PhalloBoards - An Online Community to Discuss Penile Girth Enhancement

Thanks so much for taking the time and chatting with me. I’ll try and keep things posted here.
Today I’m a little more optimistic lol. Let’s hope it stays that way.
Thanks again and talk soon.
Billy

SCBilly wrote: My first mistake…. Did I post under the Doctors forum?
Dammit!!!!

I fixed it for you

I know you may find this place to be a bit implant-averse (when it comes to augmentation, not so much erectile dysfunction, two totally separate applications, and often separate designs). That said, it doesn't necessarily mean you're condemned to a failed procedure, but that you have in-fact undergone a method that has had a history of not-so-stellar reviews.

That said, follow your post-op instructions and just take it a step at at time.

Best of luck.

They dont do penuma here so many horror stories your better off finding a subreddit for this this gorim is for fillers primarily best of luck

My first mistake…. Did I post under the Doctors forum?
Dammit!!!!

This is my first post, I’m probably doing something wrong lol but aim hoping to start a dialogue with others who have also had this procedure or knows a great deal about it.
I thought I’d read enough about the different options and methods for penile enhancements, but coming across this forum the day after my procedure, has me nervous, to say the least.
So far so good I guess. I’m a little more than 24 hours in. Everything seems fine, I feel fine. I suppose my biggest fear is infection? That seems to be all the doctor and nurses mention to me.
I’m a smoker and I haven’t totally quit until yesterday. But, if it matters, I’d only smoke 3-6 cigarettes a day….
I read a couple studies and it seemed the ones who quit prior to surgery versus the ones that never quit - Both had essentially the same healing statistics.
Maybe this subject is a nice place to start?
I have no problem answering any questions and have no problem sharing any pictures.
Thanks so much for the time and talk soon.

thebiohacker.com/forums/threads/penis-gr...ker-sponsor.3262544/

By Jeff Lewis, President, RP Therapies.

It finally happened. Penis growth has been automated. It had to happen eventually. There are too many techniques that seem to work. Some seem to work almost always, while some seem to work almost never.

The physiology of penile growth is not a mystery. It requires tension in the right place. And the right type of tension. Then healing takes place which adds tissue. If this can be repeated day after day, the growth men are looking for can become reality. Repeat over and over until the penis of your dreams is right there between your legs.

If it was that easy to do, we’d all be sporting the penis of our dreams. And we’d have had it years ago. We know it’s not that easy. In fact, it’s very difficult. But that is going to change.

It’s a new day. Four years ago, I invented a new process. The motivation was for automating the rehabilitation of my penis after prostate cancer surgery. It was a situation where money was no object and any technology needed was made available, along with a wide range of scientific and engineering input. The cost is now in the millions of dollars. That’s just what it takes to do something this difficult.

While the focus was originally on restoring lost length, the process took my original penis size from 5.5 inches BPEL to over 8.3 inches stretched length (7.3-inch BPEL) in less than five months. You read that right. I had a streak of gaining an eighth of an inch per week for 14 weeks straight. Not being familiar with PE, I had no idea how amazing that was at the time.

How solid is the proof? One part of automation today is precise measurement. Exactly how much larger is a penis today than yesterday? To answer that question, proximity sensors are used to measure penis length down to one hundredth of an inch. That technology alone took months to make work with something as uncooperative as a penis. But it works. With that level of precision, the tiny amounts of growth can be documented. I read about men who quit their PE efforts when they could not see any progress and they decided it was not working.

Starting in 2022 we began trials with other men. All were adding over an inch in less than two months. The data is collected to our cloud servers real-time. One of our Progress Reports is shown below.

So how do I get started? At the moment, you can’t. We’d love to start you tomorrow, but this is very new. It’s not ready for the mass market. Availability is limited to a handful of men each month. We do not have the client capacity for a mass market. Each client is a project to us. We only support our clients through clinics who have been trained by us. This is not mail-order. It would be nice if we didn't need an active connection with our clients, but what we do is too involved to have our clients do it on their own. Even with a partner clinic we still get involved.

What’s the catch? We are in the Penuma price range, or above. It’s expensive to do what we do.

