. If some friend spontaneously asked me now what I would recommend? I would tell them to try hyaluronic acid without any other surgery.

It's also my responsibility to help bring perspective to those who may have genuine concerns reading this that may already have PMMA in their penis. In no way am I downplaying pr2005's dilemma, but given the significance of the claims, it's important for men who've strictly received PMMA to their penis not jump to any conclusions or anxieties about their own current situation, at least from where things currently stand; let's take a look:

1. The cases being discussed in this topic pertain to large volumes injected intramuscularly. Penises are relatively low volume, injected intradermally. Furthermore, patients with muscular PMMA enhancement tend to have hundreds of (as high as 500+) cc's of filler which would make the granuloma condition more systemic, and could explain hypercalcemia. When you have THAT MUCH filler, you are going see your risk factors scale much the same way. Penile PMMA enhancement however, have 30-60cc's of filler, and a granuloma would be local, small, and treatable, in the rare event they occurred.
2. No instance of renal function associated with penile PMMA has been adequately established, let alone claimed.
3. The material I've reviewed prior to writing this suggests that a foreign body granuloma would be the culprit in hypercalcemia, not merely the presence of PMMA in it of itself. And even if you had the rare misfortune of an FBG, that still doesn't automatically condemn you to life-long kidney issues.

It should also be noted that virtually most fillers can experience the rare complication of a foreign body granuloma - tens of thousands are done all over the world every day in small volumes intradermally (like in the face and the penis) and it doesn't appear that FBGs are a commonly reported, much less significant complications that stem from FBGs. Every search I've done since the inception on this topic (especially medical sites/journals) regarding the concerns of hypercalcemia from FBGs always seemed to involve areas that require large volumes like the buttocks and breast, and also happened to vary in filler type. None of these sources seemed to indicate that the issue was widespread. Which again leads me to believe that the penile application is relatively safe.

You obviously can't rule out anything 100%, even common medications have bizarre 1% side effects, but I'm inclined to believe those with low-volume application of PMMA to the penile skin are at considerably lower risk given what I've presented.

Screen2584 wrote: In my opinion, ligamentolysis is quite perplexing and mysterious. With penis thickening procedures there are many different ways, with many kinds of fillers and graft materials, but when it comes to lengthening there is only one procedure: ligamentolysis. With fillers the penis will always become thicker, and while I read that some surgeons claim to be able to tell how much someone can gain in length from ligamentolysis, it seems very much a gamble.

Of course guys want length increase, but many are unaware that ligamentolysis is mostly only for flaccid gains. All reputable surgeons will say this, although erect gains is possible, but they will say that anyone promising it is a conman. I believe this is one reason why many people who had the surgery might have ended up disappointed, but even if they were aware of the nature of the surgery, many might have hoped for much bigger gains in length and especially erect gains.
- Yes ,any surgeon promising an erect gain is seemingly misleading the patient. BUT - Erect gains are very possible. VERY possible, but it will require work. And frankly most people witll go and get this done and not put in the work ( before or after the procedure )

Another problem is that the flaccid gains do not even seem to be guaranteed. Supposedly, the stretching after the procedure is very important, and here both surgeons and forum members will say very different things: some surgeons will claim 30-60 minutes a day for 1-3 months is enough, but some surgeons and forum members say that wearing the stretching device for 6-12 months for most of the day is required to have any significant gains.
. 1. Flaccid are almost always an guarantee, Especially from reputable surgeon. In fact, there is at least one surgeon/clinic on here that puts the guarantee in writing.
2. Who gives a F** if the surgeon recommends 3mo or 12mo ???? Anyone looking to stop early of for the quick way out should avoid the suregery! You have one dick and you're about to drop some good money on getting length; so spend some serious time ensuring that you lock in the gains you oaid for and work for more. ITs like chicks that get lio and then go back to eating like shit, or never even work out after. A fucking waste.


It seems that most people have flaccid gains right after the surgery, but then some of the gains can be lost unless you do stretching, and supposedly this will "cement" the gains. In the past, there was risk of the penis shrinking due to the ligament healing and the penis retracting, but I suppose this is so well-known by now that since long surgeons use techniques to prevent this from happening. I read that it is pretty much impossible to happen if the right techniques are used.
Well said Screen

Another thing that is often mentioned is changed erection angle and even loss of penile stability. It seems this is something that has stuck around, but both surgeons and forum members say it is either unheard of or greatly exaggerated. Ligamentolysis is actually the one surgery offered everywhere in the world, so it seems they are quite comfortable to perform it, while many doctors have strong hesitations when it comes to certain fillers and dermal graft.

It is interesting because fillers have guaranteed results, albeit with possible complications, while ligamentolysis hardly have any guarantees to it; meaning that ligamentolysis is probably a rather safe surgery, even in comparison to fillers, which might have all kinds of unwanted complications such as lumpiness. Even if for example PMMA might have great results for most people, many surgeons might be uncomfortable to deal with the complications whereas ligamentolysis seems more acceptable.

