TOPIC: Post care and Tadalafil/Sildenafil

Dr_Oates wrote:

rawiny wrote: Just got an email back when I asked if caverject is used.

“I see you had a question about an Erection during our procedure. The doctor believes it is unsafe for his patients to have an Erection during the procedure. He is working only in the penile skin layer and needs to be able to manipulate the penis. No ED medications should be used immediately before the procedure or during the recovery period. The penis will be in a special wrap, which acts like a cast keeping the penis straight and controlling the pressure around the penile shaft. Our patients will get normal nocturnal erections and these are OK and usually go away right away. Most normal sexual activity and the like can begin usually around day 35 to 40 after the patients collagen has developed and the doctor has Ok’d the patient for these activities.“

It can be much harder to inject with a rock hard Erection (the patient that is) and I dont do it any where near as much now as when I first started.Use Caverject that is. On the patient.

I guess getting the injections done with a normal Flaccid is the method of choice right now. It seems like doctors are also using shorter needles with more numerous entry points all around the shaft.

Although, I’m still curious about taking a small dose of Tadalafil before the procedure. Such as cutting a 20mg pill in half or in quarters.

It’s just because everything looks and feels so much better when taking those medications so I don’t know how it could hurt as long as you don’t take a huge dose and have a raging Erection while in the wrap.

I’m thinking the doctor can’t really say it’s ok because patients may overdo it and take a high dose and he just wants to avoid all potential risks.

I still don’t see the risk to be that high if he’s not using caverject. I’ll maybe try to take a quarter of a pill right before the injectables. I wouldn’t be hard until later on in the day if it’s Tadalafil and the smaller dose will induce a less intense Erection. Especially if it’s just a quarter of a 20mg Cialis. Right?

I see, is Silikon any different than liquid silicone and does it carry the same risks when injected in the penis?

Do you think a solid or soft silicone penile implant will work like the penuma implant without the disastrous results. I’m guessing the problem with the penuma implant was that it was like a hard plastic. I don’t know if they changed the method or if there’s a new patent out to keep the penis extended while Flaccid.

Silikon = liquid silicone (brand name).

I think it ia the site that is the issue. Skin/tissue too thin, to much mobility, trauma. Solid implants deep to all skin/fat/muscle solid agains bone dont give much trouble. In fact it is generally considered the movement that cause the problems - so some people prefer to scream them to the bone. So it will never be safe in the penis.

I also had at least one cyst, possibly two, and various painless granulomas in my penis possibly from the dermal fillers (PMMA and/or silicone1000 in microdrops). I read a study years back where it concluded a relatively high percentage of allergic reactions to liquid silicone injected for cosmetic purposes (5% if I recall correctly). I've suspected that I was sensitized by earlier silicone injections by Avanti Derma. I didn't have adverse reactions to silicone microdrops applied in 2013 or the first scrotum injection in 2016. But in 2018, within a month of getting another round of silicone injected into my scrotum, I started to have skin pealing from my penis shaft (the timing is highly suspect). The skin eventually became compromised and allowed bacteria to get in. I also had pealing on my scrotum, but I suspect that because the skin heals faster there, which may be why it didn't break down. There was also a lot of edema in the penis and scrotum before surgeries. Post reconstructive surgery a Urologist took doppler images of my scrotum and described and showed me the situation. There was collagen connected to one of the testicles and a lot of fluid build up. Since then (now in 2020), the fluid (edema) has probably gotten worse, as evidenced by my significantly larger scrotum. I compare myself to guys online claiming to have 200 to 300cc's of silicone in their scrotum, and I am the same size with only 100cc. Possibly coincidentally, I've had so-called seasonal allergy symptoms (that last 365 days a year now) for two years now (for the same duration), and I didn't have this problem earlier in life.

On the ED medicine issue, I should have mentioned in my original post that my plastic surgeon also gave me doses of Sildenafil (Viagra) while I was in the hospital room healing with my penis wrapped up and Catheter in. He was trying his best to preserve length. However, most of the length was lost during the first surgery to clean and debride the penis. He was really proud of his work (he took a picture in the OR), showing he had gotten me to four inches with the graft....SMH (sigh). It still retracted some during later healing, and much to my chagrin he commented on it during a follow up - "it looks like it got shorter."

