TOPIC: HA injectable Phalloplasty - for safety

Thanks for replying Dr Oates, I hope your sailing isn\'t bankrupting you too much!

Yes, Dr moore has done 2 lengthening procedures on me.... The first grafted onto the DFG, and wasn\'t a success, I knew from about week 6-8 that the procedure wasn\'t a success- I think I did too much at once!

I plan on getting one final ligament snip and Aqua mid in the head- I\'m thinking of doing it in two stages and get the shaft done at a later date, Together the procedures are going to cost 75K but, I trust Dr moore and will do the first operation, which will cost nearly 30K- minus all the private health insurance costs paid back, it will cost around 20K.

I gained a little over an Inch with my second round of surgery, so I am happy with that- I\'d be keen to hear your thoughts? I would love to gain at least another Inch (or more)

I\'d be keen to do a skype session with you and keen to hear you opinion!!

Cheers
KB.

Toolman wrote: Dr. Oates-
I\'ve found no one in the central USA who does HA on the glans, so I asked a Plastic Surgeon in San Antonio, Texas about it, and they are interested in learning how to do it.  Can you offer some advise to help a fellow medical professional (who wouldn\'t be a competitor)?  Thanks, 

Actually there are some videos on YouTube which give a pretty clear idea of what to do. If they are experience injectors they should have no trouble. Just start with 2 or 3 ml of HA just in the edge of the glans. The skin is very bound down over the main surface of the glans and tends to \'bubble\' ( but reduces Premature ejaculation).

Do you recommend using a candula or needle? 

Dr Oates, do you recommend cannula for glans, or needle. 

The video on youtube uses needle in glans.

And the Doc on the YouTube pokes a hole through and much of the product comes back out of the hole. 

Aseos wrote: Dr Oates, do you recommend cannula for glans, or needle. 

The video on youtube uses needle in glans.

I have been using a needle. The dermis is thick and strongly bound down - but have been considering trialling a cannula and see how difficult it is. I am not concerned in the glans of hitting a major vessel and causing obstruction - that is more of a worry in the shaft where there are big vessels to obstruct. In the glans it is more of causing vascular compression by injecting too much or too hard a product.

This is also why there is a difference for injecting for PE and for size. For size I stick to the corona - the edge/flare of the glans. For PE it is spreading it more all over the head. But it tends to bubble and get Tyndal effect (looks dark/blue). If you inject enough for PE it starts to look better. It looks better Erect than Flaccid.

Toolman wrote: And the Doc on the YouTube pokes a hole through and much of the product comes back out of the hole. 

Yes - some product can ooze back out - it tends to limmit how much you can get in in a session.

Dr. Oates,
have you ever used Girthmax HA?
It\'s supposed to be specific for penis.

On account of different glans tissue, have you ever tried to use a different filler, not the same as for the shaft?

Thanks

Doc, do you recommend several smaller injections being spread a week or two apart? or injecting all in one procedure time?  I\'ve heard that two to four injections is better in helping prevent cell death.  

mato23 wrote: Dr. Oates, have you ever used Girthmax HA? It\'s supposed to be specific for penis. On account of different glans tissue, have you ever tried to use a different filler, not the same as for the shaft? Thanks

No we don\'t have access to Girthmax in Australia. It has a trademark (October \'15) to a Urologist in Florida but I don\'t know who manufactures it and where it is licensed to be used. I was in discussion with Allergan  (maker of Juvederm and Botox) a few weeks ago about making a specific HA for the penis but understanding exactly which qualities are key for penis augmentation are a bit of a guess/judgment. Be nice to trial a variety.

But Girthmax looks interesting and if we open in Europe/UK would look at it for sure.

Toolman wrote: Doc, do you recommend several smaller injections being spread a week or two apart? or injecting all in one procedure time?  I\'ve heard that two to four injections is better in helping prevent cell death.  

Yes we like to use 2 sessions - but to ensure it all sets in position evenly. I don\'t think there is anything to say there is \'cell death\' from injecting HA. In fact there are several studies showing collagen growth/cell stimulation from HA thought to be via tissue stretching.

Hi everybody,

We are working on our first paper for Aesthetic Surgery Journal. Mostly a short recap of what is available, why we have chosen HA and how we do it. We have ethics approval applications in with Flinders University for a retrospective review of our patients and also a prospective study as well.

I have trialled a couple more Ellanse phalloplasties - Subtle77 has posted on his experience. It has potential, but is more expensive than HA and is not reversible (but is still temporary up to 4 yrs)

I am looking at more options with different HA\'s - do they have any benefits over Voluma. If we become the distributor in Australia and get it at wholesale price maybe we can reduce the cost of the procedure. Ideally would like to have the first filler with approval for Phalloplasty. There are 2 fillers in Europe approved for gynaecological use. I think the companies are starting to see the possibilities. Getting a TGA advisor to see how difficult the process is.

That sounds great Dr Oates. I\'m in Australia and watching this closely. I\'m keen keen to get HA or Ellanse but would love to either see the price come down a bit or the longevity of results increase a bit. I think any advance in these areas would see the proceedure significantly increase in popularity.

Dr. Oates: Is it safe to start using stretching/Hanging devices a month post procedure? It would be optimal if one can work on the length while still enjoying the increased circumference from HA.

We have started to tell patients about stretching devices. I think they definitely have a roll to play - but results are very inconsistent - some people do well others not. I have not had anyone tell me about any issue after Calibre.