Between hardware costs, manufacturing, management, training, licensing, the creation of a set of upsizing penis chambers, clinicians, supplies, and everything else, this will probably be the most expensive option. That includes surgery and fillers.

All of the clinical time, technology, management, and logistics are never going to be cheap. In fact, the cost of the parts alone has increased over $2200 in the last two years. The pump that meets our requirements is priced over $300. This is a very technical machine. Vacuum transmitters are $150 each with 0.75% accuracy, and for safety reasons we run a backup and compare the two.

It's not a ship-and-forget service. It’s not the next penis pump in a box.

You can think of us as the male version of the mommy makeover. I don't believe many women think they can buy that flat tummy and those high, round breasts without writing a substantial check. Amazon doesn’t sell a complete do-it-yourself mommy-makeover for $399.

So how does it work? The process itself is classic tissue growth. Stimulate and induce. Which is not to say it's either easy or fast. Our goal is an increase of 0.02 inches per day. And if we weren't digitally capturing the data precisely, we'd never know how long our clients’ penises are. And we'd have no way of knowing when something needed to be adjusted. That’s all I’m willing to share about how it works.

How well does it work? This is a chart on my monitor right now. Measurements go up and down, but the trend is clear. The periodic drops occurred when we moved him to a larger penis chamber which causes a temporary setback in length and some irregular lengths as the penis conforms to the new contour.

Progress Report.png

As mentioned earlier, we capture length electronically. Among everything else we do, that is a game changer. We are measuring organic tissue, so the measurements change with physiological conditions such as temperature, hydration, and muscular tension. Our setup directs leg separation because rotation of the hip joint can cause BPEL to move about a tenth of an inch. I haven't seen anyone else discuss this as a variable to remove in determining BPEL.

What about girth? We often add proportionately more girth than length. By progressing our clients through a series of increasingly larger contouring penis chambers, we increase girth. Most clients add between 0.8 inches and 1.2 inches of girth. We use a separate process for increasing girth which happens simultaneously with increasing length. Excess girth is the number one reason men have stopped therapy early; their partners say enough is enough. Enormous girth sounds good at first, and maybe men read about it on Reddit, but beyond a certain fit snugness during intercourse, it can go from pleasure to pain for your partner. Our most popular girth is 5.5 to 5.8 inches. 6.6 inches is common. We don’t judge.

What if it doesn’t work? One day a client will come to us with a penis made of iron and we will be unable to make much progress. It's only fair that we refund the portion of their money that we didn't deliver in penis growth. Let's find a plastic surgeon willing to make that commitment. I’ve been in business for decades. You back up what you are selling.

How much work is this? It is a daily commitment of 30 minutes at home. That sounds like a lot until it is compared to the other options outside of injections and surgery. The protocol is twice a day for 90 days. The good part is that each session is less than 15 minutes. Enjoy your coffee. Have a whiskey. It’s over before you know it. 90 days seems like a long time, but clients who started 90 days ago are concluding their therapy right now.

Another thing we do that is out of the reach of most therapies is that we track compliance. How many times has someone complained they didn't get anything out of something like dieting, all the while you are wondering if they put anything into it. I'll skip the explanation, but this is our compliance report. And yes, it's always up to the minute.
Compliance Report.png

We use this as the basis of our guarantee. Clients must have at least a “D” grade the first week, and a “C” grade thereafter, showing their adherence to the plan. We ask for two sessions per day but understand that's not always possible. They can miss three sessions in a week and still get a "C" grade.

I’ll add intensity to my manual methods and do just as good. The last thing I want to point out, lest someone try a brute force method to attain our results, is how gentle the process is. We gently stretch the penis before beginning, then carefully stretch for about 10 minutes. The chart below is a typical length progression during a session. The therapy period goes from point 1 through point 40. From about point 5 until the end we see an extremely slow progression. There is no jerking or yanking. We just slowly soften the resistance to get a little bit of gain, then stop the session.

For safety reasons, we enforce a 7-hour break between starting sessions. We don’t let anyone try to rush the process. Growth is tissue growth. That takes time.
Cycle Report.png

When will this be available? Except for a few hundred men, it’s going to take some time.

First, it’s not going to be available other than through clinics. The process is not simple. We are talking with additional clinics but it’s a commitment on their part to add this as a line of business.

