TOPIC: PhalloFill or not to fill?

phalloguy100 wrote: Well, I'm actually very UNIMPRESSED by the PhalloFILL Urologist in my area - Dr. Harb. The staff were horrible. I changed my schedule around, got childcare lined up, and took time off work to drive an hour and a half to the clinic - just to be turned down at the window because THEY made the "wrong" type of appointment. And they got pretty defensive and rude, leaving me no choice but to leave without being seen.

So much for PhalloFILL I guess.

It's hard to find clinics for this kind of thing in Michigan.

That's unfortunate, although it should be noted that these PhalloFILL Clinics are associated in name only (through training, supply source, etc.) and are in-fact independent practices & businesses -- that is to to say they are not the PhalloFILL (Dallas) that Sponsors this site. I believe that distinction is important, and I also have heard good things about other PhalloFILL offices, but if you are willing to travel there are a variety of options.

Also, as Dickwhitman suggested, P-Long is somewhere you can begin to.

I've been strongly considering getting Phallofill done for several weeks now but reading articles like this gives me pause. Does the filler actually really reabsorb/dissolve over time, or is all just leaking out of the base of the shaft and moving elsewhere?

www.boredpanda.com/mri-33-old-womans-fac...where-her-filler-is/

I understand it's a naturally-occurring substance in the body, but I have to imagine there's something else in the product, right? Sort of like how you can purchase 100% juice, but often there's more than one ingredient listed. I mean, if there are different HA fillers available with different G Prime scores (etc), then either there's a difference in ingredients or a difference in how it's prepared...or both. Otherwise, all HA fillers would be exactly the same.

Can anyone speak to this, by any chance? Preferably @PhalloFILL ? I've been waiting for so long for a product or treatment that is safe long term, and I'm really hoping Phallofill is it...but this potential migration issue and chance that it never actually dissolves may be a non-starter, which would be a major bummer.

I hope you don’t mind me jumping in here, but I think there are a few important points that apply to anyone considering HA fillers.

HA filler does gradually break down and reabsorb over time. Your body naturally produces enzymes called hyaluronidases whose job is to continuously break down Hyaluronic Acid throughout the body. These fillers are essentially using that same natural metabolic pathway. The filler is not “leaking out the base of the shaft” and traveling elsewhere in the body.

We now have well over 20 years of experience with HA fillers in the U.S. and millions upon millions of treatments performed worldwide. The recent social media discussions about “filler migration” are, in my opinion, largely a TikTok-driven phenomenon, often involving patients who had excessive amounts of facial filler placed over long periods of time. In many of those cases, what people are calling “migration” is frequently overfilling, tissue expansion, swelling, or product that was intentionally placed broadly rather than true uncontrolled movement throughout the body.

When appropriate amounts of HA filler are used and placed properly, the results generally look natural and the product slowly metabolizes over time.

Regarding ingredients, Some products also contain lidocaine for comfort during injection. The differences between fillers are not because companies are adding extra substances, but because of how the HA is manufactured, purified, concentrated, and cross-linked.

The “G-prime” people refer to is essentially a measure of firmness and structural support. Manufacturers alter this by:
• changing the concentration of HA
• changing particle size
• changing the degree and type of cross-linking between HA chains

So different HA fillers behave differently in terms of firmness, flexibility, spread, longevity, and lift, even though they are all HA products.

Overall, HA fillers have one of the strongest safety profiles of any injectable product in aesthetic medicine. They have undergone extensive safety and efficacy testing for FDA approval in multiple areas of the body. Penile Girth enhancement is considered off-label use, but the underlying products themselves are very well studied.

No medical treatment is completely risk-free, and rare complications can occur with any procedure, but HA fillers overall have an excellent long-term safety record and, importantly, are also reversible if needed. Dr.S

Of course; I appreciate any input available! And I'm sure others will learn something as they do their future research.

Is there something anatomical in the penis that physically prohibits the filler from migrating outside of the penis? Or are you saying that what little HA may actually work its way in that direction will be taken care of by our natural hyaluronidases?

In the specific case I linked to (understanding that it's anecdotal and likely atypical), it seems to me that it was a larger issue than "overfilling, tissue expansion, swelling, or product that was intentionally placed broadly", since some of it was found in her eye socket. So at the very least, some of the filler moved around even if the majority was just placed broadly, etc. Do you agree?

Regarding this:

Manufacturers alter this (G-prime) by:
• changing the concentration of HA
• changing particle size
• changing the degree and type of cross-linking between HA chains

If it's more concentrated or less concentrated depending on the manufacturer, then that means there is at least one other ingredient, correct? Are you simply referring to the concentration of HA vs. water?

I'll admit that the final two bullet points are even further above my head. But if the particle size is altered and/or various chemicals are used for cross-linking, wouldn't that sort of mean that the HA that's being injected isn't really HA? Like, it's been altered to behave differently than the HA naturally found in our bodies. Back to the food & drink analogies, sort of like how you can buy a whole turkey or ultra-processed deli turkey, and while they're both "turkey", that doesn't mean they're equally safe for our bodies.

Not attempting to be argumentative if it's coming across that way; just trying to fully understand because I REALLY want to be comfortable-enough to make this treatment happen. Thank you!

Dr Sullivan gave you a very accurate and clear response to your questions. Before I read his response I was gathering my thoughts tell you the exact same info.

Additionally, one variation between different dermal fillers is the concentration of HA molecules measured in mg/ml. I will list a few common ones here and attach a chart that shows them. For your reference all PhalloFILL clinics use Prolennium Revanesse Versa.

