TOPIC: HA injectable Phalloplasty - for safety

Dr Oates wrote:
I think there are a number of things to it.

HA - in Australia - is just expensive to buy ($ 160 - 300/ml depending on the brand and level of discount the doctor get proportional to volume). We have never had macrolane. Sure I could buy it for $10/ml off the internet but that would be illegal, unethical and very short sighted as it is likely to be a disaster.

I have a relatively high cost practice and if dont markup by 100% would lose money.

But as our volume is going up and the manufacturers are taking notice of what we are doing the possibility for greater discounts are arising. We are looking at using \"Ultimate\" by Teosyal. Teosyal are probably about #3 HA brand after Alergan\'s Juverderm and Galdera\'s Restylane ranges. teosyal claim that Ultimate is the longest lasting HA on the market. So we are interested. Also maybe they have more to gain by being linked to Calibre than Allergan has. And Ultimate does come in a 3 ml syringe - better chance of per ml discount.

As I am essentially the only person/clinic offering this in Australia we dont have any competition. But, no doubt, someone will jump onto this soon and the only way to \'compete\' with our experience will to be cheaper.

Eventually I will do training in other countries and train 10+ doctors in a course and then there will be doctors everywhere offering Calibre. It is coming.

Are you training doctors all around world?

Eventually Konio

Dr Oates wrote: Eventually Konio

Well done doc , i wish you only good , success and prosperity and popularity all around the world by the way i think you are alrady half way there...

Dr. Oates Do you inject filler on the underside of the penis? I\'ve heard of surgeons who won\'t do that. I would really like to get most of my filler injected on the underside though. Can you please answer if your technique allows that?

Johnson wrote: Dr. Oates Do you inject filler on the underside of the penis? I\'ve heard of surgeons who won\'t do that. I would really like to get most of my filler injected on the underside though. Can you please answer if your technique allows that?

Hi Johnson,

Yes we routinely inject all the way around including underneath. By using a blunt cannula we dont have to worry about going too deep and obstructing the urethra (passage for urine flow).

Dr Oates wrote:
Hi Johnson,

Yes we routinely inject all the way around including underneath. By using a blunt cannula we dont have to worry about going too deep and obstructing the urethra (passage for urine flow).

 Thanks, Oates. That\'s good to know. Androfill just emailed me saying they don\'t. That must give an unnatural look. They said it was due to possible compression of the uretha. I hope they change this. The Calibre technique should really just be more widespread.For the record, Androfill has been extremely informative about their procedure in mails to me. Just wanted to acknowledge them for that. 

i think the medicine that dr. Oates is practicing with the Phalloplasty is awesome, it is something that we will never do at out practice because we r predominately female, about 99% female.
that being said if ever HA is indicated and FDA approved for the penis in the U.S. Dr. Oates will be allergens man and should get a price break down the line.
we have a friend that is allergens man when is comes to botox and believe it or not he pays only a fraction of the price when it comes to botox and fillers but then again he goes threw 40 bottles of botox a week.
long story short my good friend was head of science at mentor corp for many years, brought botox to the market, invented the breast implant, penis implant amongst many other medical devices.
sadly to day he passed away in april of this year right as i started coming to this website which i had planned to have him come on here and help us guy\'s out but he passed. long story short, so much money is made off HA\'s, fillers, botox and all aesthetic products but it\'s not the docs that r making the money....

So, Dr. Oates, where is the Erect video (before/after)?

What filler would be the best for the thin-skinned area above the Circumcision scar line?  This is also an area where PMMA wouldn\'t ever stay easily...and lumps show easily.  Isn\'t voluma too thick for an area like this?  Would Juvederm XC be better?   Belotero is supposed to be very \"thin\" and for superficial volume needs, but it\'s a Merz product, so there\'s a minimum to buy if you go through them for just that 1 area.  

Have you not had any issues putting voluma in that tight circ area, or are guys in Australia not often Circumcised (I honestly have no idea what the norm is there)?

Oh, if they\'re uncut - then they won\'t have the tight circ problem and juvederm ultra is probably ok.  Yeah, belotero and Restylane are supposed to be the thinnest.  I had restalyne under my eyes too a long time ago.  You can get it dissolved with Hyaluronidase.  

What I\'ve read is that Restylane and Juvederm pull in more water than belotero which means belotero gives less volume and less longevity, but possibly less lumps.  I would just be interested to hear from a doc who injects all of these a lot, since they\'ve probably seen every reaction over time.  Belotero can probably create lumps too if the skin is very thin and tight... but I don\'t really know.

Restoration wrote: What filler would be the best for the thin-skinned area above the Circumcision scar line?  This is also an area where PMMA wouldn\'t ever stay easily...and lumps show easily.  Isn\'t voluma too thick for an area like this?  Would Juvederm XC be better?   Belotero is supposed to be very \"thin\" and for superficial volume needs, but it\'s a Merz product, so there\'s a minimum to buy if you go through them for just that 1 area.  

Have you not had any issues putting voluma in that tight circ area, or are guys in Australia not often Circumcised (I honestly have no idea what the norm is there)?

Hi restoration,

It does get more difficult as it gets closer to the glans. Past the circ scar the skin tends to get thinner and shiny. Also tightly bound down just under the glans corona. I have been just tapering the injection - occationally I have had to dissolve a little product there. Juvederm have a range of HA\'s with different characteristics, maybe XC may be a little easier to inject there.

aleksk wrote: While you are waiting for answer from Dr Oates, I\'d say Belotero may be your best chance. I had Restylane under my eyes few months ago and some four weeks ago I developed what resembles a FBG. I still haven\'t seen anyone about this and I worry constantly about how it will resolve. I can\'t believe my luck - this type of reaction happens in less than 1% of the cases. For this reason, I had to postpone my plans for PE. Not that it couldn\'t have happened with Belotero but Restylane looked lumpy to begin with in the under eye area which is comparable to the area that you are referring to in the sense that the skin is too thin there. 

I am hoping it may resolve on its own (as research says it does in some cases) but I am also preparing psychologically for more drastic options. 

I was actually hoping to consult with Dr Oates about this - Dr Oates, would it be possible to send you some pictures? 

Not all HA fillers are created equal.

By the way, the vast majority of young(er) men in Australia are uncut. Perhaps as many as 90-95% below the age of 35. The majority of men over 45 are cut. Australian doctors abandoned this practice many decades ago. It is not performed unless medically indicated (similar to Europe).

Aleksk,

I think Restylane has slightly higher risk of issues around the eyes. Fortunately it can be dissolved away quickly - feel free to send me pics via a PM.

Hi Dr. Oates, Do you have experience with patients getting an infection from injected filler? What is the likelihood of this and what should be done if an infection occurs?

my wife prefers the Belotero around the eyes because of the smaller particle and it\'s less hydrophilic, because of the thin skin around the eyes, there is a potential space around the eyes like a bag that can potentially out pouch...

Dr. Oates, do you have the Erect photos or the video of the procedure done yet?