Second, we are a startup with a very unique product. My goal is to take care of 3000 men per year. Yes, that's less than a drop in the bucket, but we have to start somewhere.

I don’t care – I want it now. Get in touch with us if you want it now. I can’t promise anything because of our limited number of partnering clinics. Our goal is not to frustrate our clients.

Cost is always relative to desire. I wrote the check for a mommy makeover and love the result every day of my life. If I still had my original penis size, I would write the check for this and love that result every day of my life. Our clients love their results every day of their lives now.

What does this change? Not much in the near term. We will not upset the market or hurt any of the current vendors with our small number of clients. For example, we will probably have many BathMate clients, but they already bought and tried BathMate before they got our service. I probably would have. Big Al’s visited, seen it in action, and consulted for us so he’s got the inside track with us, and has more perspective on how this might change PE. I recommend you hire him whatever method you pursue.

We are not going to challenge any of the conventional PE wisdom, even with data to the contrary. I’ve floated some contrary data and not found any interests with some of the gurus, blogs, and Reddit subgroups. There is a saying that the plural of anecdote is not data. I’ve never known that to be truer than with PE where enough anecdotes somehow become data.

What’s next?
We have worked with one penis containing filler.
After the filler was dissolved the results were amazing.
We are holding off on doing more of that work.
We have not worked with a penis in the four-inch range, so that’s coming.
We have not worked with a micro-penis, so that’s coming.
We have not worked with a penis prior to prosthetic surgery, so that’s coming.
Imagine committing to spending the rest of your life with a prosthetic five-inch erection.
Now imagine delaying the surgery to have a seven-inch erection for the rest of your life.
We have not worked with a Peyronie’s penis.
Our stretching and contouring process could be what they need.
It could add to a multimodal therapy.
We do not require a fulcrum to strain the tissue.
We have not studied the curvature of our clients’ penises prior and post therapy.
We have been told that our process did correct some curvature.
A proper study is needed to say anything definitive.
We are not looking for additional trial clients.

We are looking for additional clinics as clinical partners. Specifically, clinics already in the “penis” business. If that’s you then reach out.

We might partner with the right company who has a large footprint in the male enhancement business. If they are providing filler, then we might be a fit for their handful of walk-ins who are either not ready for injections or decide they are willing to pay our premium to get natural tissue growth for both length and girth.

In summary: We can grow your penis with your own tissue over 90 days without surgery or fillers. We increase flaccid and erect length without surgery or fillers.

I am retired from the medical software industry. Most of us have backgrounds in hospitals and medical clinics, medical software, and medical analysis. PE is new to us. We are finding our way.

I couldn't agree with you more! They told me they guarantee and inch of length and girth IF their guidelines are used. An inch of girth is a huge gain in 90 days. And I wonder if guys that had work done previously is a candidate? Would penuma clients try to use this device and cause some injuries?

I'm terribly sorry to hear about your ordeal. If you can, you should also post your experience on the Penuma subreddit (although it will likely be removed by one of Elist's sycophants, but if a view can read it, you'll have helped that many more people).

If length loss was not disclosed in any paperwork or consultation as a potential complication (which would be strange by now since it happens almost inevitably with every removal, varying in degrees of loss depending on how the scar tissue forms), you may have a legal case against him. Also, despite what I perceive is the ineptitude (or corruption) of the Board of Medicine in California for slapping his wrists with every complaint, you may still want to write one anyways.

Lastly, there is reason to believe you may able to achieve some semblance of normalcy over the next few years. You see, some of that scar tissue might be something a Surgeon can work with, and combining that with a committed long-term stretching/traction regimen may get you back to a size modest enough to let you stand as you urinate, and even venture the dating scene even. There are a few Doctors I'd recommend looking into: Dr. Carney (Atlanta, GA), Dr. Gelman (Southern California), Dr. Alter (Southern California), Dr. Solomon (Southern California), and also a Dr. Brant (Brandt sp?) but I'm not sure where he's located, just heard about him through the penumaproblems subreddit (another good resource for your situation).

