TOPIC: HA injectable Phalloplasty - for safety

I agree with smalljay, I will go as far saying that you should stay away from injections in the gland. I have had 2cc of voluma injected and the result wasn\'t noticeable. The 3 weeks bruising and the lack of real change are not worth it.

\"Stay away from Korea\" I agree with this

Hi Toolman,

Yes there have been some instances of Necrosis (tissue death due to obstructing blood flow) with PMMA.
I have been using Hyaluronic Acid gel for enhancement of the glans. Some guys have asked about it after previous surgery but my patients so far for keeping the proportion with the enlarged shaft. Not all guys come back for follow up (which is frustrating - but we are trying to contact and get them in - not everyone wants to be contacted though). Sometimes they are shy about going into details - and probably so have I.
I will ensure that we have a questionaire that all patients fill out on review so we can collate the kind of info people on PhalloBoards are interested in.
My thought is that the Erect size of the glans is probably not increased that much - more change is seen in the Flaccid state.
What has been interesting is that they report no change in sensation - although that is the postulated reason for HA in the glans being useful in premature ejaculation.

Gatit wrote: I agree with smalljay, I will go as far saying that you should stay away from injections in the gland. I have had 2cc of voluma injected and the result wasn\'t noticeable. The 3 weeks bruising and the lack of real change are not worth it.

Hi Gatit,

Interesting - certainly there is less proportional change with HA in the glans. I think it is because the injection is essentially into the spongy tissue rather than totally external to it in the shaft. I try to keep it quite superficial in the \'flare\' where it seems to make a more noticable difference.

Did you notice any change in sensation?

Dr Oates wrote: Hi Gatit,

Interesting - certainly there is less proportional change with HA in the glans. I think it is because the injection is essentially into the spongy tissue rather than totally external to it in the shaft. I try to keep it quite superficial in the \'flare\' where it seems to make a more noticable difference.

Did you notice any change in sensation?

Hi Dr, the injections were made in the flare as well. For some reason It seems that the product has dissipated or was absorbed by the body. I have been told after the injection that it happens when the HA is injected too deeply into the gland. I did see a bit of a physical difference but norhing major ar all. In term of sensation I didn\'t notice anything different.

Dr Oates wrote:
Yes there have been some instances of Necrosis (tissue death due to obstructing blood flow) with PMMA.

Have you personally observed these complications? If not, were these instances of Necrosis published by a credible source, or was it a matter of hearsay (perhaps by fellow colleagues or friends)?

While it seems plausible that Necrosis can be caused by the obstruction of blood flow, I\'d have to imagine that has a lot more to do with the practitioner, experience, and s-set than the nature of how our body reacts to the product. Or put in another way... HA should be just as capable of obstructing blood flow in the manner that you described (above) with PMMA...?

Skeptical One wrote:
Have you personally observed these complications? If not, were these instances of Necrosis published by a credible source, or was it a matter of hearsay (perhaps by fellow colleagues or friends)?

While it seems plausible that Necrosis can be caused by the obstruction of blood flow, I\'d have to imagine that has a lot more to do with the practitioner, experience, and s-set than the nature of how our body reacts to the product. Or put in another way... HA should be just as capable of obstructing blood flow in the manner that you described (above) with PMMA...?

I was referring to posts specifically on this forum regarding PMMA and Necrosis in the glans.

Necrosis has been encountered with every filler I have heard of (I am currently in Sydney for the Allergan conference - avoiding/managing complications is always a big topic).

Necrosis is usually due to injection into a blood vessel with a sharp needle.

That is why we use a blunt cannula and HA. HA can be totally dissolved very rapidly if there was a problem - and it was picked up early.

You are correct. LiPen (LiCol) D is only Dextran while LiPen (LiCol) P is 10% PMMA. It\'s been roughly a year since my procedure. My corona is still nicely filled in but most of the glans, on the left side, is missing both the flesh lost to the Necrosis and dextran that leaked out along with it. So that one side is almost as small as it was before my injection. Erect, though, it doesn\'t get as big as it used to. Still... I\'d love HA. Guess I never learned my lesson. Fortunately, my focus is going elsewhere, with cosmetic surgery. Bosley is going to cost me $5000 down and 280 a month (until 12,000 is met), if I go through with that... so yea. Crazy expensive but I\'ll get more out of having my hairline back than having a better head, at this point. :/

KittenpasteCo wrote: You are correct. LiPen (LiCol) D is only Dextran while LiPen (LiCol) P is 10% PMMA. It\'s been roughly a year since my procedure. My corona is still nicely filled in but most of the glans, on the left side, is missing both the flesh lost to the Necrosis and dextran that leaked out along with it. So that one side is almost as small as it was before my injection. Erect, though, it doesn\'t get as big as it used to. Still... I\'d love HA. Guess I never learned my lesson. Fortunately, my focus is going elsewhere, with cosmetic surgery. Bosley is going to cost me $5000 down and 280 a month (until 12,000 is met), if I go through with that... so yea. Crazy expensive but I\'ll get more out of having my hairline back than having a better head, at this point. :/

Don\'t they have a dreadful reputation? There are loads of top HT specialists in the US, why go to Bosley? 