As for those who had ligamentolysis done: I am one of those people, but I am not a good example, because I had my procedure done 3 months ago and because of swelling of the foreskin I have been unable to stretch. For that reason, I am not sure if I have had any gains at all in length, but I am quite certain that my penis has not become shorter either. I would not be surprised at all if I had gains if I could do stretching, but without stretching I can say that I had no gains.

Although it is recommended to start stretching as soon as possible for many reasons, I think that as soon as you are ready you will be able to hang and stretch and work to get your gains still, Especially if you havent and are not retracting. Due the ligaments having been cut and the penis pulled out - you have new penis and tissue waiting to be pulled on. So dont beat your self up yet, Even though i know it sucks to think about, I think you will ok once you get to doing it all.

In my opinion, ligamentolysis is quite perplexing and mysterious. With penis thickening procedures there are many different ways, with many kinds of fillers and graft materials, but when it comes to lengthening there is only one procedure: ligamentolysis. With fillers the penis will always become thicker, and while I read that some surgeons claim to be able to tell how much someone can gain in length from ligamentolysis, it seems very much a gamble.

Of course guys want length increase, but many are unaware that ligamentolysis is mostly only for flaccid gains. All reputable surgeons will say this, although erect gains is possible, but they will say that anyone promising it is a conman. I believe this is one reason why many people who had the surgery might have ended up disappointed, but even if they were aware of the nature of the surgery, many might have hoped for much bigger gains in length and especially erect gains.

Another problem is that the flaccid gains do not even seem to be guaranteed. Supposedly, the stretching after the procedure is very important, and here both surgeons and forum members will say very different things: some surgeons will claim 30-60 minutes a day for 1-3 months is enough, but some surgeons and forum members say that wearing the stretching device for 6-12 months for most of the day is required to have any significant gains.

It seems that most people have flaccid gains right after the surgery, but then some of the gains can be lost unless you do stretching, and supposedly this will "cement" the gains. In the past, there was risk of the penis shrinking due to the ligament healing and the penis retracting, but I suppose this is so well-known by now that since long surgeons use techniques to prevent this from happening. I read that it is pretty much impossible to happen if the right techniques are used.

Another thing that is often mentioned is changed erection angle and even loss of penile stability. It seems this is something that has stuck around, but both surgeons and forum members say it is either unheard of or greatly exaggerated. Ligamentolysis is actually the one surgery offered everywhere in the world, so it seems they are quite comfortable to perform it, while many doctors have strong hesitations when it comes to certain fillers and dermal graft.

It is interesting because fillers have guaranteed results, albeit with possible complications, while ligamentolysis hardly have any guarantees to it; meaning that ligamentolysis is probably a rather safe surgery, even in comparison to fillers, which might have all kinds of unwanted complications such as lumpiness. Even if for example PMMA might have great results for most people, many surgeons might be uncomfortable to deal with the complications whereas ligamentolysis seems more acceptable.

As for those who had ligamentolysis done: I am one of those people, but I am not a good example, because I had my procedure done 3 months ago and because of swelling of the foreskin I have been unable to stretch. For that reason, I am not sure if I have had any gains at all in length, but I am quite certain that my penis has not become shorter either. I would not be surprised at all if I had gains if I could do stretching, but without stretching I can say that I had no gains.

Screen2584 wrote:

Skeptical_One wrote:

Lofi1 wrote: Do you also when you run a finger along the erect shaft feel a surface that is not completely smooth but has a few "bumps"? I think this is normal both in people without pmma and in people with. The cavernous covers are surrounded by so many elements, from veins to arteries to many other things.

You're right, imperfections exist in men without any work done. Imperfections as a result of a cosmetic procedure will vary in significance both in how pronounced those irregularities are, and how critical the host is of their own body & shaft.

Typically the more noticeable imperfections, especially with fillers, are nodules, lumps, and ridges. These are usually more palpable (to the touch) than they are visual. The ones that are visually obvious deserve the most attention in follow-up appointments. The ones you can feel may smoothen over time, and even if they don't, you might be the only one who notices them. If you feel they need to be addressed, they are usually correctable as well.

Other imperfections include the placement of dermal filler, where some areas of the penis may have more dermal product than others. This can be fixed in subsequent appointments by spot-filling to even out the contour.

The penile skin is thin and has no adipose tissue, therefore more susceptible to aesthetic irregularity. This is why having a legit practitioner perform the procedure is crucial because their work will minimize the number of touch-ups you'll need, especially since follow-up appointments are (almost) inevitable. Keep that in mind when pursuing dermal filler girth enhancement.

