TOPIC: My fight against nodules

Thanks for sharing. I’ve actually read this article before. I am quite certain my lumps are nodules as they are rubbery and move under the skin. However, I think the larger lump may be a granuloma. I had a hybrid mix of HA and PLLA injected. The HA is cheap and made my penis look and feel waterlogged. The mixture wasn’t distributed evenly and resulted in uneven collagen growth and lumps. I had the HA dissolved last year, and that’s when I noticed the unevenness. I can’t wait to have this garbage removed.

I'm so sorry you're having to deal with all that. We did just update the article a couple of days ago, though not drastically, but you may want to take a look at it again to see if there's maybe some new information in there that could be of further help.

Rejuvall wrote:

Thanks for sharing. I’ve actually read this article before. I am quite certain my lumps are nodules as they are rubbery and move under the skin. However, I think the larger lump may be a granuloma. I had a hybrid mix of HA and PLLA injected. The HA is cheap and made my penis look and feel waterlogged. The mixture wasn’t distributed evenly and resulted in uneven collagen growth and lumps. I had the HA dissolved last year, and that’s when I noticed the unevenness. I can’t wait to have this garbage removed.

I'm so sorry you're having to deal with all that. We did just update the article a couple of days ago, though not drastically, but you may want to take a look at it again to see if there's maybe some new information in there that could be of further help.

Sorry, I didn’t mean for my previous message to come off so blunt. I did re-read the article when you sent it and found it extremely helpful. I wish I was based in the US. I feel like my options here in the UK are limited. Everyone is advertising penis enlargement but hardly anyone knows how to deal with the complications. I feel like a guinea pig at the minute.

Sorry, I didn’t mean for my previous message to come off so blunt. I did re-read the article when you sent it and found it extremely helpful. I wish I was based in the US. I feel like my options here in the UK are limited. Everyone is advertising penis enlargement but hardly anyone knows how to deal with the complications. I feel like a guinea pig at the minute.

No worries, I didn't read it that way. I'm so sorry you feel like you're flying blind right now. Unfortunately and honestly, it's not much better here in the US when it comes to the number of physicians with the knowledge and training to safely and effectively correct these problems. In fact, Dr. Carney is one of 4 doctors with the designation of board-certified Urologist/reconstructive surgeon/pharmacist. We're hoping that as cosmetic Urology becomes even more popular, the safety and working knowledge of these types of procedures also becomes more common. As it stands right now, as I'm sure you can attest, the field of medical Male Enhancement is a bit of a "Wild West" situation. We're doing everything in our power to change that and to help men navigate to SAFE, proven methods and injectors.

HI,
I’m sorry you’re dealing with this. At some point, it is important that you are evaluated by a medical Dermatologist, not a spa provider.

Based on your description, this most likely represents a foreign body granuloma. While I cannot be 100% certain without examining you, this is a condition that dermatologists manage routinely. Foreign body granulomas can result from fillers, injected substances (including non-medical products), or even standard injectable medications. Any Dermatologist will have extensive experience treating these.

I recognize your concern that some dermatologists may feel uncomfortable because the issue involves the penis and filler injection. However, dermatologists treat filler complications routinely and evaluate and treat genital skin on a daily basis. Penile lesions are a common part of medical Dermatology, and most experienced dermatologists are entirely comfortable managing them.

Although some urologists may have experience with foreign body granulomas (like Dr. Carney), many focus more on surgical issues such as the prostate or penile implants or other medical aspects of Urology. In practice, dermatologists often have greater hands-on experience managing inflammatory skin reactions to fillers and foreign body reactions.

I am confident there are qualified specialists in your area who can help you. Unfortunately, it appears you may not have connected with the right provider yet. I know referral to a specialist may be more difficult where you are but don't give up. It you message me your location I can ask a physician group you are in to see if any one knows someone that might be able to help near you.

