People have asked before about glans augmentation. HA into the erectile tissue of the glans tended to wash away very quickly. It can be injected superficially into the skin of the glans. The glans skin tends to be crinkly as it is over erectile tissue and needs to be able to expand. In Korea it is a common procedure to inject HA into the skin of the glans for premature ejaculation (PE). It is thought to sit over the top of the touch receptors and make the less sensitive to touch. Published studies have shown really good longevity too - will try and include the study here. But it can also go a bit lumpy and bumpy - especially if you dont put enough in.
Recently I have seen 2 guys that I did the superficial treatment for. 1 guy was happy, go reasonable increase in performance time, very noticeable increase in size, girl friend can feel it and it looks good. But.... not keen on sharing photos. He had 5 ml. Then this week saw a guy who I just did 3 ml and it was more noticabley bumpy. So I suggested more but he was not sure. So I told him about permanent glans augmentation.
There is a filler called Aquamid. Interestingly it never really gets brought up on PhalloBoards as an option for PE. It has been approved in Australia for 20 years. It has been approved in many other countries, including the USA asa urological filler - ti be used in the bladder. It is a polyacrylamide gel - 2.5% polyacrylamide gelling agent and 97.5% water.
There was a doctor using , apparently, very large volumes into the head of the penis but it just did not sound like a reasonable thing to do to me. Then last year a Spanish group had a poster presentation at a meeting. They were using it for men who were having inflatable pump insertion surgery for erectile dysfunction. the inflatable implant does not expand the glans and they wanted something to augment the glans. They have been doing it for about 3 years, using small volumes and they were getting about 5.5mm increase in diameter.
I have been doing this now for the last 2 months and I think we get about 6 - 7mm increase in diameter with the initial injection . I have had 1 guy come back for a second set. We are now looking at setting up an international trial using the technique then publishing a paper.
Adding to Dr. Oates comment, in my experience, there are only two theoretical possibilities for permanent glans enhancement. I do not support, not recommend any of them.
1) PMMA, which can produce unsightly lumps and permanent irregularities. PMMA has to be implanted under thick skin or supra-periosteal, like in the shaft of the penis or selected areas of the face or body. Its use under mucose membranes or thin skin is a contraindication.
2) Aquamid (polyacrylamide) and Bioalcamid (polyalkylimide), very similar substances that have high possibilities of severe adverse reactions. They are non-absorbable gels that create avascular areas in the sites where they are implanted, and infection is almost a universal complication that can happen sooner or later. Colleagues from Canada, the UK, and I used it for facial reconstruction in patients with HIV-associated lipoatrophy in 2002-2003. We all hit the wall!. I won't recommend any of these two products under any circumstance; I believe (and hope) that Bioalcamid was removed from the market in every country where it was registered.
The following is an interview about Bioalcamid that I had back in 2009: www.poz.com/article/hiv-bioalcamid-polyalkylimide-16308-9954
I have been worried about permanent fillers for the 20 years they have been available here in Australia. The initial problems we saw was infection from not taking enough care for what is an injectable permanent implant. But I have been surprised how little long term problems that we see with Aquamid. BioAlcamid has not been available her, that I know of.
The manufacturers tell me that the difference with Aquamid is that it does not get walled off like other permanent fillers and there is constant water exchange between the filler and the tissue thus it is more integrated into the tissue. Maybe it is marketing rubbish. Maybe there is no specific reason that there should be any integration difference between a HA which is mostly water and a geling age and Aquamid which is 97.5% water and a gelling agent that does not break down? But permanent fillers have made me nervous about complications I could not fix and have previously kept away.
With this use we plan for it to be part of an ongoing study, as test treatment should be. I very much hope to be telling you how good the results have been ove the next 20 years when we get there.
samparker72 wrote: Dr Oates, besides Aquamid, are there other fillers on offer at Calibre ?
There was a mention in an older post of Dr Dahn using Ellanse for the Glans, how did that go ?
Ellanse in the glans was also mostly disappointing. Sure we had some guys who were happy - but we were not happy with the amount of increase for the amount of product. Doing lots of research Aquamid vs Bioalcamid and complications.