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Yesterday 22:54
Hello All,
This is the first time I have seen anybody go so deep into the rationale for using fillers on top of the urethra. Good for you, guys.
Our stance on that issue has been and will remain a firm negative.
I am attaching a diagram depicting a transverse section of the penis. Notice how the tunica albuginea is thinner above the urethra and how the urethra itself feels soft, almost spongy; try palpating it along the course of an erection.
Given that Avanti Derma primarily utilizes the most potent fillers on the market (PMMA & PCL), we must exercise heightened caution compared to practices employing absorbable and reversible HA, which inherently possesses a softer consistency.
We must consider potential future complications, and it's not worth jeopardizing the possibility of partial or total obstruction.
Conversely, both patients and doctors should be mindful of aesthetics... the natural shape of the penis is that of an oval, not a perfect cylinder. We strongly advocate preserving normal structures such as the natural shape and an unobstructed urethra, avoiding ventral phalloplasty (scrotal bag reduction), refraining from overcorrections, and other considerations.
As evident, distinctions between fillers are significant, sometimes even crucial. Kudos to all members seeking education to make informed and thoughtful decisions.
DrC @ Avanti Derma
Yesterday 19:00
Does anyone know how long the stretching time with BellaFill is? LinneaSafe is 2-4 weeks.
26 Mar 2024 21:36
Beautiful thread comment from one of our patients:


3 Rounds (2019) I already had with Avanti Derma - Pmma

Now I had my Session 4 - yesterday. This ll be my Journey-Documentary.

C A S E: Empty Area
In all 3 sessions a pretty large area remained pmma-empty (or significant less pmma / squishy)

Potential reason: I had a history of FFT (2018). So maybe this could be the reason the filler could not settle there properly.
Arguments against this Hypothesis: a) There are tons of good reviews of people who got FFT and after that a good Pmma result. b) The even bigger argument: There are also Clinics who do FFT & PMMA togheter for example with BellaFill - intention: To reduce the total costs. phalloboards.info/forum/general-discussi...pmma.html#1308715311



BUT - To be fair: Casavantes tells us already - People with history of FFT are not the ideal candidate. Otherwise on the website it‘s written a bit different.
„(…)Autologous fat transfer typically results in irregularities but develops a light degree of fibrosis that facilitates soft tissue fillers’ implants. These patients are good candidates for phalloplasty.“



Why I come back ‚so late‘ with my issue ?

In the years meantime I was not „unbusy“. I was loose-cut before and I wanted to become the ideal candidate. Patience & Effort: 3 Operation I had — To get the shaft-skin tight like I have it now.
Penile Webbing surgery (has also subtle effect on your shaft skin) + distal (low) tight-cut. This effort was in the years: •2020 / •2021 / •2023 (!)

@Tight cut Advantages:
A. You make it your doctor so much easier to install the implant with a tight cut. Also it‘s the recommendation of Dr. Casavantes.

B. Settle-Time of the Filler (the first days) Especially in my case (empty area) I want to reduce migration significantly with that tight cut. So the product stays where it has been injected.

C. Usage: Filler gets nice compressed while erection.




Why Avanti Derma again?

S E R V I C E
In all this years there popped up a lot of alternatives & new Pmma Options.
Why I decided to go to Avanti Derma again: The Service.

To give an example: ..(As I said -in all my 3 sessions this area remained empty/squishy).. Service: When In Session 3 -as part of the aftercare appointments- Dr. Casavantes saw that this area again could not hold any pmma. He suggested proactive (!) that I can come the next day again (costless!) so that they fill more in this particular area.

Beside that they really check everyday on you …. Especially Ian. ( Give Ian a tip… he deserves it! )

Please do not understand that other offices have bad services: I can only tell my experience.


L I N N E A S A F E
Also: Especially in my case - I want that the carrier-substance gets absorbed fast - That the filler settles fast and stays where it has been injected. …And there is some evidence that the bovine-carrier with BellaFill takes longer to absorb / the filler has longer time migration-potential. So I think LinneaSafe is the better product when it comes to Penile Enhancement.


Why I tried it now again when in all that 3 Sessions the area remained empty?

Like I said it‘s not always about the office. Sometimes it‘s also about how qualified you are as a candidate. Now: With my (really amazing) tight cut „on point“ - the setting ll be significantly changed (old members here can confirm that) - especially regarding to my issue „filler migration“ - I can support that the filler stays there where it has been injected - in my empty area.
Also with a tight cut - for your doc it’s more legitim to (potentially) install more of the product cause your skin-mobility is significantly restricted.