Dr. S

@Dr_Sullivan , while I agree that Dermatologists are going to see the highest frequency of granulomas stemming from the use of dermal fillers (and are more likely to distinguish between nodules and granulomas when compared to other medical specialties), I believe there are rare exceptions in other fields -- such as Dr. Carney of @Rejuvall , whom you graciously alluded to. That is to say yes, those practicing Urology are generally going to be focused on the functionality & health of male reproductive organs and the urinary tract, however there are a handful of Urologists that are well-acquainted with penis enlargement (as an elective enhancement) and by extension (no pun intended) being well-versed in treatments involving both nodules and granulomas. Dr. Carney is among those few, especially given his background in Reconstructive Urology and his work in injecting a multitude of filler types over many years.

This is why I'd contend that not even all Dermatologists are created equal in the assessment of nodules vs. granulomas (some are quick to assume it's the latter, often involving unnecessary protocols when a punch excision could have done the trick). It's really down to phalloplastic specialists, a breed so rare the vast majority of quality, experienced, and ethical Providers also happen to be Sponsors of this site (such as yourself Dr. Sullivan, a top-tier Provider in every respect); in fact, the number of non-Sponsors that I could comfortably recommend that have an informed background, and can provide responsible & adequate care of phallic-related injectable complications, are in the single-digits (I should point out that there may be more I'm simply unaware of at present time, and the Sponsors here can be trusted to point you in the right direction if logistics are an issue, but personally I'm a stickler for only recommending only those who are very much "in-the-know" with respect to this area of phalloplastic expertise)... and that isn't a plug for my or anyone else's sake, it's the truth. For those who don't know, you'd be surprised how often a visit to your Family Doctor will leave them scratching their heads when you explain what you've got going on in your penis, and they'll be even less sure about the appropriate treatment route if what you're experiencing warranted a Doctor's visit in the first place.

As for Med Spas, those who have expanded their services to (keyword) specialize in injectable phalloplasty and have done so for years are not too far removed from having essentially developed a level of experience comparable to structured postgraduate training in this area (not that medical residency exists for male phalloplasty as far as I know, much less any standardized textbook, or governing association even). That said, it should be noted that Med Spas that are competent, experienced, and ethical in their work may not be the optimal candidates in providing the full suite of treatment options for complications beyond simple aesthetic irregularities (i.e. small nodules and asymmetries) -- that is to say, a good Med Spa can fix cosmetic problems, but anything that may require a more rigorous or invasive approach will be better off in the hands of a Dermatologist, Urologist, or Plastic Surgeon, depending on the nature and severity of the complication(s). This assumes of course that the Physician within the aforementioned medical disciplines possess the requisite background & experience in having treated more aggressive complications stemming from dermal filler injections.

Fortunately, severe complications from the proper injection of FDA-approved dermal fillers (used off-label) in conjunction with the proper pre-op & post-op protocols by a reputable specialist are exceedingly uncommon all things considered -- and with respect to this topic's theme (so as not to get side-tracked): never jump to conclusions about any lumps or bumps! Find a qualified Provider (as I've described above) to properly diagnose the matter before making any hasty decisions. A great article previously linked by Rejuvall (found here https://www.rejuvall.com/penile-filler-granuloma-vs-nodule ) is a great starting point, but a successful resolution can only be done in a Clinical or Laboratory setting.

I experienced a number of small nodules over the course of time I had injectables done for girth. None remain today, and were corrected in the same time I was achieving my girth goals (between 2011 and 2015). Since then I have not experienced any complications. For those experiencing anomalies or in need of corrective measures, just know there is good reason for optimism -- effective solutions already exist when care is placed in the hands of appropriately qualified specialists.

I agree, and to be clear, I’m not discounting the experience of Med-Spas. My point is that he does not need someone with experience in Phalloplasty or penile enlargement to address this issue necessarily . What he needs is a clinician with significant experience treating dermal granulomas.

A board-certified Dermatologist is most likely to have seen a wide range of granulomas and to be familiar with multiple treatment options. While many Med-Spas are very experienced with fillers, they may not always have the training or resources to manage more complex complications.

Even in my own practice, when cases are particularly challenging, I recognize the value of referring to someone with deeper experience in that specific problem. I believe his granulomas are very treatable (maybe not 100% fixable), and the clinician most likely to help him is a Dermatologist with expertise in granulomatous conditions of the skin and dermis.