If you use PhalloBoards 2.0 SEARCH feature, you'll find a lot of stories similar to yours, and many who have discussed protocols (usually prescribed by a Doctor) that has helped them. Of course, I would ultimately follow the directions of your new physician (obviously don't bother with Dr. Elist again), and I would only go with the names I listed above (they all have experience with Penuma removal, you need someone with that kind of specialization). I hope that helps and I wish you the best, sincerely.

Davidd00 wrote: Any body have videos b4 and after penuma procedure? Any review pref video or pics and if it’s worth it

Of all the options available, the PhalloBoards doesn't recommend the Penuma (or now rebranded "Himplant") for the purposes of penile augmentation.

There are a plethora of reasons why, including reports dating back over a decade demonstrating its inherent flaw(s). Also, if you go to the front page ( PhalloBoards.com ) and scroll down to the Trending Articles Section, give the New Yorker & Business Insider articles a good read.

Any body have videos b4 and after penuma procedure? Any review pref video or pics and if it’s worth it

Hobby19cm wrote: @Skeptical_One

Yes, I had the penuma implant inserted. Now I wish I have not opted for that option. I am starting a stretching regimen to see if I can get my length back. I'll try that for a couple of months if not I'll probably go see Dr. Liu in San Francisco. Thanks for your reply.

I'm sorry to hear that. Still unsure how he manages to perform these procedures in light of not one, but TWO major publications (Insider Magazine and the New Yorker) regarding the ills of that device, not to mention over a decade of some of the worst horror stories spanning over a decade+ on multiple penis enlargement (PE) sites, including the PhalloBoards.

Regardless, I would not trust Dr. Elist remedying any issue as he has demonstrated time and time again his lack of ethics. Dr. Victor Liu is a good Surgeon (leaps above Elist in every regard), and the stretching regimen is a good idea, since implant removal tends to leave scar tissue that sometimes retracts length (but CAN be regained).

Good luck.

@Skeptical_One

Yes, I had the penuma implant inserted. Now I wish I have not opted for that option. I am starting a stretching regimen to see if I can get my length back. I'll try that for a couple of months if not I'll probably go see Dr. Liu in San Francisco. Thanks for your reply.

Hobby19cm wrote: Does anyone here has developed scar tissue after getting an implant? Consequently making your penis shorter. I am looking for a Doctor that can help me with treating the scar tissue. Does anyone know of someone that can help me?

What kind of implant? Was this the Penuma (or "Himplant"), or something designed solely for erectile dysfunction (like those inflatable implants)?

It isn't unheard of to have scar tissue restrict total elongation of your original length when it comes to surgically inserted implants, it's just a risk inherent in these procedures. Implantation of a large foreign body is going to be invasive and potentially create a cascade of stressors that could lead to complications. The reason why these complications are tolerated by both Doctors and Patients alike is when it involves men dealing with severe Erectile Dysfunction (ED) to the extent that having an erection outweighs the possibility of some length loss, infection, etc.

Please tell us more about it, my gut feeling would be to have your Performing Physician offer you what he can do to remedy the problem (there is a chance only so much can be done on his end, and you may need to look into stretching devices guys use for lengthening). Then get a 2nd opinion, my recommendation for a situation like yours would be Dr. Carney of Rejuvall, a Reconstructive Urologist Surgeon with a history of treating penile injury/trauma, buried penis, Peyronie's Disease, and performing penis enlargement.

Bigmster wrote: Hi,
I am wondering whether previous HA filler is a contraindication for surgical enhancement, like Alloderm?

Completely at the discretion of the Surgeon. *Note* - the term Surgimend found below is basically like Alloderm, and I believe Alloderm is what they are primarily using now.


Bay Area Penis Enlargement (Dr. Victor Liu) says the following in his FAQ:
(Q5.) If I had other treatments for penile enlargement (fat injections, Penuma, Surgimend, etc.) and am not happy with it, can I have still get filler injections?