Like Sisyphus pushing my boulder up the hill again, I've been trying to regain my length. I kept a lot of Girth post reconstructive surgeries, and the chemical PE activity I'm doing grows the Girth much faster than length, so unfortunately it looks like another Chode is in my future. I keep daydreaming that if I can get to the length I want in a reasonable time period (still young enough), I can possibly seek out a reduction corporoplasty to reduce my Girth from crazy huge to just big.

Dr_Oates wrote: I see, is Silikon any different than liquid silicone and does it carry the same risks when injected in the penis?

Do you think a solid or soft silicone penile implant will work like the penuma implant without the disastrous results. I’m guessing the problem with the penuma implant was that it was like a hard plastic. I don’t know if they changed the method or if there’s a new patent out to keep the penis extended while Flaccid.

Silikon = liquid silicone (brand name).

I think it ia the site that is the issue. Skin/tissue too thin, to much mobility, trauma. Solid implants deep to all skin/fat/muscle solid agains bone dont give much trouble. In fact it is generally considered the movement that cause the problems - so some people prefer to scream them to the bone. So it will never be safe in the penis.

So it’s not an issue of whether the filler is safe, it’s the mobility and trauma.

I’m wondering if the mobility problem is helped if a patient is Circumcised. I heard the dr doesn’t really accept patients who aren’t Circumcised and it’s almost mandatory to get one before the procedure or after.

Unfortunately the only type of PMMA offered in the states if I’m not mistaken is Bellafill. When looking for doctors I didn’t find many and it was expensive with minimal results. Silikon is FDA approved and permanent so it’s like the only permanent options in the United States is Bellafill and Silikon.

I wish PMMA was available in the states and dr C was here so I had other options. It’s not dr C it’s Mexico, I love Mexico but things are bad right now and both my primary and Dermatologist said to stay away from Mexico.

Plus I’m too ingrained in the American health care system and have other medical history unfortunately.

I’m also wondering why there isn’t “much” bad history or bad read up of guys who gotten either PMMA or silicone.

The exception being fatmike and a handful of others who are more disappointed than anything.

FatMike wrote: I also had at least one cyst, possibly two, and various painless granulomas in my penis possibly from the dermal fillers (PMMA and/or silicone1000 in microdrops). I read a study years back where it concluded a relatively high percentage of allergic reactions to liquid silicone injected for cosmetic purposes (5% if I recall correctly). I've suspected that I was sensitized by earlier silicone injections by Avanti Derma. I didn't have adverse reactions to silicone microdrops applied in 2013 or the first scrotum injection in 2016. But in 2018, within a month of getting another round of silicone injected into my scrotum, I started to have skin pealing from my penis shaft (the timing is highly suspect). The skin eventually became compromised and allowed bacteria to get in. I also had pealing on my scrotum, but I suspect that because the skin heals faster there, which may be why it didn't break down. There was also a lot of edema in the penis and scrotum before surgeries. Post reconstructive surgery a Urologist took doppler images of my scrotum and described and showed me the situation. There was collagen connected to one of the testicles and a lot of fluid build up. Since then (now in 2020), the fluid (edema) has probably gotten worse, as evidenced by my significantly larger scrotum. I compare myself to guys online claiming to have 200 to 300cc's of silicone in their scrotum, and I am the same size with only 100cc. Possibly coincidentally, I've had so-called seasonal allergy symptoms (that last 365 days a year now) for two years now (for the same duration), and I didn't have this problem earlier in life.

On the ED medicine issue, I should have mentioned in my original post that my plastic surgeon also gave me doses of Sildenafil (Viagra) while I was in the hospital room healing with my penis wrapped up and Catheter in. He was trying his best to preserve length. However, most of the length was lost during the first surgery to clean and debride the penis. He was really proud of his work (he took a picture in the OR), showing he had gotten me to four inches with the graft....SMH (sigh). It still retracted some during later healing, and much to my chagrin he commented on it during a follow up - "it looks like it got shorter."

