TOPIC: Worried in Italy

Hello,

Longtime lurker. Probably been lurking these forums for 10 years. Originally had some filler done by an NP last year which did not go well. No serious complications but the filler was always extremely soft and water like, most of it was placed on top of shaft.

I found a Urologist after waiting 2-3 months for what the NP told me was edema to subside. When I finally saw Dr. Billy Cordon in Miami he knew exactly what it was (filler injected too close to surface/not deep enough) and dissolved it with hyaluronidase. Everything about Dr. Cordon filled me with confidence, from where he works and his credentials (Mt Sinai Miami Beach which is in my opinion the best hospital in the city) to his bedside manner.

After dissolving it I returned to have an enhancement procedure with the doctor and all went well. He uses needles instead of cannulas so there was a bit more bruising that the first time, and pain, but the results were great. I went for my 2nd round some months later as his office had trouble scheduling me (they scheduled me twice and when I got there they said the didn’t have the filler on hand) but again, the procedure itself was a breeze and everything went well. Unfortunately I have a long shaft and needed more filler than I have money for, so when I was taking a trip to Italy I decided to stupidly try my hand abroad as I read a report from a forum member Mato23 here, and DMd another member who did not make a progress report, that they had great results with a doctor Dr. Dario D’Angelo in Naples.

I am two days from having 15ml of Neuavia Intense. The filler was done with cannula and is uneven like the first time I had it with cannula. What worried me though is the bruising, or what I hope is bruising, which has spread a bit around my shaft. And the injection point which was rather large which is a bit red around it. There is a bit of pain and sensitivity around the larger bruised area on the bottom right of the shaft.

Praying to God it is just bruising and not something worse. I sent pictures to another Urologist who said it could be a bad hematoma or ecchymosis. Here are some attached pictures. Currently at emergency room trying to figure out what it is.

What type of filler was used?

HA filler, brand Neuvia Intense. All the times in USA I had Revanesse Versa.

Just saw a (lady) doctor who though concerned said she thought it was probably a hematoma. Crossing my fingers.

Just got done meeting the angriest doctor I have ever seen. After scolding me for some minutes he said he was certain it was a hematoma and that it would go away on its own. His anger strangely assured me.

Hopefully this is the end to this episode. Will keep you all updated.

I've seen worse bruising that turned out just fine, but if you don't typically bruise like this from past injections, than it certainly wouldn't hurt to have it examined.

@melon . Did your prior HA get reabsorbed or were you just adding to it? If it did break down how long did it last?
Thanks and wishing you a speedy recovery.

@melon any updates about this issue?

Just posting an update. All good on the health side of things but the filler was placed superficially and as I had 15cc placed it has been a nightmare to correct. 1.5 years later and a lot of it is still there. Tried to play tennis for a while with adding more filler/dissolving as I got to a point where 80% of my dick was hard but had a huge soft spot on bottom right shaft.

Just had 3 dissolving sessions spaced out over a couple of months. Think it’s time to finally fill it again as where the penis feels “soft and squishy” might just be squishy skin. My fear is that having so much placed/dissolved might have shifted my penile planes and make it very hard or impossible for my provider to inject it is it is firm when erect. Would be nice to get @Phallofill to chime in on this.

Phallofill had a really insightful post about G prime and injection depth. From what I understand HA filler is basically all about injection depth. I’ve twice had filler injected with a cannula and both times the same outcome happened. Obviously idiotic to have put myself through that but I didn’t think I’d have the income to support the endeavor. Thankfully things have changed a bit, hoping it’s not too late to recover and post some positive results. A lot of the previous understanding on this forum of filler and its rigidity seems wrong though.

I will just re-post what Phallofill posted as I think it’s one of the most insightful things I have read on here and I’ve been lurking for a long time, since 2.0.

3. G prime: I see conversations on here about the g prime but I don’t think it’s always understood completely in the situation of penile Girth enhancement versus free floating in the face which it is intended to be used. G prime basically tells about the firmness and elasticity of a product. And I believe penile Girth enhancement patients forget that this is irrelevant when the penis is Erect and they assume a firmer filler with a higher g prime will produce a firmer Erection. This is not the case. Remember our actual erections are from blood. We get a firm, rigid Erection from the pressure of the
blood on the outer layers of fascia. Specially the Dartos fascia which is the outermost layer of fascia. Because of the pressure on this fascia, and the fact that properly administered Dermal Filler is behind the Dartos fascia, ANY filler with ANY g prime is going to be just as rigid and firm behind the Dartos fascia when it’s under the pressure of an Erection. Remember this is assuming it’s injected correctly. If it’s outside the Dartos fascia between dartos and skin, it’s going to be a gelatinous lumpy mess no matter what. It’s never going to be firm in an Erection in this situation. That being said…. The g prime for RH4 is higher. It’s 328 in RH4 compared to 126 in Revanesse Versa. An observation of a thicker product will only be noticed in the Flaccid penis when it isn’t under pressure. I just don’t think the g prime is important in our application.”

Don’t think more hyaluronidase in my case would help, it can dissolve filler but it also makes some spots feel soft/loose/saggy. That is probably residual filler mixed with looser skin. Thankfully a lot has been dissolving on its own as well. The idea is to fill with 24cc (20 units) and see if it’s filled out will provide rigidity to the parts that have been dissolved. Could wait another year to let even more degrade but it’s been a painful 1.5 years already.

