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TOPIC: Dr. Wall Q&A

Dr. Wall Q&A 3 months 9 hours ago #1308704350

The following will be periodic Q&A submissions from Dr. Wall; the questions will be provided by PhalloBoards' Members and Moderators:
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(1.) Dr. Wall, who would you consider a good candidate for girth enhancement?
A good candidate is anyone wanting to inject confidence into this area of their lives. They should be above 18, be fit and well medically and have a goal to increase flaccid and erect girth, and increase flaccid length. Men experiencing retraction of the penis during sport/cold weather or just in general, notice a significant improvement in flaccid length after this procedure. They typically go from being a 'grower to a shower'. Men who suffer from premature ejaculation are excellent candidates for glans dermal fillers. This decreases sensation in the head of the penis resulting in significantly longer lasting performance without the need for medications.


(2.) Dr. Wall, do you use a needle for injections or a blunt-tip cannula? Do you see any advantages with your preference over the other?
I prefer the use of a blunt tip cannula. I perform a dorsal nerve block to the base of the penis first to numb it along its whole length. I then use a slightly larger size cannula then most practitioners to avoid the risk of damage to veins and arteries. Smaller gauge cannulas can more easily penetrate the deep fascia, which can lead to scarring of the fascia that can result in permanent deformities to the shaft, along with damage to underlying erectile tissue/nerves and vessels. A needle is used to inject the head of the penis. It is performed in a similar way to lip fillers. 3-5ml into the glans is the usual amount for best results. Rarely, you may need to use a needle in some circumstances such as previous use of collagen stimulating injections such as Ellanse. The collagen stimulating process causes a thickening of the internal architecture between the fascial layers making it hard to pass a cannula. This situation is uncommon.


(3.) Dr. Wall, do you use any healing or growth factors like PRP (Platelet Rich Plasma) to aid in the overall recovery and/or results of a procedure?
We use Emcyte PRP for erection enhancement P-Shots. The feedback I have about this is really remarkable. I hear many of my patients say it takes them back to when they were in their early 20s in regards to strength and longevity of erection. The caveat I will put on PRP results are that not all PRP is created equal. When investigating which clinic to attend for PRP, I suggest looking at the amount of platelets concentrated per ml. Most inferior PRP concentrating systems have 400-600 thousand platelets per ml. Emcyte PRP has 1.2-1.5 million platelets per ml. To explain how it works, Platelet Rich Plasma treatments harness the natural healing and regenerative capabilities of platelets. In normal physiology, these cells are the first to arrive at the scene of an injury. They help in the clotting process, but play a special role in healing, releasing growth and healing factors. The more platelets, the more growth and healing factors. That is why it is important to choose a device with superior concentrating abilities. Most of my patients choose to have both PRP and Filler phalloplasty as a complete downstairs rejuvenation package.

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Dr. Wall Q&A 3 months 8 hours ago #1308704356

Do you know what the best circumcision cut is to get before filler ?

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Dr. Wall Q&A 3 months 6 hours ago #1308704363

I would ask also which filler is actually using for best overall results

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Dr. Wall Q&A 2 months 3 weeks ago #1308704392

Dr. Wall Responses:

beardy07 wrote: Do you know what the best circumcision cut is to get before filler ?


@beardy07 - Such a great question, and one I would imagine not many consider prior to adult circumcision if one plans to have filler phalloplasty. I prefer the high and loose cut (not overly loose). This is especially appropriate if one has significant size goals with a plan for 20ml or more. It allows easier expansion of the tissues and a more smooth, symmetrical result.


tiritera wrote: I would ask also which filler is actually using for best overall results


@tiritera - I separate my preferences into Hyaluronic Acid filler and Collagen Stimulating filler.
  • Hyaluronic Acid Dermal Filler
Teosyl Ultimate has the perfect mix of elasticity, cohesivity, hyaluronic acid concentration and cross linking to provide an impressive volumisation with a natural aesthetic and feel.
  • Collagen Stimulating Filler
Ellanse I think provides the most impressive improvements in size, with a feel that most closely mimics the natural feel of the penis. It has 2-3 times the longevity. It’s drawback is that it is non-reversible in the case of a rare complication. It is for that reason most of my patients elect to undergo their dermal filler phalloplasty with the hyaluronic acid filler Teosyl Ultimate.

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Dr. Wall Q&A 2 months 3 weeks ago #1308704397

Is there any chance of HA filler causing ED ?

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Dr. Wall Q&A 2 months 1 week ago #1308704675

Dr. Wall Response:

beardy07 wrote: Is there any chance of HA filler causing ED ?


Hi @beardy07 , there are no documented reports of HA causing ED I am aware of in the shaft. However, overfilling of the glans can cause a reduction in glans blood flow causing it to be less hard during an erection. It is for this reason I am conservative in filling no more than 3ml per sitting in this area.

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Last edit: by PhalloBoardsSystemAccount.

Dr. Wall Q&A 2 months 1 week ago #1308704705

Dr wall how much inch gain can you achieve on a uncircumcised penis ? Inch erect or that to much

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