TOPIC: My journey with Dr. Victor Liu - Alloderm & Ligament (for girth & length)

It's really great to see some alternatives to fillers emerging over the past year or so. Even though it seems to be very early days for the Grafts 2.0 movement, I'm excited to see the progress and might eventually pull the trigger myself. There seem to be 3 documented progress reports thus far, and I'm hoping for great results for those early patients. However, I would appreciate some perspectives from some veterans here regarding concerns about the risks of Alloder/Belladerm Grafting from the early days of the 2.0 PhalloBoards. Some of the past concerns regarding Alloderm/Belladerm were infection (which I think has been addressed by SO as a result of stacking 2 or more grafts, increasing the likelihood of infection). But I'm interested if anyone can chime in regarding the risk of the Alloderm sheet shrinking unevenly, thus resulting in a curved shaft. For me personally, that would be my main concern regarding this treatment, as people in the past have always reported some level of shrinkage with Alloderm. This wouldn't be much of a problem if it only affected the Girth of the penis, since you could always fix it with fillers later on. But in regards to uneven shrinkage that could cause shaft deformation, I'm not quite sure what the current iteration of the Alloderm method does differently to mitigate that possibility. To me, the surgical path would be worth the longer recovery time if it provided lower odds of aesthetic issues such as lumps, nodes, unevenness, and the donut effect that could easily occur with the non-surgical filler option. So, I do wonder if there's still a deformation concern with the current iteration of the procedure or not.

@p76k03 since this is my recovery thread I’m assuming you are asking specifically about my procedure, which combined Alloderm with fat/filler. Unevenness is possible - in both short term and long term. If you read my thread you saw I actually had two small areas that needed correcting. Dr Liu filled these areas in with filler two months later, and it evened everything out. If this were to happen again sometime down the line for whatever reason - because bodies are complicated - I would likely just fill in those areas again.

I apologize for the confusion. I'm more concerned with the prospect of the Alloderm shrinking vertically (I'm not sure how to describe it). Since the Alloderm sheet is stitched to the shaft, it might cause curvature or deformation, which some people have experienced with the old grafting method. However, I'm probably asking in the wrong thread, as you obviously haven't experienced any of that. In your case any unevenness that occurs could be fixed with fillers.

@p76k03 ah I see. It is a good question and to be perfectly honest I’m not sure. Dr Liu has said in other forums that everyones penis shape does change over time - as you get older it shrinks a bit - but I’m not really sure how this will impact the Alloderm. It’s worth asking for sure.

I would think it would be fairy malleable since it integrates with your body, but I’m not too sure. Would be interested to know what you find out.

p76k03 wrote: Some of the past concerns regarding Alloderm/Belladerm were infection (which I think has been addressed by SO as a result of stacking 2 or more grafts, increasing the likelihood of infection). But I'm interested if anyone can chime in regarding the risk of the Alloderm sheet shrinking unevenly, thus resulting in a curved shaft.

A bit of a correction here: the shrinkage was a result of over-stacking the grafts, not necessarily infection. The excessive layering of Alloderm or Belladerm at the time was aimed at providing the patient huge gains because that's what Doctors were advertising at the time. What ended up happening was that the graft began failing due to insufficient vascularization (too much to adequately integrate the tissue scaffold/graft). This Atrophy would occur unevenly creating the appearance of shrinkage and contraction.

What is done now is that the Surgeon tailor cuts the graft to accommodate your shaft's length and will cap the thickness so as to avoid implant failure. And there is nothing to scoff at when it comes to gains as much as 0.5" to 0.75" (find any two comparable cylindrical objects at last a half an Inch bigger in circumference than one another and you'll see what I mean). It doesn't suffer from the irregularities presented by dermal fillers (nodules, ridges, and asymmetry), and is a "one & done" process. If you absolutely want additional Girth, some (not all) Surgeons will apply Dermal Filler for increased Girth, but don't get carried away, the bigger you go, the more likely you are to sacrifice natural aesthetics.

As for infections, I just suspect that was nothing more than a few reports (there weren't many back in the day) with patients experiencing statistically poor luck. If you Google infection rates, you'll see that any kind of surgery (implying incisions and accessing internal structures of the body) are about 3% -- fortunately most of them are treatable with antibiotics and it just comes with the territory. Heck, even non-surgical Dermal Filler procedures have a risk of infection, albeit small. Anytime you are in a Clinical setting, no matter how sterile and professionally clean they may be, the risk remains.