Dr. Liu's Answer:
Generally, filler injection after a person had surgical insertion of Penuma or Surgimend for penis augmentation is safe and do-able. However, it is not advisable to do surgical insertion after the person had filler injection because of the adhesions resulting from the surgery making it very difficult and even unsafe to perform. One of the problem with Penuma is that it is firm and sometimes it is palpable on the skin surface and does not look natural. One way to treat this would be with filler injection.
Some patients had fat injection for Girth enlargement and complain that the penis feels too soft and look uneven. This is a common problem with fat injection because some of the fat may be absorbed unevenly and of-course fat feels soft. This can be improved by injecting filler intradermally (inside the skin) to give a "shell" and also inject sub-dermally (underneath the skin) to even out.
It is best to see and be examined by the treating surgeon before a final decision on what is best for you.


Dr. Solomon says the following in his FAQ:
(11c) Is it possible to undergo surgical augmentation (e.g. Surgimend, and/or lengthening) even if prior work has been performed on the penis, namely dermal fillers?

Dr. Solomon's Answer:
It is possible to perform grafting after prior procedures have been performed. However, the risk of complications is increased after prior procedures. Prior procedures, both surgical and non-surgical (such as fillers or fat grafts) will disrupt normal blood supply to the skin and make healing more challenging for the patient, with increased risks of wound breakdown and infection, among other things.


The only two I'd recommend consulting with on this specificity of your question.

Good luck.

The following questions are in bold followed with answers authored by Dr. Sullivan:


How much girth/circumference can you achieve with girth
enhancement injections?

Basics:
The average flaccid girth: 3.5 to 4 inches and erect 5 inches. Most men are
looking to gain 1-1.5 inches.

Results:
A single session typically involves the injection of 5 to 15 syringes. Best results
for most patients come after 15 to 30 syringes over 1 to 4 sessions. After each
session, you can expect an increase in girth ranging from 1/4 to 1/2 inch. After
several sessions, total enhancement ranges from 3/4 to 1.5 inches. Some patients
may wish for more than 1.5 inches but be aware that as the girth increases the
naturalness of the look decreases.


How Many Sessions can a patient expect to achieve ideal results?

Most patients have great results after just one session, but 2 to 3 sessions may
be required depending on your goals. Some patients, thrilled with their initial
enhancement, opt for additional treatments. Spreading treatment over multiple
sessions allows for more fine tuning of the symmetry. It is important to avoid
over-filling during a single session. Stacking enhancements across multiple
sessions seems to produce the best results. Fifteen to thirty cc or syringes is
usually the optimal number for significant girth enhancement for the average-
sized penis. Remember your starting point matters. A man starting with a girth of
3 inches and achieving an increase of 1.5 inches has a 50% enhancement, if you
start with 5 inches and gain 1.5 inches there is a 30% improvement.


How long can filler injections take and what kind of anesthesia is used?

Typically, the procedure is completed within 30 minutes. The initial visit may be
an hour. This extra time is essential for completing patient intake paperwork and
conducting a comprehensive consultation.

I use a combination of topical numbing and a dorsal penis block. The dorsal penis
block involves administering a local anesthetic to the base of the penis, rendering
the entire penis numb. Patients experience almost no discomfort during the
procedure.


Can girth injections affect the function or sensitivity of the penis? What
complications are there to consider?

This is an important question. Most patients report either unchanged or
enhanced sensitivity with girth enhancement. Where does the enhanced
sensitivity come from? I believe some of it is from being more confident. So much
of sexual pleasure is mental, and feeling good about yourself is key to good sex.
Importantly with increased girth there is increased friction thus improved
sensation for you and your partner.

Potential Risks and Side Effects:
Bruising/Swelling - It is common to experience bruising and swelling post-
procedure. This may last for 1-2 weeks.

Discomfort - When the anesthesia wears off, there may be mild discomfort. This is
treated with over-the-counter anti-inflammatory medication.

Infection - Infections are rare, but as we are breaking the skin barrier and
introducing a foreign substance it is a potential risk.

Lumps/Unevenness – There may be lumps or unevenness especially in the first
few weeks. This usually resolves on its own. If it does not HA fillers can be
corrected using a small amount of hyaluronidase. Occasionally unevenness may
require an additional syringe or two. Some men have natural folds in their penis
due to how it is positioned in their underwear. This can cause the filler to kink or
crease. To mitigate this, we use dressings in the first week, but despite our best-
efforts creases can still form, necessitating a touch-up.

Delayed-onset Nodules - Delayed-onset nodules have been associated with both
PMMA and HA fillers. With HA fillers, these nodules can be dissolved entirely, but
PMMA nodules may prove more difficult.

