TOPIC: BBC IPLAYER: The penis extension clinic

Can one inject \"deeper\" with a canula? please, can Dr O enlighten us on this?

So far, my current position is this: it\'d cost me 1.2k (USD) and 24 hours round trip to Androfill but 5k and 6 days to Dr O. However, for my one and only Dick, I\'d have to cough up the difference going to Australia. Why? Because, instead of arguing the obvious and justifying himself, Dr O is willing to \"perfect the techniques currently available ...\"

@hoddle.

1. Allergan filler products are supplied in a sealed pack with a standard 27G needle. Millions of injections occur using these needles each year - the risk you identify is extremely low.

2. The difference in risk, if any, is insignificant at the level in which the filler being injected.

3. No, it does not make the result smoother to use a cannula. The filler can move about a little on its own for a few days after the procedure - cannula or not - caused, for example, by an Erection that occurs during sleep, sleeping on the penis the wrong way etc, Voluma moves less.

Any movement is molded back into place with a firm press onto the area of filler by the patient - easier for the patient to access when shallower. We considered using a medication to reduce the likelihood of this but thought it a step too far.

Filler injected deeper may initially be smoother (more layers of tissue above to smooth out any lumpiness), and perhaps migrate less. The advice I am given by 2 surgeons is that it is not safe to do so.

I would be very hesitant to undertake a procedure myself, without seeing what is involved and understanding the technique. I would personally want to see a full high definition video of the complete procedure and I would want a full explanation - not drips and drabs of information on a forum.

Once Dr O. publishes his high definition close up video of his procedure, and it is critiqued and shown to be safe, the we can all pack our bags and head for Australia. I would even consider it myself if Dr O is doing something in Australia, that can not be replicated here in Britain.

Or, Androfill surgeons will simply be told to use the Australian approach, if they agree it is safer.

This company is about advancing the non-surgical procedures, and preventing surgery, which is something we have considerable success in doing already.

While we discuss improving the HA procedure, which is great, in the background men are queuing up to undergo invasive surgery marketed to them by Moorgate and the BBC, the original subject of this thread.

Does Dr. Gitt in Arizona use a micro cannula when he injects voluma?

mischiefmkr wrote: I\'ve had one procedure done with the cannula and neither me nor the Dr were that happy with it. Its just less accurate, more invasive and i didnt much like the \'rooting around\' under the skin with it. It was a bit like trying to ice a cake using a hose pipe... I asked him to switch back to the needle half way through. But if someone without proper surgical training was wanting to stick needles in repeatedly, without knowledge of what and where to avoid, then i wouldn\'t be keen on that at all.

It doesn\'t sound like a micro cannula or proper technique was applied. Using a micro cannula is nothing like \"trying to ice a cake with a hose.\" That could be a good description of what you saw in the video of the Italian Dr\'s where they used a big cannula and squirted in a ton of Macrolane and tried to mold it into shape. But the type of micro cannula used to inject Juverderm should be thin, like a needle. I think'a 27g cannula (photo below) can be used for Voluma. A small entry hole is made with a needle, it\'s left in the skin for about 30 seconds and then taken out and the blunt cannula is then inserted through the hole made by the needle. The cannula is so thin that it glides easily under the skin and therefore the HA can be injected in continuous streams, unlike the \"in out\" jabbing technique we see in Dr Horns video. So the result with the cannula should be superior to a needle, it just requires more skill and experience.'

Below is a photo'of the type of cannula I\'m talking about. It\'s blunt and'thin'so can be painlessly'moved under the skin and theoretically should make injecting into blood vessels or damaging the dorsal nerve close to impossible. It\'s just a safer and superior way to inject and in my opinion no one should risk having a filler in their penis without it being administered via a micro cannula.

[can i ask you how long you have been performing HA?]

Surgeons have 2 years experience.

Caverject (Erect) is a good idea, borrowed from Dr O.

It is interesting to see that men can self-inject Caverject into their penis at home without supervision - with a needle the same size as Juvederm supplied 27G.

Needle is preferred over the cannula, when there is a good reason to change we will.

In communication with Dr O. outside the forum. The goal is the same, to advance the procedure and promote it as a replacement for more invasive surgery.

the Androfill website sells lig cuts right off the bat. - We offer it, then dissuade anyone from taking it. No one has taken any surgical option. This is the most effective way of reaching prospective surgery patients.

@Androfill
Thanks so much for this clarification, otherwise it was quite upsetting.

@number22
The whole world of technology and medicine is experimenting with new materials, procedures, etc. Experience no longer matters. It\'s quite commendable when practitioners (technicians etc.) update themselves in the modern best practices and make the necessary effort to perfect the techniques available to them.

@jogift: nicely put. revising best practice is agreed valid. my perhaps not so well put point was the implication that this meant Androfill\'s claims of doing HA for years was an exageration.

i will reign it in a bit because i\'m not so sure now, maybe i got that wrong. im just used to cosmetic doctors lying their ass off about patient numbers.

what do you mean about exoerience no longer matters though?

