PhalloBoards - An Online Community to Discuss Penile Girth Enhancement

itgoesthud wrote: I'm now 29 months past HA (volux) and it seems like some of the skin thickness it gave me is going to stick around indefinitely. There are 2 maybe pea sized nuggets left over but the rest is just thicker skin - curious if you think you're going to have the same. I have no intention of getting my HA dissolved, hopefully the PMMA people can work around it if it's still lingering, BUT...
I wonder if you're seeing the same, i.e. any indication you're getting what seems like it will be permanent skin thickening from your HA. I have not seen any doctors mention this, nor people here, and I suspect it's because nobody lets their stuff completely dissolve naturally without going in for a top up, AND, because doctors don't want to promise permanent gains from HA especially if they aren't certain how and why.

Not to get off topic but doesn’t HA induce some collagen production with each round? I realize it’s a very thin layer compared to pmma or Ellanse , but wouldn’t it stand to reason that if you have had multiple rounds of HA, the skin would be left permanently thicker by the collagen that was produced?

Dr_Tsay wrote: srogers

You are correct about the Renuva. Great for top offs or add ons after a fat transfer.
As for HA, I used to use primarily Juvderm Voluma XC in the past because it was one of the highest G prime fillers meaning the firmness and amount of lifting capacity (lifting the skin creating enhanced girth). Since Juvederm Volux came out in early 2023, Ive really enjoyed this more due the an even higher G prime. For example, in the face when Im using Voluma to create a strong jawline in a man, I would typically need 6-8 syringes of product. When Volux came out and is FDA approved for Jawline, I noticed I would need as many syringes for the same effect. So even though the product was more expensive, the patient didnt have to use as many overall to get the same effect in the jawline. Regarding GE procedures, there is also this phenomenon that a small amount of filler creates more "POP" compared to Voluma, although the volumes required to get to a larger size are still about the same overall. Another advantage is that the Volux is less "squishy" compared to other HA products Ive experienced (i.e. Versa, Juvederm Ultra, Restylane L, etc).

I have been patiently waiting on Ellanse to get their FDA approval in the United States. I have heard great things about its utlity in GE procedures anecdotally, but will hold off on using this until they get FDA approved here in the US.

Dr. Tsay

@Dr_Tsay any idea when Ellanse will be approved in the US?

srogers

You are correct about the Renuva. Great for top offs or add ons after a fat transfer.
As for HA, I used to use primarily Juvderm Voluma XC in the past because it was one of the highest G prime fillers meaning the firmness and amount of lifting capacity (lifting the skin creating enhanced girth). Since Juvederm Volux came out in early 2023, Ive really enjoyed this more due the an even higher G prime. For example, in the face when Im using Voluma to create a strong jawline in a man, I would typically need 6-8 syringes of product. When Volux came out and is FDA approved for Jawline, I noticed I would need as many syringes for the same effect. So even though the product was more expensive, the patient didnt have to use as many overall to get the same effect in the jawline. Regarding GE procedures, there is also this phenomenon that a small amount of filler creates more "POP" compared to Voluma, although the volumes required to get to a larger size are still about the same overall. Another advantage is that the Volux is less "squishy" compared to other HA products Ive experienced (i.e. Versa, Juvederm Ultra, Restylane L, etc).

I have been patiently waiting on Ellanse to get their FDA approval in the United States. I have heard great things about its utlity in GE procedures anecdotally, but will hold off on using this until they get FDA approved here in the US.

Dr. Tsay

ou812 wrote: I guess it may depend on the doctor you see but the Phalback owner wasn't recommending this for anyone with filler, for fear of causing migration. Maybe that is less of an issue with PMMA vs HA.

A lot of guys with PMMA pump, so I don't think it should be an issue, and they are probably being extra cautious since it is relatively new and any studies on its use with things like PMMA and Ellanse are likely non-existent. If this is remarkably effective for work, I'm willing to sign a waiver to see if they'll let me try, assuming I can find a tube that can tolerate my base girth lol.

Capo710 wrote: Hey guys I’m looking for recommendations for a good dr to gain some permanent girth in California. I’d love to go to Avanti but my partner can’t leave the country for a while so I’m looking at other options. Thank you

Contact Dr. Tsay (Orange County) , Dr. Luis Lee (Northern California), Dr. Victor Liu (Beverly Hills and Bay Area) , and Dr. Brandeis (Northern California, P-Long Protocol) to consider your options.

Avoid any Clinics that offer penile implants to augment your penis if you are NOT suffering from ED, as well as large volumes of silicone oil filler (i.e. not using micro-droplet technique consisting of volumes of 10 cc's/mL's or less), or really anyone not vetted by the PhalloBoards and/or its Community.

If it's your first-time, you may want to consider more temporary options, especially if you can't travel abroad; Hyaluronic Acid (HA) has a strong safety profile and is offered by the vast majority of (vetted & screened) PhalloBoards Sponsors. Many end up liking it and continue to pursue it, while others may prefer less lifetime maintenance and opt for Ellanse or PMMA. You won't know until you try.

Just be sure you have realistic goals in mind, sufficient funds to accommodate subsequent visits, and a sound state of mind and sound motivations moving forward.

Good luck.

Thank you for this.
I have HA, I got in January this year, can I add Ellanse if I set up and appointment at Avanti?

Ideally, HA should be absorbed or diluted before introducing any additional filler. However, if traces of HA are present in the tissues during the new implantation, Ellanse shouldn't cause an adverse reaction.
DrC @ Avanti Derma

If I have HA injected already, can I get Ellanse?

