TOPIC: My Christmas Gift - Avanti Derma PMMA Utmost Procedure 12/14/22 - Photos inside

40 year old active lifestyle. After seeing a post made on Reddit by /Truckerguy on his PMMA results I started down the rabbit hole of permanent fillers to increase Girth. Prior to seeing that post the only surgical options for Phalloplasty that I had heard about were ligament releases for length, HA fillers, fat transfers, or silicone injections. None of these options suited me for the goal of a natural feeling penis when Flaccid and Erect. PMMA however, seemed to be a game changer and after reading through hundreds of posts, both positive and negative I became convinced this is just what I have been looking for.

For some history, I have been doing various PE methods inconsistently for 15+ years (i.e. pumping, jelquing, stretching, Hanging) and have either deleted old photos or lost data in the process but can attest to the fact that in time I have made permanent changes in Girth give or take ¼”, length is more difficult to see since I was much more inconsistent with length exercises and didn’t feel like it was a main goal of mine. I would continue with manual PE, but finding time to be consistent with 3 kids and a busy life is difficult and honestly not a top priority when I make out a priority list of how I could best be spending my time (family, exercise, and work). I think all of us have been there questioning if spending an hour a day pulling on our unit is a good use of the valuable time we are given.

I’ll start by saying, I’m not ashamed of my starting size, it’s not small nor large. I don’t feel embarrassed by it in a locker room, and my wife has never said anything to make me concerned. Whether it is the standards of porn or mild body dysmorphia I have been doing PE for me, and me alone. The thought of a larger, thicker package has always had an appeal to me since I was a teenager. As a teenager and in my twenties I viewed my penis as a pencil Dick, long and thin. Whether it was from PE of Jelqing and pumping that view has changed and I see as being balanced overall. My thirties have been focusing on increasing the Girth and trying to see if can change from a Grower to a shower. Looking back at measurements I found from 2016 there really hasn’t been much progress made in Girth since then. I look back at the many hours of work I put in as a waste of time. I wish I could have gotten that time back and used it better (i.e. studying, working out, with my wife, etc…) Not locked in a private room tugging on my penis. I in no way, mean to offend anyone seeking natural enhancement through PE, this is just my journey I am documenting.
Starting Stats
BPEL 7.25", BEG 5.5", BMG 5", NEG 5"
BPFL 6", BFG 5", BMG 4.25", NEG 4.25"

The Why: I’m very fortunate to not have any stories of being made self-concious about my size. The only person I have ever been with is my wife and she has also said I am more than adequate. Ever since I can remember however I have always been interested in trying to increase the size of my penis. For the past decade I’ve struggled with EQ and what I assumed was psychological ED and could get an Erection, but had trouble maintaining it during sex. I tried hypnosis with improved things, but without continuing sessions the gremlins in my head eventually took back over. Then I tried Cialis which made a dramatic improvement, but some days even that would fail if the gremlins took over. Eventually I was placed on Buproprion for depression which made the biggest difference, but eventually the problem came that I had no libido. Once in the action I could usually perform fine.
While on a big health kick I decided to seek out a private endocrinologist and they determined that while my testosterone levels were within normal limits, they fit in the middle range of healthy adults 30-60 years old. They noted my FSH and LH levels were consistent with the testosterone production and suggested we try increasing the pituitary production which for many will increase testosterone accordingly. After about 3 months on the treatment my testosterone went from 400 to 900 and my depression and bad thoughts decreased to a level I’d never known could exist. My libido could be higher, but I have no problem performing with my wife and any moment. I’ve been off the bupropion for over 5 months and my only regret is not pursuing this years ago because of what a life changer it has been for me over the past year. Whenever I would have my blood work checked by my primary doctors over the past 15 years it would always come back that my hormone levels were within normal. The problem is that for some normal is not enough to have the mental effects needed.

Starting
Health: I consider myself a moderately healthy adult, I’m 165 pounds, lift weights 3 times weekly, and perform light cardio on non-lifting days. With the holidays and bad food choices around, my diet in the past month has slipped, but on average I eat a healthy diet. I don’t smoke and drink socially in moderation 1-2 times a month. I am currently being treated by an endocrinologist with enclomiphene and HCG to increase FSH and LH levels. My bloodwork which is performed every 2-3 months does not show anything of note.

