TOPIC: BBC IPLAYER: The penis extension clinic

We use a micro cannula if a patient requests it, due to a fear of needles.

Androfill wrote: hoddle10

Our surgeons simply disagree with you.

It would seem that the pharmaceutical manufacturer Pfizer may take issue with your opinion, as would the US FDA who have approved men to inject themselves in the penis, with a needle, at home , unsupervised.

One would guess these gentlemen treating their ED injecting with a needle at home ( as approved by the FDA ) are doing so in an eager and fumbling state, possibly intoxicated, and may not read the instructions on the packet word for word.

But you feel that a surgeon can\'t manage a needle better - this is your opinion.

We use a micro cannula if a patient requests it, due to a fear of needles. The result may not be as good, and a cannula is slightly more invasive.

Pfizer would never in a million years advise men to inject HA on the dorsal side of the penis at home. I explained that in a previous post and added photos to illustrate my point.

[Pfizer would never in a million years advise men to inject HA on the dorsal side of the penis at home.]

Agreed, but the likelihood that your average man at home will make a mistake when using a needle to inject their penis must have been factored in - and deemed that to be an acceptable risk?

I do not hear of any widespread incidences of occlusion.

Your point below could be valid, but I would not think this is a Dr H patient.
[Here is an example of surgery performed by your Dr and honestly I don\'t see why it inspires confidence.]

Can we wait to get a clearer view of Dr O\'s procedure, a clear video would be excellent, before assuming what he is doing is safe. Let\'s hope that it is a far better procedure than what we have - hard to tell right now.

If he is doing something better - we will move to that approach.

Androfill wrote:

Agreed, but someone must have factored in the likelihood that your average guy will make a mistake when using a needle to inject their penis at home - and deemed that to be an acceptable risk? I do not hear of any widespread incidences of occlusion.

Your point below could be valid, but I would not think this is a Dr H patient.

Why would alprostadil cause an occlusion? HA is a gel like substance that if injected into a vessel can block it. Hence you take a risk when using a sharp needle.

The photo I posted as of a Dr Horn patient. The visible scarring was from a V/Y incision performed by Dr Horn. You said earlier that you try and dissuade peope from having such surgery, so just like me, you disagree with your own surgeons.

I don\'t really understand why a Dr who performs FFT with a large cannula and thus injects into the layer above the bucks fascia, would consider it risky to do the same with a micro cannula and HA. It seems very contradictory.

Anyway I have a couple of questions for you, now you are more aware of the concerns of using a needle and have shown you are prepared to disagree with Dr Horn.

1.) do you think arterial embolization is more likely when using a sharp needle of a blunt micro cannula?

2.) do you think it is easier to accidently damage the dorsal nerve with a sharp needle or with a blunt cannula, especially given what we can see from the Androfill video?

3.) do you think it would be easier to achieve a smooth continuous flow of HA with a cannula rather than a needle?

Again, I stress, I\'m not interested in the opinions of the surgeons you work with. I want your personal opinion.

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.

So my questions weren\'t properly answered I want to you and everyone else that I\'m not being unreasonable with my concerns.

The whole point of using HA is for it\'s safety profile. Its much more expensive and only temporary, yet many of us are prepared to accept that because we want optimal safety.

The risk of arterial embolization with HA is small, but it\'s still there and everything possible should be done to keep that risk as low as possible. Using a sharp needle for this procedure most definitely doesn\'t do that and it\'s very easy to demonstrate this.

Most HA procedures use only one or two injection points. Yet as the Androfill video us, over 40 injections are made. So straightaway that small risk is increased by 30 to 40 times! That\'s a major reason why a needle shouldn\'t be used. Everytime it goes in, there is the risk of it entering a vessel. The more injections the more risk, it\'s as simple as that. So the needle method clearly doesn\'t optimise safety and the small risk associated with using HA are dramatically higher when injecting the penis.

When using the needle, great care should be taken to reduce risk. Proper technique is key. Here is a video where a well respected British surgeon demonstrates injecting HA with a needle. Please skip to 2.20 and watch from there.:



As you can see, to minimize the risk, when he injects the needle he holds it in place for a while, to check if a vessel hasn\'t been hit. He then injects slowly. Now compare that with the Androfill video. The difference is night and day. I\'m not being unfair here. Anyone can watch the 2 videos and see why the Androfill technique is much riskier as Dr Horn jabs in out very quickly. No caution is taken at all. It\'s not my opinion, it\'s there for everyone to see. Androfill posted the video to be critiqued and thus I\'ll leave it up to thise viewing this thread to decide if it demonstrates a technique of optimal safety.

Then we need to consider the added risk of the dorsal nerve. When I went to Gordon Muir, one of the most respected urologists in the UK, to have some scar tissue released from the skin directly above the dorsal nerve, he refused to try and free it with a needle. This was despite the fact he could lift the skin a good Inch away from the shaft. He simply wouldn\'t risk sticking a sharp needle in the area, as the risk was too great. On the screen shot from the carverject website, they also clearly highlight that area as somewhere that shouldn\'t be injected into. When discussing injecting over the dorsal nerve, even with a blunt cannula, Dr Oates said the following:

\"Initially I was a little reluctant to inject directly over the dorsal (upper) surface because the dorsal penile artery (nerve and vein) run midline on the dorsum. But once confident that the cannula was not going to pierce deeper through the fascia I am totally happy to do that now.\"

And that is when using a blunt instrument. Yet in the Androfill video we clearly see Dr Horn jabbing away in the area above the dorsal nerve. IS that really optimizing safety? I can\'t see how anyone could argue it is.