For example, in the same visit:
1. 50% HA.
2. 50% Linnea

Not mixed, Separate but in the same visit.
I’ve read people have had good results getting them both.
Against not mixed in the same syringes but yes in the same visit, the same procedure .

Hello @Sanchez ,
Are you asking if mixing HA with Linnea in the same treatment is all right, like mixing the products before the injection or injecting one after the other?
There is no medical justification for any of the above.
I'm curious... can you explain the rationale behind such an idea?
Best regards, DrC @ Avanti Derma.

I also have a Titan IPP and am considering AD for PMMA. They've said they make the decision to take patients with inflatable prosthesises after evaluation.

Could you expand on that they evaluated? What made you a candidate?

Has having the IPP made molding the fillers easier vs having to deal with retraction?

I don't get dog ears, so did you leave it mostly inflated during the recovery?

Were you inflated during the injections?

Could you add some before and afters?

Thanks for any info

I posted about it here with some images! overall pretty happy so far hopefully it stays a while.

phalloboards.info/forum/progress-reports...r-experience-uk.html

They DO offer it in their Belgium clinic, so I’m not sure it purely a commercial isssue.

How was your experience with the HA?

I recently had HA in the UK and was hoping to get ellanse done in London. I guess i won't be doing that now. The safety profile of ellanse doesn't seem too bad from what i have read up on. Maybe better profit margins with the HA and subsequent top-ups in comparison to the semi-permanent ellanse.

I'll preface with this. When I finally pulled the trigger back in 2019 to get dermal fillers, in the back of my head I knew my end goal would be something substantial so long as it was safe and functional.

I took a break from PMMA due to logistics, COVID and because I wanted to be a bit patient with watching options develop. All of a sudden, HA practitioners began popping up with pleasing results, rumours of practitioners using other fillers began swirling (such as Ellanse, Scultpra, Radiesse, etc) and I wanted to just wait and see.

In early 2023 I stumbled across two HA practitioners in the greater Toronto area. The consult at one just was not for me. The second seemed more cautious about my PMMA and his bedside manner seemed agreeable to me. I went a couple of times for HA. His approach was a bit rudimentary compared to my prior experience at Avanti. Topical numbing only, small amounts of HA (to be cautious, which I totally agreed with, this is not a knock), product placement always seemed to be in line with the trend some practitioners have of just placing it on top. It gives it a pronounced appearance flaccid but that's about it. Not ideal in my mind. I wasn't overly thrilled with the aesthetics and still wanted more but I was kind of told to wait. Of course nothing changed.

Fast forward several months and I randomly did a Google search, scrolled and found Leonardo Medicine. Never had seen the result before in a search. I checked out his site and did some digging, doctor seemed quite accredited. His results pictures were also excellent. So I finally reached out and he did a virtual consultation. Initially it was for his Hybrid Filler, which is a blend of HA for bulking and Radiesse to promote collagen growth more akin to the sphere based fillers like PMMA and Ellanse but not as permanent. He wanted to wait while he talked to other doctors who have come across PMMA patients and talked to Radiesse's manufacturer to get their input.

We decided to not try Radiesse at the time.

But he was willing to add size and do an aesthetic correction with HA. I was stoked. Lol.

Arrived at the clinic. It's in a building that was once residential it appeared but has been fully renovated. I'd compare his suite to a large two bedroom apartment. There is also a physiotherapy office, some type of medical testing clinic and I think a family practice and his independent office. Clean bright procedure room, secondary room and office, washroom, consultation and waiting area. I honestly love his practice. You feel private and comfortable. For anyone who has seen Avanti's office, similar clean and comfortable space. Parking is easy, highway access is easy.

Anyway. Topical numbing. Then an injected nerve block. Then for most patients an injection to induce an erection (Trimix I think it's called?). This never worked for me so we stopped using it and I had more luck just inducing one without for whatever reason. He prefers to inject erect or at the very least see it erect so he can have erect aesthetics in mind when filling. He uses some type of light that shows veins etc to make it even easier to work with the cannula or other syringes. Whole thing usually takes about an hour and a half from going in until leaving, give or take.

After my first fill, I was very happy with my aesthetics. At no point beyond that was it really to overly correct anything. Most guys would have been very happy at that point honestly.

So full disclosure, I have had quite a bit done. I am extremely happy with it. He can definitely do a very natural looking minor enhancement for those that want it, I've seen many of his results like that and talked to guys here in PM and on Reddit who ended up going and were very happy with half an inch or an inch.

Here's all of my appointments and volumes excluding this week. The attached pics are one comparison from when I first went to him and then prior to my most recent appointment (I was there for a hair treatment study a couple weeks ago and offered for him to take a pic).

August 7, 2023: 10 syringes of Revanesse Ultra (1.2mL for each syringe)
September 18, 2023: 8 syringes Revanesse Ultra
October 10, 2023: 8 syringes Ultra
October 30, 2023: 6 syringes Revanesse Contour
November 28, 2023: 4 syringes Contour
December 18, 2023: 5 syringes Contour
January 19, 2024: 6mL PRP

Not shown in pics below is what I am now, I went in yesterday for:

April 1, 2024: 8 syringes Contour + 6mL PRP

I will update and share more pics if the interest is there.

All summarized, I've been very happy. The addition of the PRP to the filler layer seems to have also helped keep things feeling very nice. I can't really say enough good things.