I take the following supplements daily
Morning
Vitamin D 6,000 i.u.
Vitamin K2 500mg
Vitamin C
B12
Collagen 14g powder and MCT oil supplement with bulletproof coffee

Evening
Zinc
Krill Oil
Copper
Vitamin C

I use a red light panel 1-2 times a week for 15-20 minutes. I’m really interested to see if this will have a positive benefit on my collagen synthesis post surgery.

Botox treatment the week prior to my appointment 50 units injected subepithelial along the dartos muscle to prevent retraction and another 50 units injected in four spots intracavernosal to increase EQ. The procedure was performed 12/7/22. So far I've noticed my penis is a little more full, but nothing profound a week out.

Now on the day of the procedure. I took an early morning flight and got into San Diego around 11 AM. My shuttle driver was there right as I came down to baggage and was extremely pleasant to talk to. Throughout the day I kept asking myself if I was crazy to be doing this and thoughts of what could go wrong started running through my head. What if I mess up my penis?

My appointment wasn’t till 3:30PM so I went to lunch at El Patrero which was recommended by the shuttle driver and got a breakfast platter with chorizo, eggs, beans, potatoes and steak. Talk about excellent, there wasn’t a thing on the plate that was bad. After that I did a little walking before finally checking into the Grand Hotel and taking a 2nd shower prior to my procedure and taking a bunch of pre-op photos. If anyone goes into my photos there are going to think I’m nuts.

On the way to my appointment, I stopped by the Hyperbaric Oxygen Therapy Spa and scheduled an appointment for a treatment. They didn’t have any appointments available for Thursday, but I have one scheduled for Friday. Anything that can help with healing I’m willing to try. I also found a place that does cryotherapy close by and might explore that if I have extra time to kill over the next two days.

I finally made my way up to Avanti and checked in. I got there about 45 minute early, but Ian got me into a consult room to fill out paperwork and relax. In that time I read Dr. Casavantes book, “Girth Matters” and relieved myself that this was the best method to increase Girth, but also freaked myself out at the complications that can occur. That said I came in with full faith in the whole team at Avanti that they will do their best. I took an Ativan given by Ian, not sure how much it calmed me down, but anything to help I’ll take.
When my time was finally there, Ian brought me into the treatment room, had me switch into the surgical gown, and began with photos. I didn’t anticipate how awkward it would be to have a young attractive guy taking photos of my package. I did fine with it, but it did trigger a little bit of locker room anxiety that I normally don’t have. He was completely professional and brought me to ease in minutes though.

Next was getting up on the table and start the process of cleaning, drawing blood for the PRP, and anesthetizing the area. Thanks to "6x5to6x7" who posted the morming of my procedure and made the recommendation of sunglasses and ear pods, thank you. The lights above were super bright, and to break periods of awkwardness and take my mind off of things it was nice to turn on a podcast and randomly check in and see how things were going. Aside from the first few shots of lidocaine I barely felt anything. Near the end, the only thing I could feel was the weight of my penis on my leg as they moved it from side to side which was pretty awesome considering it was in its Flaccid state.

Dr. Morales said she was very happy with how the procedure went. We also had some extra shop talk about PRP and Botox as I work in medical. The following injectables were used:
Lidocaine
7ml Linnea Safe 10% and 15ml Linnea Safe 30% for a total of 22ccs
6cc of PRP injected along the shaft
100 units Dysport (botulinum toxin) in multiple entries along the shaft, very superficial as I watched
100 units Dyspot for the scrotox procedure