Vascular Necrosis – This is where the filler is inadvertently injected into a blood
vessel. Although most affected individuals make a full recovery without lasting
scars it is an important possible serios complication. Girth enlargement is a
medical procedure and all procedures have possible serious complications.


How does a newly girth enhanced penis feel?

Great! It’s like driving a new car. The enhanced girth offers a sensation that is
amplified for many men. There's a subtle difference in how the penis feels
compared to before, but it remains discreet, detectable mostly only to yourself.
The injected area might be marginally softer, usually if larger volumes are used.
Usually, partners don’t notice a change in firmness; they do notice the change in
girth.

Consider many intimate toys have trended towards a softer exterior, for
enhanced comfort, a little bit of softness may be more comfortable for partners.
Also consider, the penis doesn't just gain in volume but also in weight, giving a
more noticeable hang when naked and in clothes. Most men really enjoy this
heavier feel and get a great boost in self-confidence.


How long can you wait before resuming intimacy or strenuous activity?

To prevent infections, it's advised that patients wait between 5 to 7 days after the
procedure before engaging in sexual activities. This period allows for adequate
healing and reduces potential complications. After 7 to 10 days sex and
masturbation are okay and might even assist in reducing any post-procedure
lumps. Physical activities such as the gym can be resumed after 3 days, but
caution should be taken to avoid any pressure to the penis.


Can you gain length from girth injections?

Unfortunately, no. However, there is the feeling that it is longer because the
increased weight of the penis makes it “hang” more. Girth injections increase the
thickness of the penis, not its length.


Question of Filler Migration?

After the filler is injected, a compression sleeve is provided to ensure the penis
remains extended. However, since the penis is not a static organ and can change
shape during various activities, some filler movement is normal. For the first 2-4
weeks post-procedure, any uneven distribution of the filler can be adjusted
through gentle massages. After a few weeks and after couple months, the filler
integrates substantially with the tissue, making migration very rare. One
advantage of using Hyaluronic Acid filler over other treatments like PMMA or fat
transfers is its adjustability. If any irregularities occur, Hyaluronidase can be
injected to dissolve the undesired filler areas, and additional filler can be added if
needed.

Although PMMA fillers, like Bellafill have the potential to move, following
aftercare guidelines can significantly reduce this risk. Abstaining from sexual
activities for a minimum of one week, using the provided dressing and avoiding
kinking greatly reduce this risk. As PMMA becomes part of the tissue and collagen
production, migration becomes highly unlikely.


Granulomas:

Granulomas are inflammatory reactions by the body to foreign materials. They
can occur when certain substances, like silicone, are injected into the skin. While
PMMA injections can cause granulomas, they are rare. If they do occur, they can
be treated, though they might not fully disappear. The chances of getting
granulomas are extremely low with HA dermal fillers. If granulomas do form from
HA, they can be easily managed hyaluronidase, which dissolves the filler if
required.


What to expect on the Procedure Day?

Before the Procedure:
- I will examine you and we will discuss your goals. Once we decide on the both
the filler to be used and the amount I will perform a dorsal penile block to make
sure you are numb for the procedure.

During the Procedure:
- I will carry out a series of dermal filler injections. The total volume injected will
range from 5 to 15 syringes on average (although some men may do more), based
on your individual anatomy.

After the Procedure:
- A dressing will be applied to the injection area, which you'll need to wear
continuously for the first 5-7 days. During this time, avoid sexual activities. We
will guide you on dressing care and provide the necessary supplies for a smooth
recovery at home.

Follow-Up:
- A follow-up appointment will be scheduled for you three to four weeks after the
procedure.
 

Blunt-Tip Cannula vs Needle?

Both the Blunt-Tip Cannula and Needle methods have their own advantages.
However, I prefer using the needle technique. The reason for this preference is
that I believe the needle provides more control and allows for precise fine-tuning
during the procedure. Additionally, by employing a nerve block during the
process, the procedure becomes extremely comfortable for the patient, reducing
any potential discomfort.


What makes a good candidate?

The best candidates are circumcised individuals without pre-existing scar tissue,
primarily interested in girth enhancement, and have realistic expectations about
the results.