\"The clinic promoting surgery on BBC television in the UK is Moorgate, not Androfill. There is no common ownership or control between these two firms. (Moorgate Clinic has nothing to do with Androfill. Doctors performing the Androfill HA procedure (including the Penoplasty surgeon who appeared on the BBC), are free to provide surgery to any other clinic that they wish to. No patient has been sold surgery by Androfill to date. Androfill site aims to dissuade people from taking unnecessary surgery, steering them towards safer and more effective non-surgical options.\"

Sorry for incorrectly suggesting your clinic Androfill is affiliated with Moorgate.
Don\'t get me wrong I think it\'s brilliant that you offer HA, I just think that it\'s a little off putting that the doctor you use performs unethical procedures in other clinics. Which leads you to beleive he doesn\'t care about the welfare of his patients or that he genulinly believes fat injection is a good technique which suggests he isn\'t a very intelligent doctor.

@number22
Let\'s take an analogy. Having worked on 1,000 carburator cars before has no bearing on the methods of working on a microprocessor controlled injector cars.

The practitioner has to update his knowledge on the \"new\" material he is using, practice to steady his hands and the minute movements needed in depositing the filler under the skin. Experience with FFT, etc. are no longer necessary ...

That doctor did 3 HA procedures on me and i am still really happy with the result. He has his own surgical practice as well as through a couple of clinics. Thats fairly standard \'consultant\' business model. He knows what he\'s doing in my ecperience and having talkied with him at length.
Having said that, sticking a bit of HA in a penis is a lot easier, more accurate and more controllable than fat transfer. I tend to prefer a proper surgeon who knows the anatomy well, what\'s going on under the skin etc, over a non surgically trained injector. Although an injector with years of experience, that i would be happy with too if i am honest. I think experience of the specific procedure and material being used is the key criterion for me.
For sure injecting HA on an Erect penis is also a significant improvement aesthetic wise.
I\'ve had one procedure done with the cannula and neither me nor the Dr were that happy with it. Its just less accurate, more invasive and i didnt much like the \'rooting around\' under the skin with it. It was a bit like trying to ice a cake using a hose pipe...
I asked him to switch back to the needle half way through. But if someone without proper surgical training was wanting to stick needles in repeatedly, without knowledge of what and where to avoid, then i wouldn\'t be keen on that at all.

Avoid fillers in the penis unless the Dr performing the procedures has the skill to use a micro cannula.

Thanks hoddle, that\'s what I meant by \"perfecting the techniques (currently) available\" ...

Androfill wrote: [Caverject (Erect) is a great idea.
It is interesting to see that men can self-inject Caverject into their penis at home without supervision - with a needle the same size as Juvederm supplied 27G.

Needle is'preferred'over the cannula, when there is a good reason to change we will.>

So a good reason to change is arterial embolization. If you use a sharp needle you can potentially'inject a thick gel into a vessel which can block blood supply and cause Necrosis. The risk is small but we are talking about the penis here. Any fool can inject the penis with HA using a needle. It\'s easy. There is a reason someone like Dr Oates has taken time to perfect a technique using the micro cannula and it\'s patient safety. Also it should give a better result as the needle has to come in and out all the time, whilst the cannula doesn\'t.

The comparison with Carverject is a poor one, as Carverject isn\'t a thick gel and the idea is to inject directly into the corpus cavernosum. With HA care must be taken not to inject into the CC, hence a blunt cannula is superior. Also, patients are clearly shown how to inject Carverject safely by their Dr and they also have an online tutorial on the Carverject website. In that tutorial they are clearly shown where to inject and where not to inject. One of the key areas not to inject is the top side of th penis above the dorsal nerve and where the blood vessels are. Look at this screen shot:

Now here is a screen shot (posted below) taken from the video on Androfills website. Dr Horn makes numerous injections in the exact area where you wouldn\'t want to risk a sharp needle (see the screen shot posted above). Though the risk is small, surely that alone is enough for you reconsider your position. I understand you are just trying to make a living and don\'t have a problem with that. But there are so many other Dr\'s out there you could approach to work with. As I said previously we need a UK version of Dr Oates. Any old nurse with filler training could inject th penis with a needle, but the micro cannula technique takes more skill and experience. In my opinion you should find a Dr who is experienced with the use of micro cannulas.

mischiefmkr wrote: I tend to prefer a proper surgeon who knows the anatomy well, what\'s going on under the skin etc, over a non surgically trained injector.

Why does surgical training impress you when it comes to non surgical procedures? Here is an example of surgery performed by your Dr and honestly I don\'t see why it inspires confidence. Look at the scarring at the base. To me if a Dr is happy to do that type of procedure I don\'t know why you would trust his judgement. You might think I\'m being harsh but it\'s hard to argue that given PE vets have been arguing against the use of V/Y incisions for close to 2 decades and the reason for it is what is visible in the photo. Why would a Dr still be doing that in this day and age?

At the end of the day Dr Elist has surgical training and knows the anatomy of the one is very well. But would you want him injecting you?