After everything was finished, Ian took updated photos and remeasured. He said that my stretched Flaccid was 3.5”/9cm and directly afterward was 4.3”/11cm and said it’s likely that that will be the final Flaccid Girth after swelling has gone down. In a stretched Flaccid state it makes the Girth smaller than my typical Flaccid Girth so I will be interested to measure over the next few days since the smallest Flaccid I’ve measured over the past year has been 4.25”/10.8cm. When looked down after the surgery it looks like a 5” penis, but I’m just going with how they measured today.
Ian then proceeded to show me to massage and roll/push the product around to avoid high and lows and how to deal with the extrusion of product and hopefully avoid painful nodules at injections sites later. He showed me how the Hanger works and then wrapped by penis and said to keep it on for 4 hours. After that I should massage and try to get a good nights sleep and do my best to sleep on my back. I have my follow-up scheduled with Ian tomorrow morning at 9:30AM. Tonight I’m instructed to take Flomax/Tamulosin 0.4mg tablets before bed for the next 20 nights, Cefalexin 500mg every 8 hours for 6 days, and Ibuprofen 600mg every 8 hours with food. As far as sexual activity he recommend waiting 15 days, but said masturbation was fine as long as the puncture sites are not bleeding and it’s not too vigorous. I didn’t bring a pump, but plan on very light pumping next week to see if helps distribute the product and help with retraction.

Again, I apologize for long-winded post, but I want to write this down while it’s all still fresh in my head. I’ll try to get updated photos and progress posted for the next few weeks.

Thanks for sharing amigo. Love the detail. Looks like you’re going to have a great result!

How the heck did you get wood so soon! HA! Well done. Took me a good 24-36 hours.

Great Christmas gift.

48 hour update - bruising is down, just a little on the left side. Just a little mild soreness around the base, but otherwise feeling good. I've been massaging frequently and visiting with Ian twice daily and had my last follow-up with him today at 4PM. My flight leaves tomorrow afternoon and is only a 3 hour flight so I will massage before the plane boards and soon after I land. I've been wearing my ball and noose Hanger just about 24/7 to prevent retraction, but as you can see with my loose Circumcision I have some skin that still wants to flow over unless I am fully Erect. Dr. Morales intentionally stopped the filler close to the Circumcision line to prevent even more thick skin around the area. Ian felt that after the swelling goes down some more it will be less noticeable, but maybe something that can be corrected more in round 2 or a smoothing session. Aside from that, I have just one spot that is still leaking a very small amount and looks more like plasma than filler since it is a very thin clear fluid.
Yesterday morning before my first follow-up I met up with 6x5to6x7 for coffee. It was awesome to discuss this with another person face to face and realize that most of us are just regular guys looking to enhance ourselves, no different than women going in for work that is considered normal these days. This forum is great for people to share their experiences and remove the stigma that we all must be some sort of deviant or have body dysmorphia.
Ian has helped a ton and commented that I have a very consistent fill, with my tight base it looks there is more filler in the middle and neck, but likely is just due to the swelling and will get better over the next few days. The great news is I've yet to go over 6" MEG and even holding close to that while Flaccid. Over the next two weeks I'll be interested to see what measurements change. I've been fortunate to have full 100% erections a few times throughout the day and at night while supplementing with 5mg Tadalafil that was given after. Can't wait to test this new penis out with my wife, don't know how I'll make it the full 15 days or longer. If I can maintain close to 5.75" final Girth I may just opt for a smoothing session, this already seems like a lot to handle.
After my morning follow-up today I also went in for a hyperbaric oxygen session at a clinic on the main level. Not sure what benefits it will really offer, but it was a cool experience. My time in Tijuana is coming to an end, but it's been a good one overall. I haven't had a single bad meal. I've eaten at Emma's the French-inspired restaurant on the main level of the Grand Hotel twice since it was so good, and today went for street food and did quite a bit of walking over the past two days to outdoor shopping malls. My conception of Tijuana was that it would be seedy and dangerous, but every interaction I've had has been positive.

Can you after 4 weeks erections pics put in the forum...

I’ll try and update progress photos for the next few months while things are changing. Day 4 today, spent yesterday traveling back home and massaging while I could at the airport. I was able to keep the Hanger on most of the day and last night went with it off.
Size seems to be holding, I’ll do some updated measurements after my workout and shower today. Good to be back home and in my routine/diet. After the shower going to get 20 minutes in on the red light panel while massaging.
Aside from my loose skin near the glans that covers up part of it I’m impressed with the size. While Erect I can’t get my fingers around the he shaft. Can’t wait to show my wife when it’s healed. It’s my special surprise to her!!