At the end of the day this isn\'t a cheap procedure. A 10 ml enhancement costs '3600 and it\'s only temporary. The only reason guys would even consider paying that kind of money is because they want to ensure the risk they are taking is as minimnal as possible. I\'m not being unreasonable here, I think I\'ve demonstrated quite clearly that Androfill aren\'t doing that. Surely for that kind of money guys should expect the highest standard of care possible, whilst it seems to me that Androfill are focusing more on doing things that easier and quicker for them, rather than optimizing patient safety.

@hoddle. would you know straightaway if you hit a vein with a needle and put filler there or is it something that would take a few days to realise?

A bruise or redness would happen I\'d imagine. If there was a blockage it would probably turn white and you\'d have to try and massage it out, and inject hyaluronidase. But these measures don\'t always work, hence Necrosis is a risk when using a filler. It\'s a rare complication, but every possible measure to be taken to avoid it. A micro cannula is blunt, so it\'s pretty much impossible to inject into a vessel.

are you saying that hyalurodinase wouldnt necessarily work in the event of worse case scenario? so youd be left with 2 options: surgery or do nothing and get Necrosis?

number22 wrote: are you saying that hyalurodinase wouldnt necessarily work in the event of worse case scenario? so youd be left with 2 options: surgery or do nothing and get Necrosis?

Hyaluronidase isn\'t always effective.


At the end of the day no procedure is risk free. So Dr\'s have to do everything in their locker to minimise risk. I think a micro cannula is the least we should expect in that respect.

If patients kick up enough fuss and demand it becomes standard Androfill will change their approach or someone else will come along and fill the void. If tomorrow the Viel twins on Harley Street, started offering micro cannula HA would you not be more tempted to go to them instead of Dr Horn?

Our old friend Hunkydory didn\'t respond particularly well to Hyaluronidase. Even some small spots that were directly injected into didn\'t remove it. It\'s odd as some areas that were hardly touch dissolved quickly, whilst other areas needed several attempts to dissolve and some still haven\'t. So injecting it to clear a blockage doesn\'t mean it\'s guaranteed to work.

But the main thing is being able to target to the blockage I\'d imagine and of course getting treatment in time.

But as I keep on saying, we shouldn\'t have to worry about that, as a needle shouldn\'t be used in my opinion. If I\'m paying hell of a lot of money to have HA as I\'m worried by the safety profile of other less expensive methods, then I sure as shit expect to have it administered in the safest possible way. So what if it takes a lot longer to inject via cannula and more skill is needed. This is costing thousands of pounds/dollars, so the least I should be able to expect is 30 mins of the Dr\'s time and to be confident he\'s skilled enough with a basic tool to ensure a nice result.

If I wanted it injected I\'d go to Indiano123!

smalljay wrote: LMAO (last line of your post)


So Hunky had hyaluronidase, huh? I don\'t remember reading those posts here, but now they\'re all gone .
I was asking about it mainly because after my glans scar excision with Dr. Alter, I will likely be left with a deformity of the coronal ridge on one side. Crazy enough, I may consider Brian Rosenthal for injection of a little Juvederm Ultra just on the coronal ridge in that spot, if the deformity bothers me enough. Hyaluronidase makes me feel better but yeah - it\'s probably not a surefire shot. Rosenthal has some mixed results/reviews on here but he\'s up front that HA does pose a \'rare\' risk of Necrosis. He also refuses to use Voluma on the glans as he feels it is too thick and poses a higher risk of Necrosis - another reason I am keen to go with him if I do it. I\'ll only go if the deformation/size change from surgery really, really bothers me.

Hoddle, would you ever consider Macrolane as the brand you choose for the penis (shaft)? For whatever reason it seems to be significantly cheaper than the other HA\'s which is good for our needs. I only just now remembered it. I have emailed Wade asking for a price quote and I will let you guys know when I hear back.

Hunkydory only recently used it, after he left the forum.

The kind of gains I\'m looking for are so small, that I don\'t think I\'d need to consider Macrolane. I\'m only after about a 0.4\" gain and think I could achieve that with 6cc of HA. So for such a small amount I think I\'d rather pay for the better quality HA products. But having said that, maybe in small amount Macrolane can produce good results, so maybe I should consider it. If it doesn\'t work I could just dissolve it and will have only lost '1000. Maybe it\'s an experiment worth considering.

Just my 2 cent here regarding needle Vs cannula.. Dr.N also Said needle is unsafe and will only work with a blunt cannula.. (PMMA)

Does anyone know whether Dr C uses cannula or needle for the Silkon 1000 microdroplets?

What is the implication for silicon micro droplet technique with a needle?