TOPIC: 15 syringes PMMA (Bellafill) at 3 weeks & discussion about the circumcision area

This is a patient that I treated recently. He was new to me and to using PMMA for Girth enhancement. I placed 15 syringes in his penile shaft and neurotoxin for retraction. When I place my product, I place it in the space between Dartos fascia and Buck’s fascia. When providers place it here, we use the blunt cannula to dissect out a space between those two layers. Towards the glans, the Dartos layer gets thinner and you have to make sure that the cannula stays under that layer in order to protect from placing it directly under the Foreskin. In guys that are Circumcised, sometimes the Circumcision fuses those two layers together to the point where it is really hard to dissect through there and stay in the proper plane. I think that these are the guys that may not think that we can inject “past the Circumcision scar”.

I guess the point of this post is because I have seen several guys lately (like this one) that have a history of pumping. In these men, it seems like it is much easier to dissect out the space that we make to place the filler. The cannula seems to work within that potential space easier and this holds true towards the glans. So, I’m not sure if you guys have discussed this much on here before, but I would like to hear thoughts on pumping prior to getting Girth enhancement in the sense of using it to “prime” the tissue for easier expansion.

Jason

Avanti recommended pumping in between procedures to make room. I think they said wait 2 months before pumping, but it gives them more room to work. I'm guessing it helps break up fibrosis and expands the skin. I know round 3 they said there were some tight spots and fibrosis, but round 4 was much easier and quicker. My only guess is because of pumping and Dr.Morales breaking it up during round three.

I've had 4 rounds with Morales at Avanti, I'm extremely pleased with their work. I've been thinking about scheduling with Rupeka to get some volume underneath too, and to widen out a little more. It's very hard to find any pictures that show any appreciable results on the underside of the shaft, but I am curious.

Phew, was really hoping it wasn’t gonna be me. I got 15 syringes 3 weeks ago today and I previously pumped a bit. You got material past my scar as well and it looks pretty even, no shelf.

Yup! Love it!

I’m going to see Rupeka in May and am hoping it’s possible to get some filler past the circ scar. I’ve pumped on and off for years. If it’s not possible I’m sure he will figure out something to get some better esthetics.

Most of the time I can, I just have to make sure that the cannula stays under the superficial Dartos. Injective tissue, if it doesn't or can't, then you run the risk of getting the PMMA under the Foreskin where it would clump more.

How long should one stop pumping before the procedure? A few days to make sure inflammation is gone?

Hey, If pumping is causing any meaningful tissue edema or inflammation, you’d want it stopped long enough for the tissue to return to its true baseline otherwise I would be injecting into artificially expanded, edematous tissue. I would recommend stopping 2–4 weeks prior to your appointment. 2 weeks minimum for a casual pumper and 4 weeks for a more aggressive or daily pumper because the tissue needs to fully decompress, the edema to resolve, and the tissue planes to settle back to their resting state.

Best,
Jason