Revanesse Versa: 25 mg/ml
Juvederm ultra plus: 24 mg/ml
Teosyal RH3/RH4: 23 mg/ml
Restylane Lyft/Defyne/Refyne: 20 mg/ml
Juvederm Voluma: 20 mg/ml
Juvederm Vollure: 17.5 mg/ml

And as Dr Sullivan stated they all contain 1% lidocaine generally across the board. The only other ingredient would be a very small amount of preservatives also in all of the and of course water to hydrate the HA molecules. (There would be very little volume to inject if the HA molecule was not partially hydrated in the syringe)

So the higher the mg/ml the more HA you are actually receiving.

As far as the g prime…. It isn’t not related at all to the concentration of the Dermal Filler as he also states. It’s basically how much the Dermal Filler will flatted when compressed. As he stated it’s the firmness.

In my opinion g prime is irrelevant in Girth enhancement IF the Dermal Filler is injected below the Dartos fascia where PhalloFILL is injected. Your erections are crested from liquid blood.. and that blood makes solid erections behind the Dartos and bucks fascia. When we deliver Dermal Filler between the two layers the erections are just as firm as they are naturally. If the Dermal Filler is outside the darts fascia just below the skin, the g prime could possibly make a difference in the fitness. But for PhalloFILL the g prime is irrelevant.

We chose Revanesse Versa based on the volume of the syringes which is 1.2 ml versus 1.0 ml for most of the other syringes, the concentration of 25 mg/ml, and the phenomenal safety record of this Dermal Filler coming from FDA data of adverse events of interest. I’ll also attach that showing the safety profile.

I know you’re not being argumentative. I know you’re just trying to better understand it, and honestly, these are very reasonable questions to ask before doing any elective procedure.

So first, let me explain HA.

Hyaluronic Acid is basically a very long chain made of repeating sugars. Specifically, it is made of repeating disaccharides, which just means two sugars linked together over and over again.

Think of it almost like:
bead-bead-bead-bead-bead-bead

where each “bead” is a repeating sugar unit.

And all HA — whether it is in your skin, joints, eyes, or filler syringes — is fundamentally this same type of molecule.

The body changes the behavior of HA by changing the length of those chains.

For example:

* In joints, HA chains are extremely long because they need to act more like lubrication and shock absorption.
* In skin, there is a mixture of long, medium, and short HA chains because skin needs hydration, flexibility, and support.

So your own body already naturally creates different “versions” of HA by changing chain size.

The filler companies do something very similar.

When companies make fillers like Voluma or Volux, they alter:

* chain length
* concentration
* and cross-linking

to give the filler different properties.

Now regarding what is actually inside the syringe:

It is:

Hyaluronic Acid
water or saline (hence the different concentrations)
a tiny amount of lidocaine in some products
and a small buffer to keep the pH similar to body tissue

Now, the one real difference between natural HA and filler HA is cross-linking.

Importantly, the manufacturers are not adding some giant foreign plastic material into the filler. They are simply creating links between HA chains.

And when the body eventually breaks those links apart, what remains are just normal HA chains again, which are then naturally degraded by the body into sugars and water.

Migration.

I honestly think migration is one of the most misunderstood and overhyped topics online.

The reason filler usually stays where it is placed is because several things are working together:

First:
HA filler is a thick gel, not a liquid.

If you put honey or gelatin on the side of a plate, it does not freely run like water. HA behaves similarly.

Second:
Once filler is injected, it becomes integrated into the surrounding tissue.

The body contains collagen fibers, fascia, and connective tissue networks that act almost like a fibrous scaffold or web.

A simple analogy would be injecting gel into a sponge. The fibers of the sponge trap and stabilize the gel.

Third:
In the penis specifically, filler is injected into what we call a “potential space” between fascial layers.

A good analogy is two wet sheets of paper pressed together. You can gently separate them and place something between them, but once the material is there, the layers still naturally press together and resist movement.

And fascia is much stronger and tighter than wet paper.

So anatomically, there absolutely are structures that help contain the filler and resist migration.

Now, could microscopic amounts of HA move somewhat through tissue over time? Possibly. Biology is never absolute.

But clinically meaningful migration with properly placed HA filler is actually uncommon.

Regarding the MRI image you linked:

I personally think the “eye socket filler” interpretation is likely overstated or artifact-related.

MRIs can be difficult to interpret, even for physicians, unless someone specifically specializes in radiology and cosmetic filler imaging.

And if you look at the second image from that article, the filler in the lips remains very sharply localized, which actually argues against major migration.

Everything else shown in those MRI images is also consistent with areas where filler could simply have been intentionally injected over time.

At the end of the day, every medical procedure carries some level of risk. Nothing is zero-risk.

But HA fillers have been used for decades, millions upon millions of times worldwide, and because HA is so biologically similar to what already exists naturally in the body, we have an extremely strong understanding of their safety profile.

That long history and enormous real-world experience is one of the reasons many physicians consider HA fillers among the safest volumizing materials available when used appropriately.

Dr. S

I left out one thing from my response that I just noticed. One of you mentioned longevity of HA Dermal Filler and compared it to the face. You really cannot do that IF the Dermal Filler is being injected between the two facial planes as it should be. Or in my opinion and it sounds like it is also Dr Sullivan’s opinion that it should be between those two layers he described as wet pieces of paper. I generally describe those two layers as two layers of outer fabric one of those water hoses that retracts into a little ball of fabric when the water is turned off and then expands into a rigid waterhole when the water is turned in. Between those two layers of fabric or between those two layers of wet paper, there are minimal lymphatics and it’s avascular meaning not much is going on inside there with blood flow which is unlike when the Dermal Filler is injected into the face/lips. Much different environment. That’s what makes the Dermal Filler last so much longer on male Girth enhancement compared to injections in the face.