TOPIC: HA injectable Phalloplasty - for safety

Hi Dr. Oates, When you inject on the underside of the penis, isn\'t there a chance of migration to the scrotum?

Dr Oates,

Thanks for the previous reply. Do you think it will be possible to precisely schedule refills so that there will be minimal change in size for a prolonged period of time (say a decade)? I am curious as to what happens in the final stages when the HA degrades i.e. will there be obvious disfiguratuon or will it be generally smooth.

Johnson wrote: Dr. Oates: If it absorbs more water does that mean it gets more squishy?

In the first couple of weeks a bit swollen - but not really.

Kosty wrote: Dear Dr. Oates
i had my first ha girth enancement in may 2016 with Dr. Antonini in Rome with filler Girthmax from dr. Paul Perito
phalloboards.websitetoolbox.com/post/dr-...o&pid=1293258853
then i went in Thiailand and after 3 month i saw reabsorbtion and venture in this Bangkok clinic guided by
Prof. Kunachak’s
www.laser-surgery-bangkok.com/?penile-enlargement,175
fortunately they use Voluma (i realized after reading your post)
but the final result was far from the pics posted by your patient you treated in Perth (page 17)
phalloboards.websitetoolbox.com/post/ha-...50915?&trail=255
my penis came out misshapen
My question is:
do you have any connection with experienced doctors in Bangkok who follow properly you technique?
Or , are you available in Thailand sometimes?
Can my left sided misshapen cocoon be fixed with further Voluma injections and where should it be injected??

 

 

the Yoskarn refill was made in 3 sessions:
4cc along the staff ..almost ok -
6cc around the base as in pics -
6cc to fix the furrow at the lower base but it did not work and only improved the cocoon....

Hi Kosty,

Sorry been in Africa for a week and right now am in hospital after having an arthroscopy on my knee about an hour ago!

Hopefully you have massaged like crazy to try and smooth/spread it out. They may have been using cannula - blunt ended and safer but harder to use. Some penises it is not as easy to get the cannula to break through the fine fibrous layers that are in the loose tissue the HA goes into. Then you push the cannula, think it has gone where you want but just stretch the fibrous layer, inject product, but it bounces back and ends up in a clump. When I train my doctors I explain that if you find this happening -STOP. Then just pass the cannula back and forth without injecting product and make sure you get the feeling of \'pops\' and it breaks through. Then you can massage the lump flat and inject product around it. Fortunately my doctors have a good aesthetic eye, do lots of CALIBRE (our name for injectable PE) and want to do lots more, so work on getting good result.

We are about to \"go big\" in Australia and do a nation wide media campaign. After that we will probably do training for doctors in SE Asia. I would like to set up a clinic in KL or Bangkok myself  and have the doctors work for me under my supervision (getting greedy).

I would suggest getting some more done. Mainly with the access point at the base and filling in the deficient area and doing lots of break throughs with the cannula to try and get some spread. Then another access point in the deficient ring more towards the middle of the shaft. Maybe a total of 4ml.

It should be able to end up pretty smooth and even and will be pretty big too. This is one of the reasons we have switched to a 2 session protocol for over 10ml - to get a smoother better result. So dont panic too much - it can be sorted out.

Kosty wrote:
Actually after the first 4cc Voluma session in bangkok the shape was satisfactory improved from the first session in Rome,
together with the trust in this clinic
 

then i asked for further improvement at the lower part of the staff and this second session was a failure as u can see in pics...i tried the third session to fix the second, but it did not work..

Dr. Kunachak’s in bkk stated the misshape coccoon happen when penis is not Circumcised,
but i have not a clue if this is true or not..

Catching up... it is more difficult uncircumcised - but that is the way things have gone here in Australia.

clueless2 wrote: Hi Dr. Oates,

For HA injection, what is the degradation curve in your experience? Measuring after post-op swelling, does it degrade in a linear fashion or more like a sigmoidal curve? Would highly appreciate further details to compare between PMMA and HA injections.