Like Sisyphus pushing my boulder up the hill again, I've been trying to regain my length. I kept a lot of Girth post reconstructive surgeries, and the chemical PE activity I'm doing grows the Girth much faster than length, so unfortunately it looks like another Chode is in my future. I keep daydreaming that if I can get to the length I want in a reasonable time period (still young enough), I can possibly seek out a reduction corporoplasty to reduce my Girth from crazy huge to just big.

What did your plastic surgeon say about your issue and what was the visit for. I’m sorry to hear about your concerns with the filler.

You mentioned the Silikon going down into the Balls. Was this an intentional enlargement of that area or are you saying that it’s from leakage from the shaft?

You also mention lengthening, did you also have a lengthening procedure or ligament release? The filler by itself is supposed to increase length a bit.

The results also depend on the patients physiology, every patient reacts a different way. Patients with shorter length or small glans will have different results. I have bad skin so I’m kind of worried about that.

I’m not too big, my starting size is 5.1” mid shaft Girth and
6.8” non bone pressed Erect length. When I look at a guy who’s a true 8” - 8.5” I see how that extra Inch makes a big difference in looks.

But it’s more about the Girth when it comes to what matters when it comes to stimulating the vaginal canal. You can also get length with solid silicone implants like we are talking about.

And you can stretch using air devices for temporary length gain if your concerned about length. I don’t personally like it because it’s only temporary and effects the skin for me personally. It makes the skin red and discolored for me so I stopped.

The filler is going to cause more than enough bruising and I’m going to keep my Dermatologist up to speed every 3 months as well as the dr who’s actually doing the injections.

I’m hoping when all said and done I can just end up with a healthy, natural, and girthy looking penis when all is said and done. And maybe something can be done to lighten the skin.

I'm not sure of current offerings at Avanti Derma (AD). But there were at least a few years where AD was providing rounds of liquid silicone to patients' scrotum. There were also several years where AD used Silicone1000 (liquid silicone) in microdrops to touch up and even out the penis, usually for previous PMMA rounds.

Very few doctors/surgeons in the US have experience with PMMA and silicone injected into the genitals, though the number is increasing (for the wrong reasons). It was a nightmare getting rejected by surgeon after surgeon, all the while my skin was rotting (Necrosis) and my wounds were getting larger. Clearly I had infected wounds (confirmed through bacterial cultures), and the wounds were a sequella to dermal fillers (high confidence) - either the PMMA, silicone, or both. In much older threads (probably back on PB2.0), many proponents of PMMA were certain it was the silicone. That may be true. I mentioned in the earlier post how I didn't have a negative reaction to 2013 microdrops and 2016 scrotal injection, but within weeks of the 2018 silicone added to my scrotum it began to go south. Symptoms like pain, redness, fever, puss, etc. are a no-brainer - seek medical attention for possible infection right away. However, I didn't know to be concerned about the skin peeling - dumb. If treated sooner, possibly by some cortisone based prescription and possibly antibiotics for good measure it's possible I could have put the fire out and slowed or stopped the progression.

BTW, I've got lots of experience with pumps - used for hundreds of hours for mostly temporary gains (some excess skin gain in the past). I've bought many stretchers too, mostly all garbage, even the popular ones. The fit on me was always so poor, that they were garbage when unboxed. The Restorex stretcher I commented on on PB3 and in old post on PB2 is very well made, with sophisticated features for treatment of Peyronies disease (PD). The latch on it is also superior IMO to the lasso type stretchers. But I mentioned how they didn't make it for really short people (like I've become due to trauma). I commented that this is odd, because PD often causes shortening, so the device should be able to accommodate people who are (or have become) shorter than average.

FatMike wrote: I'm not sure of current offerings at Avanti Derma (AD). But there were at least a few years where AD was providing rounds of liquid silicone to patients' scrotum. There were also several years where AD used Silicone1000 (liquid silicone) in microdrops to touch up and even out the penis, usually for previous PMMA rounds.