( Explaining „squishy/empty“ : While Erection - When you touch the area - your thumb sinks - through the skin - on your original shaft. Contrast to my other areas: They feel like very hard rubber while erection. While flaccid this contrast between the areas is already noticeable - but it gets even much more obvious while erection. )
26 Mar 2024 13:20

PmmaFan wrote: How many Pmma Doctors we know so far who do the underside of the shaft? Only Rupeka ??


Started a new thread on this. One of the contributors noted his doctor also injects on the underside. I think he said his doctor was in Thailand or something, and I believe he used HA. I had Bellafill used.
26 Mar 2024 13:18

PmmaFan wrote: I also would really want to know how many weeks is the recommended stretcher-usage with BellaFill


I don't know if it's Bellafill or the volume I received, but I didn't feel i needed to stretch after my procedures. I don't think there is anything wrong with stretching, I just didn't need to after those last two procedures.
26 Mar 2024 13:17

VT86 wrote: @6x5to6x7
I'm looking to get 10-15ccs soon to go from 6.2" girth to as close to 7" as it will get me and am wondering about elongating the penis after the procedure.
The doctor mentioned he would just wrap me in gauze to maintain shape and smoothness.
I read your earlier reply about you not needing to do that, so I'll see how it goes

But, would you think it would be bad to use something like an ADS? This is what I currently have: www.stillonsystems.com/
Silicon noose and keeps it stretched out pointing down. I feel the gravity would be beneficial there as well
Would it be possible to do this immediately after the procedure or would there be too much pain?

Thanks


A couple of thoughts.

You are looking to gain 0.8" of girth from 10-15cc's, or are you saying you intend to get many 10-15cc injections to achieve an ultimate girth of 7" inches? I ask because I do not believe you will achieve 0.8" from just 10-15cc's. Although we are all different, I think it is nearly impossible to achieve 0.8" of girth from just 10-15 cc's.

Given the quantity and the product I received from Dr_Rupeka, I did not have to stretch. I did wrap the first few days but that was for minor bleeding and leaking, and a little for shape. That said, I don't think there are any negatives to stretching. I think stretching can be good. I just didn't have to the last two rounds I received which were both 60 syringes of Bellafill.

When I have stretched in the past after a procedure, I always stretched immediately. It didn't seem like there was too much pain to stretch.
26 Mar 2024 13:07
Here's a quick update: on Day 16, the swelling is less important, but still there and I can still feel the squishiness of my skin, as if it was pumped. I haven't pumped in years, but I still remember how it feels and it definitely feels like there's some additional swelling going on. So I've come to the conclusion that the inflammation and swelling will take longer to go away compared to what is usually reported here, and I'll have to wait much longer before concluding anything. I can also understand why I was a bit confused and disheartened a couple of days ago: I thought that the swelling would follow the same path as the average user here, but that's definitely not the case. Consequently I'll wait much longer (6 to 8 weeks) before trying on my new size to avoid causing any damage.

As for the shape, it's quite symmetrical, but I see that I'll probably need another round to fill the bottom of my shaft because when erect, that part is narrower.

In my last post, I also forgot to say that when my wife touched my penis, she couldn't really detect that something was done. She just said that it looked plumpier, but it seemed natural to her. Which makes me repeat the same thing that has already been said here several times: with our own hands and the expertise we have of our own body, we can easily detect the edges of the implant and the imperfections that make it feel unnatural, but to the uninitiated, who don't know where or what to look for, it seems much more natural than we think (unless you go overboard I guess). And by the way, my wife has known me for over 20 years, so she should be able to spot anything suspicious!

Here's two pictures to show how I can squeeze the skin: that thickness is caused by both the swelling and the implant
26 Mar 2024 09:00
Just came across a form of phalloplasty that I’ve never hear of before:

Mechanism of Penis Enlargement Surgery through Fascia Detachment
The penis consists of the corpus cavernosum, which is covered by a white membrane called the tunica albuginea, made of collagen fibers. In addition, this white membrane is enveloped by Buck’s fascia. This Buck’s fascia acts like a corset, constricting the tunica albuginea and the corpus cavernosum, thus limiting the length and girth of the penis. The idea is to detach this Buck’s fascia as much as possible, which limits the size of the penis. Additionally, by detaching between the corpus spongiosum and the corpus cavernosum, an increase in the size, especially in width, can be anticipated.

Has anyone heard of this type of surgery? Or could anyone shed more light on it?