Hi Clueless2,

I mentioned recently the \"isovolumic degradation\" that is it stays the same volume for quite some time before starting to reduce. I guess what we need to do is get guys in and do a Girth measurement every 3 mths for a few years until it is gone. I was speaking with a researcher on Monday night and looking at starting publications as there is nothing much really available.

Our experience is that over 12mths it seems pretty stable. But a percentage of guys come back for more because they want to be even bigger.

Kheiron wrote: Dear Dr Oates , I\'ve read earlier in this topic the discussion about Macrolane prices in Europe. Since I am in Europe and I plan quite a large augmentation, I am considering this path.

The questions are:

1) When injected, does Macrolane induce further enlargement (thanks to water absorption, collagen generation etc.), or gained volume equals injected volume?

2) In larger quantities (over 60cc gained volume), can the gel move during sexual intercourse (like accumulating \"out of the way\" at the base of penis) allowing for relatively \"normal\" depth of penetration despite acquired volume?

I would be very grateful for your answers.
Thank You

Hi Kheiron,

I have not injected Macrolane - but I have dissolved it. Basically I think that injected volume = gained volume.

Large volume like 60ml sounds like a great way to have a deformed disaster. Macrolane does not have a great reputation - but I have never used it myself.

I routinely get 1\" Flaccid Girth increase, 1/2\" Erect Girth with 15ml Voluma. If you really want something massive - then get 15ml at a time separated by a couple of months.

Do you want it moving around? Then get it all done in 1 go. Someone will be able to dissolve it for you once you come to your senses a couple of days later.

People get 60ml FFT because the majority of it is water/ will fade away anyway.

The hard thing may be getting someone experienced and with an aesthetic eye. Get 15ml max in 1 session and see how you go. Start a thread so we can all learn from your progress.

Good luck.

Johnson wrote: Hi Dr. Oates, When you inject on the underside of the penis, isn\'t there a chance of migration to the scrotum?

Hi Johnson,

No - it really is not that mobile. I guess it may be possible to push some down there in the first day of so. But not much. It is not injected in big blobs.

Next Monday I have a guy coming in for 12ml HA into the scrotum to give a bigger bulge in his pants. Will take photos and post!

clueless2 wrote: Dr Oates, Thanks for the previous reply. Do you think it will be possible to precisely schedule refills so that there will be minimal change in size for a prolonged period of time (say a decade)? I am curious as to what happens in the final stages when the HA degrades i.e. will there be obvious disfiguratuon or will it be generally smooth.

I dont think it will be that precise. Just come back when you want some more. We find guys get used to the bigger size, feel more confident and come back because they like feeling like a big swinging Dick and more is better. This is something we will be doing research into as well.

aleksk wrote:
Dr Oates, one of the major outcries against Macrolane in breast (which was very popular at some stage in Europe) was the concern that it will make the diagnostic procedures for breast cancer very difficult or even not viable. Are you not concerned that the same may happen in this case? Testicular cancer is not that uncommon unfortunately. 

No not really - Macrolane was injected into the breast and felt like lumps. Lump in breast = problem = testing/mammograms etc.
We are not injecting into the testicle at all. The HA goes into the scrotum - which has HA in it anyway. It is adding a little more fluid around the testicles. If it makes you/ your doctor fell your Balls then it is probably only going to lead to earlier diagnosis of problems (how often to most guys check?).

Hi Doc,

Thanks for all the information that you have been providing!

My question is this: Do you come across any issues when injecting into an uncircumcised penis? 

Will there be any problems with the Foreskin retracting after the HA is injected?

Buffdawg

It is more difficult, getting the balance between the nice gentle blend out towards the glans especially while Erect and not getting too much product towards the Foreskin while Flaccid.

I think I just failed to post some pictures so will try again of a guy who first had 15ml back in January and just came back for more because he was happy with the first treatment. He was pretty big to start with too.

Maybe no one like his photos? I should have another pre/post this week.

Today did my first scrotal enhancement with 12ml. Be interesting to see if it is enough to make a worthwhile difference.

Apologies if you have answered this previously but do you have anybody in Europe trained under your techniques?

Dr. Oates, those are are very natural looking outcomes you posted.  It looks like good work.  I wouldn\'t be able to tell visually they ever had any work done.