Day 5 Progress Report
First full day back at work and was able to keep the Hanger attached all day. Today I noticed that the void near the glans has become less noticeable. Girth is still holding.
Still haven’t shown my wife, but can’t wait to see and hear her reaction when we have sex!! In the pictures you can see the base didn’t get as much product and best Ian and I tried it just kept migrating with gravity. At my 2nd round they could be able to fill in the are nicely. No hard nodules and painful spots to note.

2 Week Update
Healing has been going well and still using the Hanger around 14 hours a day and massaging as much as I can. Over the past week I've noticed that the implant feels a lot firmer than I was expecting and not as natural as a Flaccid penis. From those who have had this done, does that eventually decrease and become a lot more natural feeling as the carrier is broken down and replaced with natural collagen?
I texted Ian about a concern I had today with a small section of skin right near the Circumcision line that is adhered to my shaft and does not move and prevents my Foreskin from moving forward. It literally is one small spot that is tacking everything down in a section where they did not add filler. Ian assured me that at my Round 2 visit she would be able to detach the section so it moves freely. I consider myself luck that I don't have any painful spots or hard nodules, but just some random unevenness that subsequent visits should fix.
My size has remained really consistent, this morning I measured 5.75" FMG and 6.15" EMG. At that size I'm not sure I really need to do a full round 2, but would like to fill out my base more as I have missile-shaped shaft now, even though the tape measurements say it is equal. I haven't told my wife, but she got to see it last weekend and commented that it looked huge but likely though I had pumped earlier. I cheated and had sex last Sunday and wish I would have waited as I was quite sore afterwards. I could tell she liked the bigger size and kept wanting more even after I was spent.
I worry in a few months I'll want to go bigger after becoming adjusted to the new size, but don't want to end up with something that is unusable due to size or unnatural feeling.

Updated photos.
Photo one shows the area that is stuck to the shaft

Great update bro. I need to update mine as well. I'll try to do that this weekend.

I’m almost 1 year out from my first round of PMMA and scheduled for a 2nd round for another Utmost package at Avanti this December. Nice I get there I’ll create a new post documenting my progress and alterations I’m looking for in this round to make some small corrections.

Awesome! How is the implant feeling one year post-op?

For the most part it all looks and feels very natural. I have one section near the Circumcision scar that I got a tissue adhesion that I’m hoping can be released that affects how my skin rolls over the glans. There is also a lump that can be felt on the middle right section that if broken up will really even things out.
1 year out and my Girth gains have stuck, so I’m hoping that if I get another 0.25-.5” and even from the base to scar line I’ll be ecstatic.
Just working on how I’ll avoid retraction for the month following. I have a PeniMaster pro, vacuum Hanger, and ball weights. I’d like to rely on wraps at night, but my glans often turtles in when I go to sit due to the size discrepancy .

Mindmaniac wrote: For the most part it all looks and feels very natural. I have one section near the Circumcision scar that I got a tissue adhesion that I’m hoping can be released that affects how my skin rolls over the glans. There is also a lump that can be felt on the middle right section that if broken up will really even things out.
1 year out and my Girth gains have stuck, so I’m hoping that if I get another 0.25-.5” and even from the base to scar line I’ll be ecstatic.
Just working on how I’ll avoid retraction for the month following. I have a PeniMaster pro, vacuum Hanger, and ball weights. I’d like to rely on wraps at night, but my glans often turtles in when I go to sit due to the size discrepancy .

Awesome post and photos. Your last set of posted photos was about 10 months ago when there still a lot of swell. I’m curious what it looks like without the swelling. Could you please post a photo now of what it looks like when Erect and Flaccid. It would make for a good comparison photo for before your second procedure as well. I thank you in advance.

Great questions. I’ll be updating all measurements and photos pre-surgery in December along with documenting the overall experience and post photos and measurements.