Very few doctors/surgeons in the US have experience with PMMA and silicone injected into the genitals, though the number is increasing (for the wrong reasons). It was a nightmare getting rejected by surgeon after surgeon, all the while my skin was rotting (Necrosis) and my wounds were getting larger. Clearly I had infected wounds (confirmed through bacterial cultures), and the wounds were a sequella to dermal fillers (high confidence) - either the PMMA, silicone, or both. In much older threads (probably back on PB2.0), many proponents of PMMA were certain it was the silicone. That may be true. I mentioned in the earlier post how I didn't have a negative reaction to 2013 microdrops and 2016 scrotal injection, but within weeks of the 2018 silicone added to my scrotum it began to go south. Symptoms like pain, redness, fever, puss, etc. are a no-brainer - seek medical attention for possible infection right away. However, I didn't know to be concerned about the skin peeling - dumb. If treated sooner, possibly by some cortisone based prescription and possibly antibiotics for good measure it's possible I could have put the fire out and slowed or stopped the progression.

BTW, I've got lots of experience with pumps - used for hundreds of hours for mostly temporary gains (some excess skin gain in the past). I've bought many stretchers too, mostly all garbage, even the popular ones. The fit on me was always so poor, that they were garbage when unboxed. The Restorex stretcher I commented on on PB3 and in old post on PB2 is very well made, with sophisticated features for treatment of Peyronies disease (PD). The latch on it is also superior IMO to the lasso type stretchers. But I mentioned how they didn't make it for really short people (like I've become due to trauma). I commented that this is odd, because PD often causes shortening, so the device should be able to accommodate people who are (or have become) shorter than average.

Are you Circumcised because I heard the risk of infection goes up for non Circumcised patients.

When did you become aware of the Necrosis and what medical treatment did you get. Do you still have the filler and how is it doing now?

Usually after the procedure you need to send pictures adleast twice a week to the doctor so he can keep a vigilant eye on it.

Or are you saying it happened months down the road?

I agree with you about the cortisone cream and maybe taking the antibiotics the doctor prescribes like you said.

For the skin I personally recommend light hydrocortisone samples from the Dermatologist office up to 3 times a week spaced out.

Same with a light coat of Triamcinolone or other topicals. Epsom salt baths are good for the skin after the procedure as well. Wet cotton cloth wraps along with the topicals help also I think.

I don’t think Cialis is supposed to mess with antibiotics so I’ll take your advice and take the antibiotics just in case.

The shaft does have lots of injection sites so it may be prone to infection.

A bad batch of filler, although rare could be the case and it does come from South America and there were photos of those laboratories posted on this site. People were saying the locations the generic brands were being made look sketchy but what do I know.

I don’t think they ship fillers made in the US to Mexico.

There could be a generic brand of silicone they get from South America and it was a bad batch.

I don’t think there’s anyway to tell or prove that it was a bad batch or not.

@Rawiny - this will be my last post in this thread. The discussion is going too far from "Post care and Tadalafil/Sildenafil"

There are a few details in my signature and more in my post history about what I went through with infection, Necrosis, and then surgeries (two). The second surgery (reconstructive) took a skin graft from my thigh to replace most of the skin of my penis shaft - therefore all the PMMA and silicone in my shaft is gone. It took about 18 months to heal to 95%. There is still a small area that isn't fully healed. The scarring is bad, and there is a section of edema since the surgery that increases with use of PGE-1, along with everything else.

When something goes wrong, time is of the essence. You must identify symptoms of the problem as fast as possible in an effort to reduce damage before things get worse. Finding a doctor to help that is "in network" (American insurance abysmal), willing, and able to help was a HUGE problem. Bottom line up front (if I had to do it all over again): I found a respected plastic surgeon in my area, but I wish I had found Dr. Carney at Morganstern (in Atlanta) sooner, and I would have gone to him for surgeries instead. He would have taken steps to retain/preserve/regain as much length as possible.