The methods have been refined over time, and they are showing positive signs thus far. I should note that it's really down to Alloderm at present time. I don't know of any Surgeon who prefers Belladerm over Alloderm, and Surgimend is currently under a Recall. So if you were to study any graft matrix, I'd look more up on Alloderm at present time.

Thank you SO for chiming in. If you think my question is not relevant to the post, I'll happily start a new one. But continuing with the subject for now, so in your view, it is not that Alloderm would always guarantee to shrink over time (in 2-5 years, not 10-15 years' time, where you get older and your body might change naturally), but it is due to the nature of stacking the grafts that causes the grafts to "die" or fail due to insufficient vascularization that causes the appearance of shrinkage over time, correct? If so, I do think it's a really attractive alternative to fillers, barring the risk of infection (which is not unique to Phalloplasty) and poor vascularization (which the chance of is now greatly reduced with the advent of this new technique). For me personally, I'm 5.5 EL but only 4 EG, so wanting to gain 1.5 to put me at 5.5 EG seems very unrealistic through Ellanse alone without sacrificing the aesthetics of the penis (which is the only method I considered when I first discovered PhalloBoards 3 years ago). But I do think with the reintroduction of the Alloderm method combined with fillers, it's a better option as a starting point for my Phalloplasty journey with my 5.5 EG goal in mind. For now, I'm in the process of seeking more review data from other sources since it seems very new here and there have only been 3 progress reports so far. I'm really intrigued with one of the sponsors, Proud Urology, here claiming they have thousands of patients since 2016 with their 5S Surgery which is very similar to what Dr. Liu does, so I'm trying to dive into local South Korea's social media to see if there are any reviews by the locals who have had the surgery longer. But I do imagine that since SO have accepted them as the first Asian Sponsor, he must've already seen great results/reviews before accepting them as a sponsor, so it's really encouraging to see the progress with this new technique. One thing that I find unfortunate is the fact that since this is such an invasive procedure, a lot of people who have had semi-permanent / permanent filler (Ellanse or PMMA) are probably going to be recommended against this procedure, meaning there wouldn't be as much review data as there would be for other injectables such as Ellanse or PMMA.

p76k03 wrote: Thank you SO for chiming in. If you think my question is not relevant to the post, I'll happily start a new one. But continuing with the subject for now, so in your view, it is not that Alloderm would always guarantee to shrink over time (in 2-5 years, not 10-15 years' time, where you get older and your body might change naturally), but it is due to the nature of stacking the grafts that causes the grafts to "die" or fail due to insufficient vascularization that causes the appearance of shrinkage over time, correct? If so, I do think it's a really attractive alternative to fillers, barring the risk of infection (which is not unique to phalloplasty) and poor vascularization (which the chance of is now greatly reduced with the advent of this new technique). For me personally, I'm 5.5 EL but only 4 EG, so wanting to gain 1.5 to put me at 5.5 EG seems very unrealistic through Ellanse alone without sacrificing the aesthetics of the penis (which is the only method I considered when I first discovered phalloboards 3 years ago). But I do think with the reintroduction of the Alloderm method combined with fillers, it's a better option as a starting point for my phalloplasty journey with my 5.5 EG goal in mind. For now, I'm in the process of seeking more review data from other sources since it seems very new here and there have only been 3 progress reports so far. I'm really intrigued with one of the sponsors, Proud Urology, here claiming they have thousands of patients since 2016 with their 5S Surgery which is very similar to what Dr. Liu does, so I'm trying to dive into local South Korea's social media to see if there are any reviews by the locals who have had the surgery longer. But I do imagine that since SO have accepted them as the first Asian Sponsor, he must've already seen great results/reviews before accepting them as a sponsor, so it's really encouraging to see the progress with this new technique. One thing that I find unfortunate is the fact that since this is such an invasive procedure, a lot of people who have had semi-permanent / permanent filler (Ellanse or PMMA) are probably going to be recommended against this procedure, meaning there wouldn't be as much review data as there would be for other injectables such as Ellanse or PMMA.