If you are hyper-critical of even the smallest flaws I wouldn't consider dermal filler girth enhancement. A dermal graft matrix might be better suited for those who prioritize natural aesthetics above-all else (Doctors like Dr. Solomon and Dr. Liu offer Surgimend, a dermal graft matrix implant).

But to clarify: those people who already got permanent fillers like PPMA, would it be possible for them to get a dermal graft matrix implant? I think it would not be possible.

And for me that got dermal fat graft, I assume the same would be true? I started to think if some filler could be added to improve the aesthetic result? I guess it might be fat transfer, but the more I read about fat transfer the more convinced I have become that it is likely to cause imperfections rather than fix them.

I did read a study that dermal graft matrix implant had been inserted in conjunction with fat transfer, in an attempt to improve the result, but it is done at the same time as surgery. Fat transfer is not permanent either, which is not the case with PMMA, so I guess it would be hard to fix if the result was not good if there is both PMMA and a dermal graft matrix.

Getting work performed on a penis that already has a prior enhancement largely depends on the discretion of the Doctor. PMMA is a dermal filler injected non-surgically whereas grafts are implanted through de-gloving your penis and placing it around your shaft; these present two different implant zones so in theory, both can be performed on the same host.

The issue is that some Doctors may not be comfortable working on a penis unless they were the ones who had worked on it previously. For example I know Avanti Derma won't perform PMMA on a penis that has had any major surgeries done to it. Some may offer it but might have you sign a disclaimer. It really depends.

Skeptical_One wrote:

Lofi1 wrote: Do you also when you run a finger along the erect shaft feel a surface that is not completely smooth but has a few "bumps"? I think this is normal both in people without pmma and in people with. The cavernous covers are surrounded by so many elements, from veins to arteries to many other things.

You're right, imperfections exist in men without any work done. Imperfections as a result of a cosmetic procedure will vary in significance both in how pronounced those irregularities are, and how critical the host is of their own body & shaft.

Typically the more noticeable imperfections, especially with fillers, are nodules, lumps, and ridges. These are usually more palpable (to the touch) than they are visual. The ones that are visually obvious deserve the most attention in follow-up appointments. The ones you can feel may smoothen over time, and even if they don't, you might be the only one who notices them. If you feel they need to be addressed, they are usually correctable as well.

Other imperfections include the placement of dermal filler, where some areas of the penis may have more dermal product than others. This can be fixed in subsequent appointments by spot-filling to even out the contour.

The penile skin is thin and has no adipose tissue, therefore more susceptible to aesthetic irregularity. This is why having a legit practitioner perform the procedure is crucial because their work will minimize the number of touch-ups you'll need, especially since follow-up appointments are (almost) inevitable. Keep that in mind when pursuing dermal filler girth enhancement.

If you are hyper-critical of even the smallest flaws I wouldn't consider dermal filler girth enhancement. A dermal graft matrix might be better suited for those who prioritize natural aesthetics above-all else (Doctors like Dr. Solomon and Dr. Liu offer Surgimend, a dermal graft matrix implant).

But to clarify: those people who already got permanent fillers like PPMA, would it be possible for them to get a dermal graft matrix implant? I think it would not be possible.

And for me that got dermal fat graft, I assume the same would be true? I started to think if some filler could be added to improve the aesthetic result? I guess it might be fat transfer, but the more I read about fat transfer the more convinced I have become that it is likely to cause imperfections rather than fix them.

I did read a study that dermal graft matrix implant had been inserted in conjunction with fat transfer, in an attempt to improve the result, but it is done at the same time as surgery. Fat transfer is not permanent either, which is not the case with PMMA, so I guess it would be hard to fix if the result was not good if there is both PMMA and a dermal graft matrix.

Lofi1 wrote: Do you also when you run a finger along the erect shaft feel a surface that is not completely smooth but has a few "bumps"? I think this is normal both in people without pmma and in people with. The cavernous covers are surrounded by so many elements, from veins to arteries to many other things.

You're right, imperfections exist in men without any work done. Imperfections as a result of a cosmetic procedure will vary in significance both in how pronounced those irregularities are, and how critical the host is of their own body & shaft.

Typically the more noticeable imperfections, especially with fillers, are nodules, lumps, and ridges. These are usually more palpable (to the touch) than they are visual. The ones that are visually obvious deserve the most attention in follow-up appointments. The ones you can feel may smoothen over time, and even if they don't, you might be the only one who notices them. If you feel they need to be addressed, they are usually correctable as well.

Other imperfections include the placement of dermal filler, where some areas of the penis may have more dermal product than others. This can be fixed in subsequent appointments by spot-filling to even out the contour.

The penile skin is thin and has no adipose tissue, therefore more susceptible to aesthetic irregularity. This is why having a legit practitioner perform the procedure is crucial because their work will minimize the number of touch-ups you'll need, especially since follow-up appointments are (almost) inevitable. Keep that in mind when pursuing dermal filler girth enhancement.