I don’t use a cannula. I don’t believe a cannula is necessary or warranted for inflections in the penis. We use cannulas in the face in order to avoid arteries. We don’t have this to avoid in the penis where we inject. PhalloFILL providers only use needles to inject with. A good injector that can feel the layers in the penis as they pass through each, should have no problem finding the space between the two layers is Dartos and buck’s fascia where the filler should be injected.

Thank you replying. I wonder if you can even hit the right layer with cannula. I know Dr. Cordon uses needles and he always hits the right layer. If you go back and read many posts on this and the old 2.0 forum you would see that we all were under the impressions that cannula=good and needles=bad. Before some more recent posts explaining injection depth, filler rigidity, and penile structure there was a lot of misinformation being repeated. We’ve even invented terms along the way, like the “accordion effect”, to explain how superficial filler acts with Foreskin.

In your experience, have you ever dissolved large amounts of filler (15cc+) and refilled? If so, has the patients penile structure changed to the point where you can no longer hit he layer you intend to hit? That is my big fear moving forward, that I have made my injectors job moving forward a lot more difficult or near impossible.

Attached are some pictures showing the current state of my penis. Pictures I think don’t do this procedure justice as it’s hard to tell if a Dick is firm or has squish to it. Most of my penis is firm but there are parts going toward the base that are soft, due to more filler being placed superficially there.

I don’t see the photos.

I have never said this on a post before…. Because I don’t want to discount the way another provider on here injects using a cannula, but my believe is that you cannot inject in the penis with a cannula the way it needs to be injected to be smooth and under the Dartos fascia. I also believe using an injection (bi mix or tri mix) prior to the injection for an Erection makes the layers impossible to get in between to get the Dermal Filler below the Dartos fascia, therefore making it superficial and just below the skin giving the gelatinous feel and accordion appearance.

I have reversed 80 ml of Dermal Filler and replaced it with Dermal Filler in the correct plane and made the patient happy. I do 15-30 ml reversals regularly and inject them correctly. Here are photos of a couple of them. Both of these were originally injected by providers that are known to be reputable.

Thank you for your reply. Your presence on this forum and engagement with its members is highly appreciated. Knowledge is power, and ultimately you are saving a lot of men time (which is irreplaceable) and money in virtue of avoiding to undertake the filling->dissolving->filling tennis match. Discounting how other providers inject is maybe wrong, but discussing technique without mention of provider has to be allowed and welcomed by everybody, provider and patients alike.

Those pictures are inspiring, though I wonder if when the patients are Erect they have firm erections. If you say you’ve been able to hit the skin layer after reversing 80cc then I have my hopes up. 80cc is an absurd amount of filler to reverse. How did you know when it was time to stop dissolving and start filling? I’m guessing after dissolving his Erect penis was still not 100% devoid of filler but rather than filler was reincorporated and smothered out after you injected.

Again, a big thank you for your info on these forums. I know you don’t have time to advise every patient about the intricacies of filling. A super post by you addressing concerns this community has had for years (deubunking the accordion effect, debunking Circumcised vs uncircumcised which I think is really just tied into the accordion effect and a mobile Foreskin, and telling patients what to ask their doctor when they sit down) would be amazing. The Foreskin is very interested in how it slides over the shaft, and obviously injection technique influences how the Foreskin would move.

I wish I had learned from others mistakes but I now hope anyone reading this could learn from mine when choosing their next injector.

Thank you,
Melon

Thank you for your kind words. It’s very nice to hear my comments are helpful to you and others.

I can usually dissolve all of the incorrectly placed Dermal Filler or enough that I choose to stop and begin a correct fill. It has taken me as many as 4 sessions to accomplish that and I’ve used upwards of 30 ml of hyaluronidase over multiple sessions. That’s an expensive reversal. That enzyme is very expensive since also. An experienced provider that understands the difference in how the Dermal Filler feels when it’s in the correct plane will know when the Dermal Filler is removed or reduced enough to proceed.

The erections in the photos I attached are reported to be completely firm as they were prior to injection. This obviously was not the case when the Dermal Filler was too superficial.

Do you think I should keep dissolving until I can basically feel my old penis again and it’s hard? The dissolved parts have somewhat lax skin/soft feel, which I think might go away if refilled with HA. You can notice the HA on top when semi-Erect, when it’s text it’s not so noticeable. How many vials of Hylenex is 30ml? Done spot correction over the last year and a half but not sure how to move forward. I just want a hard penis again, and now some parts are hard some parts are soft. On the right side of shaft as the dip begins the skin is lax and it’s soft, and on the left side it’s a bit soft where hyaluronidase was injected starting maybe 1cm lower than right side going to 1 Inch above the base. The base and 1 Inch above are hard.

Attaching some pictures. Would appreciate some insight. In total I’ve had

10 Revanesse Versa 10/22
Dissolved that 1/22
10 units with PhalloFILL early/23
15 units Italy 9/23
Dissolved twice but not entirely
10 more units with PhalloFILL trying to even things out
3 dissolving sessions from 10/24-now

So it’s been 1.5 years since badly placed 15cc, 2.5 years since I had the 12cc dissolved (most of it dissolved).

I think at this point you and I need to have a verbal conversation. So much to address and I need a little more information I can ask quickly on the phone. Could you send a text message to PhalloFILL. Ask to be assigned to me. William. 972-663-5588.