I'll happily answer your questions but I would recommend any further questions be created as a New Topic in the General Discussion section since this is Southbay612's Progress Report, and would prefer it not get sidetracked too much.

As for my take on shrinkage and contraction of these dermal grafts, it comes from my discussion wit Surgeons over the years. It made the most sense when Dr. Solomon (who had spent years repairing matters related to graft failures from other Surgeons who are no longer practicing due to retirement), saw the common denominator in all the patients with complications --> too many "sheets" or "stacks" of Alloderm or Belladerm. He knew you really weren't supposed to use that much for the reasons I mentioned in my previous reply (tissue integration, vascularization and so on), and a conservative approach would yield the best chances of graft success.

Yes, assuming the Surgeon would do both graft and filler (I don't believe Dr. Solomon uses fillers at all, strictly dermal grafts, but Dr. Liu and Proud Urology may offer it at their discretion), you could conceivably achieve 5.5" in erect girth.

Yes, I'd recommend doing your research on Dr. Liu and Proud Urology but don't be surprised how limited your findings will be -- penis enlargement isn't a mainstream topic and finding authentic reviews can be challenging. A lot of times when vetting a Sponsor, I have to take other things into consideration and not just strictly reviews (assuming there isn't an alarming trend in negative comments). Guys aren't going on their public account to post a 5 Star rating on Yelp or Google Reviews. Heck, I have thousands of visitors to this site, but only a small percentage post, much less progress report. Many of them read, research, book an appointment, get their procedure, and go about their lives.

For that reason I think we all should appreciate members like Southbay612 for his contributions, by providing a detailed account of his journey for our Community.

If you have any additional questions, you can Private Message (PM) me, or start a New Topic. Thanks.

In my case I have gained about an Inch in Girth, granted my procedure was roughly 5 and a half week's ago. But I have had 0 deformity, very nice esthetics in both Flaccid and Erect. During erections it's so solid, I simply love it. I had the mistaken impression that skin graft Girth enhancement would have a soft feel because well it's "skin" right? On the contrary I was pleasantly surprised of firmness. I am telling you from now even though I have never tried fillers or fat...they don't even hold a candle close to this. When you have an Erection it looks and feels perfect.

The only fillers that can come close to this I would imagine are PMMA and elanse. Bet even then.... sorry if I'm being a fan boy...but it's firmness and realism ... My wife keeps complimenting me..and she is such a straight shooter almost heartlessly honest...damn it's that good!
And just so you get an idea of how brutally honest my wife can be. When I had my circmumsicion done 6 months ago, I had the shock of my life it was uneven it looked pretty iffy. I tried to get some emotional support from my wife about it. She basically called me a stupid idiot that went a cut his Foreskin off and made my perfectly normal looking Dick into a mess. I mean talk about being a bitch right?! But now she is worshipping my penis..no joke.

I agree that these kinds of posts, particularly for a new and fairly invasive surgery with high upsides, are going to be scarce. I've sifted through 500 posts from the local Korean reviews and struggled to find posts as insightful as those I would encounter in these forums. This is especially true when, as I previously mentioned, people with prior permanent/semi-permanent fillers would likely be dissuaded from pursuing such a procedure. I'll keep my replies on topic for now and will create a new thread if I have additional questions. Thanks again for chiming in!

Hi biccboy I'm following your thread as well and I'm glad that you have become a fanboy of the procedure and having great results I do think I'm starting to become a fanboy and quite certain that this is the surgery for me and might eventually follow the same path as you did. I originally never considered Korea or any part of Asia(only US or AU) as an option before Proud becomes a sponsor and I've been able to see some local reviews even though logistically it would make more sense for me to get the surgery here. Since there has been some bad experiences and reviews regarding Korean doctors from the old forum which I think is more common than the success stories. But I've been reading the reviews here and on the local Korean sites and have since confinced my self that it's a great option for me. I'll stop by your thread to ask some Proud Urology specific questions later!