If you are hyper-critical of even the smallest flaws I wouldn't consider dermal filler girth enhancement. A dermal graft matrix might be better suited for those who prioritize natural aesthetics above-all else (Doctors like Dr. Solomon and Dr. Liu offer Surgimend, a dermal graft matrix implant).

Denver2530 wrote: I found the listing. It's under the Doctor Forum, Doctor Oates in Australia, and the product is called Aquamid. I'd post a link but I don't know if it's allowed and exactly how to reference it. Easy enough to find. Are there any known doctors in the U.S. offering this?

Granted, the following excerpts are 6 and 3 years old (respectively), but still relevant:

Dr. Oates on PhalloBoards 2.0 in December of 2016:
Aquamid is something I don't use - I just don't feel comfortable with permanent fillers. I am certain there are plenty of people with Aquamid in their face with no problem. I have seen Aquamid disappear despite being 'permanent'. The people who come to me have problems. Early infection is the main issue. It really needs to be done as a sterile procedure - which wa not understood when it was introduced a decade ago. I have seen it to be mobile within a long tract on the face and be able to be pushed about. But a colleague (friend of Dr Moore)who did 15ml of Aquamid to the penis was one of the people who got me interested in PE.
10 ml in the head seems a huge amount, so does 50ml in the shaft. If you do go that was do it bit by bit.


An exchange between Dr. Oates & Dr. Casavantes regarding Aquamid, and its more notorious relative, BioAlcamid in August 2019:
Dr. Oates:
Dr C,

You obviously have the most experience with injectable phalloplasty worldwide. We don't have PMMA available in Australia. Contura, the company behind Aquamid a polyacrylamide permanent gel filler has asked me to do a study on using it in the gans. You mentioned you have used these fillers before - but don't now. Can I ask why that is? Was PMMA just better or there was a specific issue with polyacrylamide?


Dr. Casavantes:
Dear Dr. Oates,
It is a pleasure and an honor talking to you.
It comes as a surprise that polyacrylamide has made it through the Australian FDA!!!
In the early 2000s, Aquamid (polyacrylamide) and especially its infamous cousin BioAlcamid (polyalkylimide) was an international nightmare that hit colleagues in Mexico (myself and my friend Dr. Francisco Perez-Atamoros, a famous Dermatologist whos patients are politicians and actors), Canada, the UK, and other countries. Please read threads in www.thebody.com
I tried to stop the release of BA in the UK through the Minister of Health in Puerto Rico (an acquaintance at that time), but we were ignored and many English doctors hit the wall as well.
What made Aquamid less dramatic is that they promoted it for small areas. BA was promoted for gluteal augmentation, facial reconstruction and so on.
These fillers are non-absorbable gels that create "pseudo-seromas" prone to infection and rejection. They are also very sensitive to physical trauma and manipulation, creating severe acute inflammatory reactions even years after the implant.
They came to us at the time of the crisis of HIV-related lipoatrophy and we had lines of new patients with high expectations, but months later turned into unhappy, panicked patients waiting for extraction of the product with faces that were more deformed than before their treatment. Furthermore, I documented at least one case of penile necrosis associated with BioAlcamid, but not with blood flow blockage. Fortunately, he was not my patient.
Fifteen years later, we still have patients coming for extraction of BioAlcamid, that over the years, turns into an adipose-like material and eventually liquefies and even drains spontaneously. Extrusion (face) is quite easy through an opening with a lancet or a 16G Nokor needle, but the whole experience is beyond traumatic for the physician and especially for the patient. Glutes were much more dramatic and difficult to treat.
I can elaborate on this but I'll try to keep it as short as my rocking mind allows at this moment; feel free to ask for as many details as you want, clinical pictures included. My life and my career turned around (for the good) with the discovery of PMMA and the guidance of Prof. Gottfried Lemperle and Almir Nacul 15+ years ago.
My best recommendation is to stay away from those two products. Your career and reputation are too good to risk them.
Best regards!
DrC

I had dermal fat graft inserted 9 weeks ago, and now I suffer from phimosis too. The surgeon told me to wait another month, and I consulted with many urologists who basically said:

1. Either it will resolve by itself in time
2. Circumcision will be needed

I am very curious what you were told about the circumcision? after having had fillers? Did the doctor mention there was a much higher risk to perform the circumcision?

Phimosis is relatively common, and circumcision is very common, but none of the urologists I spoke to have any experience with penile enhancement and how it might affect circumcision.

A general physician who is a personal friend told me "off-the-record" that it should be no different, but he said that when the urologist/surgeon hears about penile enhancement they will be terrified. It is understandable too if they have no experience. I fear I might have to travel abroad to see the surgeon who performed my procedure to have the circumcision done if it is turns out it is needed.