While both circumcised and uncircumcised men can undergo the procedure,
those who are uncircumcised might need follow-up touch-ups.
 

Use of Platelet Rich Plasma (PRP) to Aid Gains?

While I perform this procedure for aesthetic purposes this will not increase girth.
If your goal is girth, you are better off investing in a filler procedure. If the
question is where to spend your money PRP or filler, filler wins every time.


 Best Circumcision for Girth Enhancement (Filler)

You do not need to be circumcised. We treat both circumcised and uncircumcised
patients. Male Enhancement injections can be performed regardless of
circumcision status. Patients need to understand that if uncircumcised they may
require a touch up and if they are looking for larger girth enhancement, they
would benefit from a go-slow multiple treatment approach.


Preference of filler and/or brand?

Juvéderm Voluma XC and Juvéderm Volux XC are the longest lasting HA fillers in
the U.S. They also have a firm feel. HA’s are safe and have been around for
decades. The results are very consistent and predictable. I also use Defyne, Lyft
and RHA-4 however Juvéderm Voluma XC and Juvéderm Volux XC are my
preferred fillers.

If a patient is looking for a more long-term option especially if they have already
had HA filers. I choose to use the bio-stimulatory dermal filler Bellafill. Bellafill
provides immediate, long-lasting results and can last 5 years or more.


Can Filler cause ED?

No, not routinely. However as with any medical procedure extremely rare
complications can occur. The likelihood of the girth enhancement causing ED is
extremely rare. This is because we do not enter the corpora cavernosum which
holds the blood for the erection, nor do we inject anywhere near the nerve
bundles that affect the erection.


Can girth enhancement injections be performed on a penis that uses an
inflatable implant?

In most cases yes. Rarely, it would not be possible. For example, if an implant was
inserted and there were complications such as infection or scar tissue then girth
enhancement with filler might not be optimal.

Why are silicone injections regarded as the least safe option as a girth
filler?

Even when medical-grade silicone is used and even with the correct technique
(the microdroplet technique) its use is complication prone. The mechanism by
which liquid silicone works involves the formation of foreign body granulomas,
which can lead to firm nodules. These nodules may not only be challenging to
remove but can also erode the skin, resulting in ulcerations. This complication can
occur immediately or years later. It is unpredictable. I have seen this complication
many, many times and for this reason I do not use silicone. It is also very
important to consider that many providers using “silicone” are not even using
medical grade silicone. There are so many safer options that are very long lasting
so why take a chance?


Are there any solutions for glans enlargement?

Hyaluronic Acid (HA) fillers like Vollure can safely be used to increase the size of
the glans (head) of the penis. I take a go-slow approach here only injecting a
limited volume at one session. I keep the number of syringes injected here to a
minimum (I only inject a maximum of 2 mL of HA) and ask the patient to come
back to add more product later. Although I know it is said that the results are not
long-lasting due to the vascularity of the glands, I do not necessarily believe this is
true. Consider the lips another very vascular area, filler typically lasts 1.5 years
here if the correct filler is used. Filler may not last as long in the glands as the
shaft, but it is certainly long lasting.


Can you describe your experience with cosmetic medicine and the
importance of injection technique? How does this benefit girth
enhancement?

Injection technique is extremely important. I have been using dermal fillers since
they first became available in the U.S. two decades ago. I have used all filler types
including hyaluronic acid (HA), PMMA (Bellafill), calcium hydroxylapatite
(Radiesse), poly-lactic acid (Sculptra) and silicone. I have injected almost every
anatomical location including the face, lips, hands, neck, chest and of course the
penis. I have used both needles and cannulas. This experience allows me to safely
inject for girth enhancement.


Do girth dermal filler injections adversely impact blood pressure or
increase risks of hypertension?

No.


If I had other treatments for penile enlargement (fat injections,
Penuma, Surgimend, etc.) and am not happy with it, can I have still get
filler injections?

Yes. Filler injection after a person has had surgical insertion of devices such as
Penuma is safe and do-able. It can even be used to correct problems with the
device. If the device is visible or palpable, its appearance can be improved with
filler injections. Unevenness after fat injections can also be improved by injecting
filler.



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