TOPIC: HA injectable Phalloplasty - for safety

Johnson wrote: Dr. Oates - given everything you know - which is all in all the best choice - Ellanse or Voluma? 

aleksk wrote:
Any chance you can post pictures? 

aleksk wrote: I am still struggling with a complications from an ha filler in my face. I finally got a referral from a dermatologist and hope something can be done. I found an article which said that for most people a foreign body granuloma is a once in a life-time event so I hope it doesn\'t mean that if I have it injected in my dick there will be complications. 

Unfortunately, this problem has prevented me from getting ha until it gets resolved. I am hoping a steroid injection to the site and some pulsed light treatments will solve the problem based on all the research I\'ve done. I can\'t believe I\'m in the unlucky 1% who has to deal with this shit. 

I think the combination of two fillers in the same area may have contributed to this problem. 

In the meantime, I\'m reading about any advances in the filler space to be able to make the best choice on the price-quality scale. I\'m still interested in Ellanse and hoping Dr Oates will report something new about this economical, long-lasting and bio-voluminizing filler. 

Also, in the PS world I note there has been quite a bit of talk about this new permanent filler called Allofill. I wonder if there may be any applications in PE. I guess it would have the same problems as fat injections? However, I\'ve been thinking and reading about it more. I\'m speculating here, but since it\'s fat that they do not have to harvest from you, I wonder if the solution for PE may be small quantity injections at a time until the desired volume is achieved. Wouldn\'t that be much, much safer and aeshetically pleasing than trying to fill the dick all at once with 20cc or so of fat that is more than likely to lump, unevenly absorb and result in all sorts of other unwanted shit. You would have to find a doctor who would be willing to cooperate and do this small injections at a time. Does this make any sense? It sounds 100% safe and potentially 100% permanent. But then we all know how much of a gamble fat grafting can be. What do you think about this new filler, Dr Oates?  www.allofill.com/

Speaking of fat grafting, I wonder if anyone tried this in PE using Stromal Vascular Fraction (SVF) enriched grafts. I\'ve been reading a lot about this lately and decided to give it a try to solve a problem I have (not PE related). Apparently, it\'s much, much superior than simple fat grafting and there are numerous studies behind it. I am just wondering if we are discarding fat as a potential filler based on the early quite rudimentary procedures where they simply liposuctioned and injected without much sophistication or technology. It seems that there have been some very large advances in the field. 

Anyway, hope to hear what Dr Oates and everyone else thinks about Allofill and my idea of very gradual injections - perhaps 5 or 6 sessions to inject 20-25 cc?. I don\'t know, I\'m just speculating. But I\'ve always wondered, apart from the Drs\' economic interest, why PE filling is not done more gradually. Surely small quantities at a time are much, much less likely to result in lumps, irregularities, unwanted inflammatory responses, rejections etc. I understand it may not be possible to spread as little as 4-5 cc evenly at a time, but I\'ve heard of cases who get as little as 5 cc of Radiesse or other filler and did see a difference and reported that it was aeshetically pleasing. I can\'t help but think, apart from the fact that it may not be economical and practical for the doctor, isn\'t this the way to go? 

As a side note, I hope more people can do research on filler advances and post here as I always do. We really need to get the discussion going about Ellanse and everything else. PMMA belongs to the Middle Ages of PE with all its complications, and even fillers like Voluma which are clearly overpriced and out of reach to many are simply not adequate in the long run.




Hi Aleksk,

Some interesting points.

I had not heard of Allofill before. So it is fat, presumably from selected people having liposuction. We dont have it in Australia. Fat is interesting as a filler anywhere. The key probably is in the harvesting and processing. Its main advantage is that you have your own fat injected - no worries with blood borne infection/rejection etc. To avoid rejection, and not need life long immunosuppression like for a kidney transplant, I can only assume there are no cells in Allofill. So what actually is it? I have contacted them for more info.

Maybe fat transfers benefits come from the stem cells naturally in fat. Maybe the same for SVF. There have been claims for years about 1 system or the other giving reliable fat transfers. Maybe there is. But you would think the doctors would get to know pretty quick if something was way ahead of other techniques. Maybe someone is. I am not sure - but would love a reliable and affordable FFT technique.

Granulomas tend to inmprove with hyalase - but may need a push to resolve the inflammation (FBG). So yep, steroid plus 5FU. Consider the antibiotic Minomycin, not for infection but rather the immune modulating effect.

Multiple smaller injections of HA - absolutely fine. But lumps are generally not much of an issue up to 10 - 15 ml. It may be disappointing to have 5ml and not get enough benefit. We went through that for years in the face. We routinely do CALIBRE as a 2 session procedure for 15ml now.

Ellanse - I would like to trial 2 more guys at cost price for 3 yr version of Ellanse. Will need to check the price (Sunday night now) but will be about $300/ml. Phalloboards member only. Will start a thread for this.

richard wrote: Dr Oates;
We know that there are often small to medium lumps in the injected Juvederm. If your patients comes to you about a medium lump at one year. What are your methods of treating it? 
Thanks so much i am looking forward to your professional answer.