Hi. At first I intend to get a width increase with Dr Morales, using PMMA or Ellanse. But I was looking in the internet and find Dr Morganstern Non surgical and Lengh and Width increase, the price is around 8,500 - much more than the procedures in Avanti Derma (Dr Morales). Anyone now how kind of material Dr Morganstern uses? And have a experience with him?
Among Dr Morales and Dr Morganstern who is the best?
The price in Avanti Derma using PMMA is very attractive, only 3500.Ellanse around 5500.
Last edit: by Skeptical_One.
Both happen to be Sponsors of the PhalloBoards.
Dr. Morales does strictly Girth enhancement by way of PMMA, Ellanse, or Hyaluronic Acid (HA). This will require traveling across the border so a Passport will be required.
Dr. Carney or Dr. Morganstern (both of Morganstern Rejuvall) who have a wider menu of services which include lengthening, non-surgical and surgical Girth enhancement, scrotal webbing, and more. As for the fillers employed by Morganstern, I believe they are Hyaluronic Acid (HA) and Fat Injections (FFT) at present time. They are located out of Atlanta, GA.
Both are incredibly talented and experienced, you'll just have to weigh your options based on costs, travel, and consultations (as in, contact them).
It appears the before and after gallery of the Morganstern site reflect their “permanent” examples using fat transfer. I thought I read in other posts, that fat transfer is not the preferred approach due to risk of lumping, potential complications etc. Is this still the case? One positive is that they claim to have their own technique and that it’s more or less “permanent”? But is this also accurate, because I thought there is reabsorption of fat that occurs over time. @Skeptical_One can you provide some objective views and insight?
Last edit: by Girther.
Free Fat Transfer (FFT) is a surgical method in which your own fat is harvested for Girth injections. However, not all candidates are ideal --> lean men, etc.
The evolution of FFT is based similarly to the advancements in dermal graft matrices --> you cannot overfill because if you do, the implant will not vascularize and integrate into the surrounding tissue, and thus will be absorbed/broken down over time, eventually leading to lumps and bumps. If you are to take a conservative approach and layer incrementally, you can extend the life of the fat implantation considerably, thus requiring less top-offs. It's also your own tissue making it relatively safe.
As for their contention of permeance, I simply have to take them at their word but I cannot say I know for certain its actual lifetime when "done correctly."
However one thing worth noting: Hyaluronic Acid (HA) and Ellanse are showing longer lifespans than indicated by the manufacturer. A circulating theory behind this is that the layer in which you get fillers injected into the penis have less lymphatics versus a place like your face, where dermal fillers are popular. These lymphatics are the pathways and mechanisms by which your body dissipates foreign material, and it could explain why fillers last longer in the penis than in the face (and faces are largely where the manufacturer's get their data from). One could possibly extend this theory to fat (when done correctly), but I can't say for certain as far as the physiology is concerned. In other words, this is just a theory/musing. This would be a question best aimed at Dr. Carney.
Speaking of which, here is his direct take on the matter:
I was rather surprised hearing that the sentiment on the PhalloBoards is that an FFT is not a permanent Girth enhancing procedure. Fat tissue that survives the transplant process is a permanent outcome. However, as I thought more about it the next day and realized why lots of people might not feel that way.
Surgically-speaking, a penile FFT is considered to be a fairly simple procedure. However, as you’ll soon discover it’s deceiving in that regard.
I regularly perform organ transplants in the hospital that are considered dangerous and overwhelming to some surgeons. I can tell you with assurance that an FFT penile procedure is far more challenging to achieve a successful transplant than most doctors and patients realize.
An FFT is a “transplant”, and like every other type of human transplant procedure, there’s a lot of places it can fail since we’re trying to move a living organism from one location to another. When a patient gets an FFT and ends up eventually “losing it all”, that simply means the transplanted tissue eventually died and was reabsorbed into the body as waste.
To succeed in this procedure, your doctor must get six points just right. Shortcomings with any aspect will affect the final outcome.
The Right Patient: Not every man is a good candidate for an efficacious FFT. A patient has to possess the right proportion of height and weight. He needs to be fairly healthy as patients addicted to potato chips and comparable junk food usually have fat that won’t transplant with success. Significant obesity usually triggers a poor outcome. Men who’ve had a previous Girth enhancing procedure utilizing a permanent man-made injectable like PMMA or Silikon are not good candidates for FFT unless that material is first removed since the injected agent blocks the tiny blood vessels in the penile shaft necessary to ensure the transplanted fat cells stay alive. Likewise, men beyond the age of sixty-five will almost never get a good result – regardless of overall health – as human fat rapidly degrades to a more viscous state after a certain age. Such fat tissue simply won’t survive a transplant. Finally, this is a surgical procedure that requires mild anesthesia. If a patient has health contra’s for anesthesia, this procedure won’t be a viable option.