Please stop!

Skeptical One Addendum: I have deleted a number of posts that are steering the topic off course. This is a Q&A and all future posts need to be directed toward Dr. Oates and not towards each other. This may put Hoddle\'s \"Please stop\" post in context. Please carry on

Androfill provides penis enlargement surgery and non-surgical penis enlargement in the UK.  We also inject using Hyaluronic Acid for penis Girth.

A couple of patients suggested I post on this website in an attempt to add to the discussion.



Dr Oates: \"...why I don\'t think there is anything better available at the moment. When I find something better, then we will look to change.\"

Androfill uses Hyaluronic Acid fillers for the same reasons expressed by Dr Oates, including safety, reversibility, quality of the result. 

We use Juvederm Ultra 4 and Voluma.  

Ultra 4 is a thinner filler with a softer feeling filler than Voluma, so we often use this with 1st time patients as it is a very gentle introduction to HA vs. the firmer feeling Voluma.

The downside is that Ultra 4 doesn\'t last as long and in some cases is more prone to migrate to the Foreskin region for a few days following the procedure.  To address this we have used Hyaluronidaise (Hyalase) to dissolve Ultra 4 filler that has moved on two occasions.  On both occasions we dissolved the stray filler and replaced it with fresh filler at our expense around the well integrated filler.

Voluma is less likely to move about, and mostly stays where it is injected, but it is quite a bit firmer (more cohesitivity) and so is more noticeable to the patient in the first few days.

Our preference is Juvederm Voluma, it lasts for longer than Ultra 4, it\'s very firm (firmer than usual erections), and stays close to the injection site.

HA is the best approach currently available due to the safety, limited downtime and result. Another positive is the huge amount of research pouring into HA fillers meaning they will continue to improve.  

Desirial, for example, will have a CE approved filler for penis enlargement in the near future which should greatly enhance the results of HA procedures.


Dr Oates:  \"One of the great advantages of HA\'s is that they are completely reversible with a medication called Hyalase \"


In general there seems to be too much short term thinking among patients. At the very least, revisions are costly financially and emotionally. 



Dr Oates: \"HA\'s always last longer when injected in large amounts. HA\'s should have good tissue integration when injected correctly. That is it should not be injected in 1 big blob. \"



Due to the cohesitivity of Voluma it might also be slightly uncomfortable if the filler is injected in one rigid blob.  Voluma in one blob would act as a rigid scaffold pushing against the shaft.

@ Androfill, has Skeptical One verified your account already?

Also, please take a moment to read the forum rules. 


(R5.)Members cannot advertise any commercial product or service, which includes containing links in their signature or profile which goes to a website that sells products or services. You can, however, discuss the legitimacy of commercial products designed for the penis in the \"Penis Enlargement Exercises, Equipment, Supplements, & All Other Non-Surgical Methods\" message board (the content, however, can still be subject to deletion).I\'ve removed the link to your website.

I will only approve physicians or other medical professionals. At the very least, despite what bias they may have, their opinion is educated and insightful. Representatives of a brand/product have no incentive to employ knowledge of medicine and their sole purpose here is to advertise. No offense to member Androfill, but unless you have a physician you work for who is willing to speak to the forum, I ask you desist from further posting.

p.s. (Per our private message, you do say you work for a physician, if he\'s willing to speak to the forum directly, I may be able to approve postings). I should also ask we resume Dr. Oates Q&A, and if you have any further questions, private message me, thanks.

Dr. Oates - I have HA now. The first Doctor went way to superficially which feels like an amateur mistake. I walked out with little hard bumps everywhere and was a little in shock - my penis looked ike the surface of a gourd. I have since had more done (not the same doctor) placed more deeply and it looks great. I am very happy with it. However, I still have the evidence of the bad work from the first guy.

In my opinion, the first Doctor went way to superficially which feels like an amateur mistake. (I had a loose skin issue from a prior Dermal Fat Graft Removal which lasted 15 years and died). I think the Doctor placed all the product just under the skin to fill it out, rather than treat me like a regular enlargement procedure. 

(1) How easy is it to dissolve very specific areas that are perhaps a few mm but in multiple locations and not disturb the rest of the work?
(2) will it resolve on its own before it all absorbs back?

Do patients walk out of your office with little bumps everywhere - this guy said it was perfectly normal and all would go away in a month or 2 - I am almost at 2 months (6 weeks out) and it is better but still odd. Everything I have since read says this is not normal and bad procedure.

Thank you in advance - love having you on this board!

One of the Androfill surgeons will post a response.