Hi Dr Oates

I received multiple HA treatments from Dr Gav, but in the end I was not satisfied with the result, because of the unnecessarily large volume and the squishy texture, making it impossible to have sex, and impossible to put on a condom. Therefore I have decided to dissolve the HA and get Ellanse treatment from Dr Danh.

I have recently gone to Dr Tall in Brisbane to dissolve the HA filler over 3 sessions, I think they've done a good job with what they could work with, but there's still some minor residue filler that's just very stubborn and could not be dissolved. They're not squishy or anything, but the nodules are very palpable but not squishy.

I don't necessarily mind the nodules, but does their existence affect the outcome of the Ellanse treatment in any way? Does the Ellanse need to be placed underneath the residue HA?

And for someone with my stats, (12.5cm erect length, 8-9cm shaft length up until Circumcision scar), 10.5cm mid shaft Girth prior to any HA injection, 11-12cm erect circumference at present (with the undissolvable residue HA), how much gain can the 10ml give me, versus the 15ml.

I appreciate your clarification

Hi AudienceK,

Sorry to hear about you issues. Dr Gav is no longer part of our network and with the strict isolation of WA it has been difficult to train up a new doctor in Sydney. Can I ask how many ml you had? There was another post on PhalloBoards reporting HA not being able to be dissolved at all (a different filler we dont use). It could be a couple of things. It could just we 'walled off' by a bit of fibrous tissue and not letting the hyauronidase get it the H. But hyauronidase penetrates really well so i dont think it is that. They could be little Nodule reactions and trying an injection of a tiny bit of steroid may help and be worth a try.
10ml Ellanse is likely to be enough to get 2cm Flaccid Girth increase, maybe east 13cm erect circumference. As it is all in the same plane the Ellanse is probably around the lumps and hopefully firm enough to hide them.
Keep us informed of how you go!

Thank you Dr Oates for taking the time to answer my questions. With my FaceTime consultation with Dr Danh 2 weeks away, and the treatment appointment 6 weeks away, I'm sure you can understand why I'm feeling a little lost and in limbo.
I was going to go back to Dr Gav next week, but found out that his Ellanse treatment would cost $1100 per ml, so I think the extra few weeks of wait would be worth it considering how much money I can end up saving.
I also think it would be great to help Dr Tall to incorporate Ellanse treatments so there's one more option in Brisbane.

Now, to get back to the topic, there must have been something like 20 ml of HA injected into my penis, but it's hard to estimate how much was "effectively" injected, because I received the first treatment uncircumcised, and when I got an accordion Dick, I had to dissolve some of the HA in the Foreskin followed by a Circumcision, which cut out a little more HA in the surgery. After my Circumcision healed, I went back to Dr Gav to top up the gaps and dents left by the HA loss due to my Circumcision. But the texture and firmness was just not ideal for the end result.

When I went to Dr Tall to have the HA dissolved, she first used a needle to inject the hyalase, and it got rid of about 60-70% of the HA; on my second visit, her technician used a canula that dissolved another 20% of the HA; on my last visit, trying to dissolve the nodules and remaining residue, a canula was used, but I don't think it made much difference at the end, which is how I concluded that whatever could be dissolved, had been dissolved, and that the stubborn residue is here to stay (or will be absorbed by my body slowly); and the remaining filler doesn't really bother me, the texture is not squishy, it's not very noticeable unless firmly palpating my penis.

I do wish to make sure, though, that whatever residue HA/nodules is remaining in my penis will not make Dr Danh's job much more difficult, that he can still do the Ellanse treatment in spite of it; and that the presence of the residue will not get in the way of my collagen production, such as blocking the PCL from stimulating my cells to produce collagen.

I'm wondering if you've had patients who have done something similar, dissolving HA with very little residue that just couldn't be dissolved and still getting a great Ellanse outcome with collagen produced as expected. This would greatly assure me. Many thanks!