So, I've gone through around 500 posts from local Korean review sites for Proud Urology, as that seems to be the only source for any long-term reviews for this procedure dating back as far as 2019 and as recent as 2021. I think my concerns regarding potential curvature or deformation in respect to the Alloderm graft potentially pulling the shaft of the penis once the graft dissolves over time, since it's stitched to the shaft, might be inaccurate. By all accounts from patients' recovery threads, the stitching started to disintegrate/pop between 4-6 weeks (most of the time while the patients were having sex, which caused panic for most of them and is also similar to what Biccboyanaconda reported in his thread). What ended up holding the graft together is the fact that at that point, it has achieved vascularization at least up to a point where it becomes part of your anatomy. That's why, by almost all accounts, the Erect length right after the surgery for the recovering patients is reportedly shorter since it has not achieved proper vascularization yet. The old technique of stacking the graft, which has led to poor vascularization as I've discussed with SO, would most likely cause partial/uneven vascularization of the graft, which might ultimately cause the deformation. At least that's what I've gathered. Now, what's interesting is I believe you didn't report any lost Erect length, while Skiman, Biccboyanaconda, and all the patient reviews seem to echo the same thing in which they lost some length, which is what I would expect if you have not yet vascularized grafts stitched end to end to your non-Erect penis. Especially since I would consider you a Grower based on your FL & EL. But I do think in the long run it would be a non-issue since I've never seen any complaint of the length not coming back after a period of 8 months (I've seen people complain that it takes them 6 months to regain their original length). But I also think that is in large part due to the clinic not recommending any kind of Hanging after the lig cut for some reasons (which I assume is because traditional PE is not a thing there?). I have not seen any kind of discourse about any kind of regimen to help with affirming the gains from the lig cut surgery, so that certainly wouldn't help the lengthening process. I think the only common long-term complaint that people have reported ultimately is the 'chin phenomenon' where after 6-8 months, people realize that there's a noticeable difference between the end of the shaft and the glans, which I would suspect to be the product of people who have suboptimal vascularization and/or collagen growth that it disproportionately affects the end of the shaft more than other areas. But this too should be fixable with a filler down the line if it were to ever occur (although it is not ideal since the point of surgery is to have a one and done procedure, but alas, if you're looking for aesthetics, I think it's pretty naive to not expect some kind of touch up down the line). All in all, I'm almost certain that this is the surgery to get for me, and I do hope it works out well for you in the long term as well.One question that I have for you is: Are you familiar with the AutoExtender AutoSleeve at all? Here's what it looks like: it similar to Dr. Liu's own device at all? I think you mentioned that Dr. Liu doesn't recommend the use of traditional Hanging or a stretcher for a few weeks after the surgery, but rather suggests using a sleeve - Dr. Liu's own sleeve device with minimal weight. I'm trying to figure out a post-surgery regimen for myself if I decide to go through with the surgery. Since I'm most likely going to choose the Proud Urology route like Annaconda, I'm trying to find an alternative to Dr. Liu's own device. Based on your description of a sleeve-like device, this is the only thing that comes to my mind.

How is it going Southbay?

Any update on you progress?

I have been pumping for a month now and I can see a little improvement on my end. My ultimate goal is to do the lig cut as you did with Dr. Liu. How is your post surgery regimen?

Do you have any pictures of the stuff you use for i.e. Hanging or stretching?

Thanks

Hi @p76k03 - I'm not familiar with the AutoExtender AutoSleeve but I am including a pic of what I use here. It is a simple sleeve design with weighted pellets on the inside and requires some bandage wrap to stay on. I didn't loose any length but remember I also had my lig cut (Skiman didn't). I had immediate flaccid length gain and have since had additional gain of about 0.25 inches flaccid and a 0.5 inch gain erect - could be a mix of the sutures dissolving and the weights - also scar tissue softening up at the incision.

@Hobby19cm it's going great and no real new updates at this point. I've moved to a 'maintenance' protocol of ~30-60 minutes daily in hanging because I am at this point satisfied with my gains and really just want to maintain. This was suggested by SO and I confirmed it with Dr. Liu. I continue to measure about 0.5" gain in erect length (give or take depending on erection quality) and 1.25" flaccid length gain. As requested I'm attaching a pic of the weighted sleeve provided by Dr. Liu. He can give instructions on how to wear it (bandage wrap required) and it can be a bit tricky to keep on so am happy to help if you're having issues.

For the record I'm also QUITE pleased with my girth gain, which was my top priority. My sexual partner is quite pleased, too

Southbay,
Thanks for the update and reply. Keep up the gains.