As I understand this method only relies on releasing the grip that the bucks fascia corpus cavernosum and spungiosum. Allowing the chambers to fill with more blood? Leading to size increase. No need for dermal matrix, Pmma, etc…

Anyway this method is new to me so any further info would be greatly appreciated.


yamamotoclinic.or.jp/man/penile/en/

Here is the website of the clinic advertising and describing this method.
26 Mar 2024 07:06

itgoesthud wrote: curious, were you bandaged/wrapped during the flight or just flopping about? I still wonder about wrapping/bandaging when the noose isn't on
(i havent gone for PMMA...yet...I'm getting my ducks in a row in advance!)


No I wasn't, I was wrapped the following day of the procedure for a few hours to reduce edema that's about it. Wasn't suggested by the practitioner to wrap when I couldn't hang so I didn't. In my mind it would have been better than nothing especially given the circumstances with all the delays on the trip home.
26 Mar 2024 04:53
curious, were you bandaged/wrapped during the flight or just flopping about? I still wonder about wrapping/bandaging when the noose isn't on
(i havent gone for PMMA...yet...I'm getting my ducks in a row in advance!)
26 Mar 2024 03:35

uncuthero wrote: It was due to circumcision and my second round of filler.i suggest you hold off on pumping until your 6 week mark you dont want anything to move from where its at let the collagen build then you could pump as far as traction goes your device is what many call a ads all day stretcher you can use that as much as you want traction devices are something else like extenders ,vacuum hanging. If you were to do traction i suggest light traction until the 6 week mark like maybe hang half a pound to a pound nothing too much. Dr casavantes might have some recommendations everything im telling you is based on what dr morales told me and the research that i have done


Understood, thank you
25 Mar 2024 16:10
Thank you, I am very happy with the result, both on erect and flaccid measurements. One under-appreciated effect for me was the movement along the grower to shower spectrum. Very satisfying psychologically and in addition to my partner’s reactions to the larger size, which have been both notable in her reactions and own admission. For those on the fence, it really does make the impact you are seeking in performance.

On the product decision, my understanding is that Renuva is really there to top-off prior fat transfers. I think it is fairly costly per ML and you more total MLs when using fat transfers or Renuva such that building up solely using Renuva would not be recommended. I wasn’t considering a fat transfer based on my research on the forums (although I understand they have come along away from where they were 10 years ago). Ultimately, I liked the safety profile offered by HA given the non-permanent nature, reversibility if was very dissatisfied, etc. In terms of which filler, I think Dr. Tsay would steer most people towards either Voluma or Volux. Volux is supposed to provide a better, firmer result that lasts longer all things else equal, but is more expensive. Dr. Tsay does perform fat transfers but I was pretty sold on HA before contacting him and steered the conversation down that route.

I asked Dr. Tsay if he would ever consider using Ellanse in the future if and when approve by the FDA and he seemed excited about the opportunity, but he doesn’t seem inclined to consider Bellafil/PMMA as I think he has had experience with people who come to him for HA after receiving PMMA they are not happy with.
25 Mar 2024 15:29
It was due to circumcision and my second round of filler.i suggest you hold off on pumping until your 6 week mark you dont want anything to move from where its at let the collagen build then you could pump as far as traction goes your device is what many call a ads all day stretcher you can use that as much as you want traction devices are something else like extenders ,vacuum hanging. If you were to do traction i suggest light traction until the 6 week mark like maybe hang half a pound to a pound nothing too much. Dr casavantes might have some recommendations everything im telling you is based on what dr morales told me and the research that i have done
25 Mar 2024 14:02

uncuthero wrote: Hey voltz when we rode the shuttle together i told you about the loss of length after a procedure after a few months of tugging. Hanging or traction you will regain the length. quote]

Sorry I was under the impression the loss of length you experienced was due to your circumcision. As far as traction goes when do I begin to use the device I have and how long should I use it? It's comfortable enough where I can wear it for an hour at a time if I wrap where the silicone ring attaches in back of the head.

Should I use the smallest circumstance cylinder I can fit into when pumping?

25 Mar 2024 09:35
Hey voltz when we rode the shuttle together i told you about the loss of length after a procedure after a few months of tugging. Hanging or traction you will regain the length. Now when it comes to pumping i would not pump till 6 weeks after the procedure let things settle and even then all you want to do is 5 min sets with nomore than 5hg on the gauge. I told you flying is another animal when your swollen. The delays really screwed up your plans i remember your flight was at 1pm. Either way keep your penis stretched as much as possible the noose gets uncomfortable and hurts after a while so im constantly taking it off. Apply heat to help with swelling. Im always available reach out to me if you got any questions
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