Sorry to get delayed in answering AudienceK

AudienceK wrote: Thank you Dr Oates for taking the time to answer my questions. With my FaceTime consultation with Dr Danh 2 weeks away, and the treatment appointment 6 weeks away, I'm sure you can understand why I'm feeling a little lost and in limbo.
I was going to go back to Dr Gav next week, but found out that his Ellanse treatment would cost $1100 per ml, so I think the extra few weeks of wait would be worth it considering how much money I can end up saving.
I also think it would be great to help Dr Tall to incorporate Ellanse treatments so there's one more option in Brisbane.

Dr Tall is now offing Ellanse in Brisbane!

Now, to get back to the topic, there must have been something like 20 ml of HA injected into my penis, but it's hard to estimate how much was "effectively" injected, because I received the first treatment uncircumcised, and when I got an accordion Dick, I had to dissolve some of the HA in the Foreskin followed by a Circumcision, which cut out a little more HA in the surgery. After my Circumcision healed, I went back to Dr Gav to top up the gaps and dents left by the HA loss due to my Circumcision. But the texture and firmness was just not ideal for the end result.

When I went to Dr Tall to have the HA dissolved, she first used a needle to inject the hyalase, and it got rid of about 60-70% of the HA; on my second visit, her technician used a canula that dissolved another 20% of the HA; on my last visit, trying to dissolve the nodules and remaining residue, a canula was used, but I don't think it made much difference at the end, which is how I concluded that whatever could be dissolved, had been dissolved, and that the stubborn residue is here to stay (or will be absorbed by my body slowly); and the remaining filler doesn't really bother me, the texture is not squishy, it's not very noticeable unless firmly palpating my penis.

I do wish to make sure, though, that whatever residue HA/nodules is remaining in my penis will not make Dr Danh's job much more difficult, that he can still do the Ellanse treatment in spite of it; and that the presence of the residue will not get in the way of my collagen production, such as blocking the PCL from stimulating my cells to produce collagen.

No - it is not necessary for 100% of the HA to be gone to use Ellanse, it won't stop the body reaction to the PCL.

I'm wondering if you've had patients who have done something similar, dissolving HA with very little residue that just couldn't be dissolved and still getting a great Ellanse outcome with collagen produced as expected. This would greatly assure me. Many thanks!

I dont have that many patients who have transitioned from HA to Ellanse but certainly dont know any that then did not get the response to Ellanse.
Best of luck with your treatment.

Thank you for your reassuring answers Dr Oates

I visited Dr Danh this week, and it was a great experience, he truly is a master at placing the product smoothly, while having great music taste. I had a consultation with him on Tuesday, and he fit me in to a cancellation the morning after and performed the procedure. We opted the 10ml package but Dr Danh used 7ml in the first session. It's quite remarkable how much difference even 7ml of Ellanse was already making.
On the dorsal aspect of my shaft, in the mid to proximal part, that's where the residue HA mostly concentrated, and Dr Danh didn't put any Ellanse in that area, because "it would look funny". However, while doing the post-procedure massage, I could feel distinct textures/levels of firmness due to the different products used.
I think I should give it one more go to try to dissolve the residue HA with a fine needle instead of a cannula, injecting the hyalase just in a few spots, and go back to Dr Danh and use the remaining 3ml in said area.
Lastly, I'd like to find out, when performing Ellanse treatments over 2 sessions, how much time should pass before the 2nd session? Would 2 weeks be too rushed? Would 4 weeks be more ideal?

Hi Dr Oates.
Following up, I went for another hyalase injection at Dr Tall’s clinic the day after (impatient and stupid, I know) the Ellanse injection. It’s Day 3 since the hyalase injection and the skin in the area where the hyalas was injected feels puffy, rubbery and very thick, when I pinch the skin of my shaft, it’s not like pinching just skin, but pinching skin with a thick layer of soft gel stuck to its underside.
I think I should have left it alone and not bothered with further dissolving.
I know that Ellanse doesn’t get dissolved by hyalase, but could some of the CMC in the Ellanse have absorbed the water content from the saline that the hyalase was dissolved in? So the CMC became diluted and the texture became much softer and sticking to the skin of my shaft. Do you think my hypothesis is right here? What can I expect to happen next over the next few weeks? Will this soft pad of gel just be broken down and absorbed by my body, leaving the particles to stimulate collagen production? Or will this soft gel just linger on?
Appreciate your explanation.