The Right Harvest: Improper attention to delicateness during the adipose tissue harvest is another source of failure. The fat cells must be extracted in a quantity that will provide a size increase worthy of a surgical investment AND they must be kept flourishing during that substantial withdrawal. Fat cells are rather fragile and although damaged cells can be transplanted, few will survive over the long term in such cases. Exactly “where” the tissue harvest occurs is another source for disappointing results. You can’t extract fat from just any location and expect it to succeed as there are variations in the quality of fat tissue in different parts of the human body. Likewise, some fat material has characteristics more akin to subcutaneous penile tissue compared to other more pliable fat that can leave patients with a distinguished “squishy” outer finish.
The Proper Treating of the Fat: Once harvested, the fat must be reconstituted in a manner that will make it suitable for subsequent reimplantation. We use an FDA cleared fat transplant filtration system to optimize purity, but I credit Dr. Morganstern and his many years refining these procedures with developing a novel shaping technology that optimizes the reimplantation procedure. Again, during this particular process within the treatment is yet another incidence where the fat cells can become damaged and/or die.
The Fat Injection & Placement: Finally, the harvested fat tissue gets transplanted into the penis. The most common mistake I’ve seen in this aspect of FFT is with doctors using the wrong needle for a particular patient. There’s no such thing as a “one size fits all” in any aspect of Phalloplasty. Also, there’s an art form to the distribution technique that when poorly executed usually results in unevenness or lumps within the shaft several months down the line. Another common error is when the surgeon attempts to add too much fat into a singular procedure. We understand most men want the biggest possible outcome in a singular procedure but if you add too much at once, it increases the likelihood you’ll eventually end up relinquishing almost all of the transplant. One other mistake I’ve seen is where the doctor agrees to perform too many congruent procedures along with an FFT. Certain procedures are notorious for triggering excessive hematoma which prolongs any healing process. Living tissue transplants stand little chance of long-term viability if the time window for healing is overextended.
Survive the 72-hour “Tissue Vulnerability” Window: Assuming everything I just discussed was performed to perfection, the number one reason most fat tissue transplants will fail to live up to expectation is because of a 72-hour post-transplant assimilation period. For about three days after post-procedure, the transplanted cells will be unable to access any life-essential blood supply. Some of the cells will almost always die during this nutrient-starving phase. We pre-treat the penis before each procedure with a patented device that Dr. Morganstern developed that triggers endothelial cell production for healing penile trauma / Peyronie’s disease. We found this technology bridges the lack of blood flow nutrients immediately following surgery to a level that minimizes the loss of viable fat cells.
Following Prescribed Aftercare: Given the delicateness of the vulnerable cells during transplant and variations in how quickly healing occurs between one individual and another, it’s crucial to follow any prescribed aftercare program indicated by your surgeon to ensure long term success. Regardless of how capable your surgeon and how well your particular transplant procedure came out, it can fail quickly if you don’t follow recommended post-operative care.
Finally, in fairness to the skilled Phalloplasty surgeons out there performing FFT, I’ve had more than one patient show up in our clinic claiming to have “lost all his previous FFT” with another doctor. However, upon close examination, we discover many of them actually retained a life-lasting portion of transplanted tissue.
How does that happen?
Following any FFT surgical procedure, there’s going to be a good bit of swelling and bruising. It takes months for all that swelling to completely subside. Some men confuse this loss of fluid – which can double the Girth of the penis – with loss of fat tissue and lose sight of their pre-procedure width.
We very recently introduced a new non-surgical fat-tissue transplant procedure that will result in most patients adding about a half-Inch of Girth from a treatment. One of the reasons I was particularly excited to develop this new technology was so we could provide a less invasive and affordable pathway for patients to achieve that “post-surgical swollen Girth” that many men adore and get depressed over losing once all healing is complete. It’s worth mentioning that this new procedure is NOT well suited as an initial procedure for men already over seven inches as we’re restricted in the amount of transplant tissue we can successfully collect from this pathway.
Another FFT complaint we sometimes encounter is patients were left with palpable fat “bumps or nodules” in their penis in the months or years following surgery. It seems some of you are aware that our clinic is able to redeploy the same technology we use to break up fibrosis and plaque in the penis that’s commonly associated with Peyronie’s disease to resolve these nodules since we’ve had a number of patients visit from around the globe for such repairs who indicated they heard about us on the PhalloBoards. However, I want to be clear that 98% of such nodules associated with an FFT are not from “fat tissue”. Rather, they’re pockets of excess edema which became trapped during the post-surgical healing process.
Most FFT surgeons recommend massaging the transplanted tissue for a period of time following your procedure to help reduce the likelihood of this unsightly outcome.
The following user(s) said Thank You: Girther
Last edit: by Skeptical_One.