I live in the DC area, with some of the supposedly best hospitals in the country like Johns Hopkins, but I was getting bounced around from surgeon to surgeon for months before getting the help I needed. I'd ask doctors (including my primary care physician) if they knew someone who could help or if their staff could research it, but It's like doctors don't talk with each other anymore, and you are left doing your own research on who can help using Google. Also in the good ole USA, you get a bill from each doctor who can't help for the worthless office visit. I learned to explain my situation to the nurse scheduler before booking the appointment and he or she would assure me that the doctor could help, and that I should come in. Then in the appointment, it was always the same - sorry I can't help you, but here's a bill for $150 for wasting your time. The insurance companies get part of this bill too. It would be more cost efficient for everyone, if all the insurance companies had nurse concierge services that would listen to your problem and then make calls to find a doctor/surgeon that could help that was covered (some companies do this but not mine). Since insurance is generally provided by my employer, it would also benefit them if I was spending less time out of work going to useless appointments and on the phone at work calling around to many doctors.

FatMike wrote: @Rawiny - this will be my last post in this thread. The discussion is going too far from "Post care and Tadalafil/Sildenafil"

There are a few details in my signature and more in my post history about what I went through with infection, Necrosis, and then surgeries (two). The second surgery (reconstructive) took a skin graft from my thigh to replace most of the skin of my penis shaft - therefore all the PMMA and silicone in my shaft is gone. It took about 18 months to heal to 95%. There is still a small area that isn't fully healed. The scarring is bad, and there is a section of edema since the surgery that increases with use of PGE-1, along with everything else.

When something goes wrong, time is of the essence. You must identify symptoms of the problem as fast as possible in an effort to reduce damage before things get worse. Finding a doctor to help that is "in network" (American insurance abysmal), willing, and able to help was a HUGE problem. Bottom line up front (if I had to do it all over again): I found a respected plastic surgeon in my area, but I wish I had found Dr. Carney at Morganstern (in Atlanta) sooner, and I would have gone to him for surgeries instead. He would have taken steps to retain/preserve/regain as much length as possible.

I live in the DC area, with some of the supposedly best hospitals in the country like Johns Hopkins, but I was getting bounced around from surgeon to surgeon for months before getting the help I needed. I'd ask doctors (including my primary care physician) if they knew someone who could help or if their staff could research it, but It's like doctors don't talk with each other anymore, and you are left doing your own research on who can help using Google. Also in the good ole USA, you get a bill from each doctor who can't help for the worthless office visit. I learned to explain my situation to the nurse scheduler before booking the appointment and he or she would assure me that the doctor could help, and that I should come in. Then in the appointment, it was always the same - sorry I can't help you, but here's a bill for $150 for wasting your time. The insurance companies get part of this bill too. It would be more cost efficient for everyone, if all the insurance companies had nurse concierge services that would listen to your problem and then make calls to find a doctor/surgeon that could help that was covered (some companies do this but not mine). Since insurance is generally provided by my employer, it would also benefit them if I was spending less time out of work going to useless appointments and on the phone at work calling around to many doctors.

Your showing guys what to do if something goes wrong after the procedure so it is kind of post care lol.

But I see now, thank you kindly for sharing this information. So you were looking around for surgeons in the US that could fix it but if you new at the time would have went to dr Carney instead of the surgeon in your area.

Yeah there’s some good dr’s on the east coast, dr Carney being one of them. If you live on the east coast flights are pretty cheap if you have to fly back and fourth to seek treatment.

What you said about the antibiotics and infection also has to do with aftercare. I’m still curious if it’s ok not to take those.

Say if you fly home and just wait the 3 days to take off the wrap and take a bath. I don’t think I even want to touch the penis. If I do I would be wearing gloves, then I would just take photos, send them to the doctor and rewrap.

The injection sites would never be touched the whole month unless it’s with sterile gloves and clean bandage cotton wraps.

That’s why I think the antibiotics would be overkill but no dr is ever going to say not to take the antibiotics.

That’s why I was wondering if I should not take them and just take a small dose of Cialis and keep everything sterile around the injection site.