Thank you so much for your thorough reply. I really appreciate it. You’re absolutely right in saying that dermatologists have more hands-on experience when it comes to filler complications. I did visit a Dermatologist on two occasions. The first time, he injected me with saline in hopes to flush the lumps and shrink them. The second time, he injected them with Kenalog. Unfortunately, neither have made much difference at all.

After my previous reply, I found and reached out to a plastic surgeon who specialises in various areas of the body, including the penis. I explained my situation to him and he is confident that he can excise the lumps for me under local anaesthetic. He operates in the same city I live in which is amazing. I will be booking an appointment with him tomorrow so I will keep you posted.

i’m glad you found a plastic surgeon who will work on your penis. The only plastic surgeon in Austin that I was able to find if the Doctor Who injected me and so he’s not really an option. He did offer to do my surgery for free, but I didn’t trust him.
So if anybody knows of a plastic surgeon in Austin Texas, who will work on a penis let me know. In a few weeks, I’ll be doing the skin advancement flap, but may need some work after that from a cosmetic standpoint.

Why are you limiting yourself to Austin? How did that work out for you?

I think I’ve covered it before but cost is a factor and just the logistics of going out of state for a procedure/surgery isn’t practical. And Austin should have some very good plastic surgeons who will tackle penises. The ones I have talked to were Dermatologist or board certified in the field, but don’t work specifically on purposes.

atxguy wrote: i’m glad you found a plastic surgeon who will work on your penis. The only plastic surgeon in Austin that I was able to find if the Doctor Who injected me and so he’s not really an option. He did offer to do my surgery for free, but I didn’t trust him.
So if anybody knows of a plastic surgeon in Austin Texas, who will work on a penis let me know. In a few weeks, I’ll be doing the skin advancement flap, but may need some work after that from a cosmetic standpoint.

Me too! I have an in-person consultation with him in January. After that, it will just be a matter of booking the procedure, which should take place shortly afterwards. I’m not yet sure whether he’ll make an incision and roll back the skin, or excise each lump individually. I’m really ready to put all of this behind me.

The Dermatologist I’ve been seeing is also a registered nurse who specialises in penile filler. He uses a blend of CaHA and HA, which I plan to explore to restore some Girth and even out the shape once my penis has fully recovered from the surgical procedure.

I really hope you’re able to find a surgeon in Austin. There is definitely someone out there who can help you, so don’t lose hope. I spent two years searching for a local plastic surgeon with no success before I finally came across the one I’ll be seeing in January. Hopefully, someone here will be able to put you in touch with the right person. Wishing you the very best of luck with your skin advancement flap procedure, and I hope you see a significant improvement from it.

Hi, I'm uncut and interested in doing Bellafill later this year, but struggling to find enough reports. My glans is typically exposed or at least half way depending, not completely covered like how Phimosis is unless I have shrinkage/severe cold. Was that the same for you? Did your skin become harder to retract and envelope your glans AFTER some treatments or was it always like that? I really rather not get cut. I'm 4.75" Girth (hoping to get to 5" with PE) and shooting to get PMMA up to 6" which will match my frame. Do you think it's possible?

Quick update. Done four of the five layering sessions.
They’ve done nothing. So I’m out about $15,000 since July. It was never guaranteed so I get it but it’s just another frustration that I’m having to deal with.
The pics I’ve attached are from January 2026, most recent and then the July picture of 2025. You can see nothing really has changed. The only two options left are the flap I discussed below or degloving. This is not unacceptable. Look or feel. Some may remember that I got 34 out of 34 rejections looking the same way it did in July so no change so I would expect more rejection. My ego can’t quite take that anymore.

So the next step is to do a skin advancement flap. That will connect the two sides and cover the gap basically. That will happen sometime in February.

Hope the skin advancement flap is successful so you can be done with this nightmare. I’m having my first consultation with the plastic surgeon tomorrow so I will post another update soon.

Me too. Thank you

I realized last week how draining this has been. I’m emotionally exhausted.