AudienceK wrote: Hi Dr Oates.
Following up, I went for another hyalase injection at Dr Tall’s clinic the day after (impatient and stupid, I know) the Ellanse injection. It’s Day 3 since the hyalase injection and the skin in the area where the hyalas was injected feels puffy, rubbery and very thick, when I pinch the skin of my shaft, it’s not like pinching just skin, but pinching skin with a thick layer of soft gel stuck to its underside.
I think I should have left it alone and not bothered with further dissolving.
I know that Ellanse doesn’t get dissolved by hyalase, but could some of the CMC in the Ellanse have absorbed the water content from the saline that the hyalase was dissolved in? So the CMC became diluted and the texture became much softer and sticking to the skin of my shaft. Do you think my hypothesis is right here? What can I expect to happen next over the next few weeks? Will this soft pad of gel just be broken down and absorbed by my body, leaving the particles to stimulate collagen production? Or will this soft gel just linger on?
Appreciate your explanation.

Hi AK,

When the HA is dissolved it goes to water. if it is just water or diluted CMC I dont know. I think it will just get broken down. Keeps updated.

On timing, either getting it done soon after like 2/52 or later like 3/12 seems to work best.

The "paddy, puffy" layer under my shaft skin has been thinning down, the shape and texture of my penis look and feel like when I had just finished the Ellanse treatment session, so I think it will be good going from here. It's been 1 week since the Ellanse procedure, and almost 1 week since the last HA dissolving procedure.

Good to hear AK!

2 weeks after the 1st session now. The swelling has completely gone, and I can palpate the product really well now - hills and valleys. I don't know if it's the loss of swelling, or if the carrier gel has already started the absorption process, especially noticieable at the distal end because that's where the least project was injected.
There's some irregularity on the lateral left side of the shaft, sort of half way there's a gap/dent between a solid layer of product distal to the dent and a Nodule of product proximal to the dent.
On the dorsal aspect of the shaft, there's a "void" of any Ellanse, because that's where there used to be some HA, which finally got dissolved, but because the HA got dissolved, now there's no filler in its place, which makes it a noticeable gap on palpation.
There's still 12 days to go before I see Dr Danh for my second treatment to fill in those gaps, but will the Ellanse be absorbed so well that Dr Danh won't be able to palpate those gaps and judge how much product to inject into each? Now I understand why you said earlier the second session is best done 2 weeks or 3 months after the first session, but I really don't want to wait for month 3 as I may be doing some international travelling by then; but Dr Danh isn't available until 15 March.

On another note, once the carrier gel is absorbed, prior to the new collagen forming, can the PCL particles be felt by palpation at all?

Hi AK,

I dont always seem to get a message when a post is made in these question forums. I guess you have already seen Dr Dahn? Any voids he should be able to inject and fill with more Ellanse, the carrier won't have dissolved that much. Let us know where you are at.

Yes Dr Oates, but after the second treatment, I'm not particularly happy with the outcome.
After the first treatment, there was some indentation in the proximal half of my penis so I asked Dr Danh to fill it up, but he still injected the project more or less evenly along the shaft, which means the distal half of the shaft that already got product just became bigger, and the result is lumpy.
I'm going back to see him for the week-12 review and I intend to get some more injection done exclusively on the proximal half on both sides (the left worse than the right).

Ta AK,

I think you will find that Dr Danh injects with a needle rather than the cannula to keep it in just the areas that need further filling. You had 10.5cm Girth (Flaccid of erect) pre, how is it now?

Needle for the areas beyond the Circumcision scar yes, but not sure about the rest.
What Dr Danh in trying to create a smooth outcome led to both the abundant and the leaking areas receiving the same amount of product, and that doesn’t fill up where it’s been lacking. I’ll have to be very firm and assertive to him in insisting the product just be injected in where it’s affected by indentation and nowhere else.
The starting circ is right, but I haven’t measured it since because it looks deformed and the circumference doesn’t matter if it looks deformed,