TOPIC: Voluma or other HA fillers in the circ area - (Dr. Oates?)

Have people had success getting rid of \"the ring\" in this area with HA? Is voluma too thick to go up here? Are any other fillers or techniques (tiny needles?) recommended? Voluma was a pain to inject - I think I used a 22 g cannula even though most people use 27 gague needles. So that tight area is even harder to deal with.

If Dr Oates is reading this, what do you use to get it in there - a needle or microcannula? Does it stay? I\'ve just experienced HA wanting to leave tight areas for more space...not always right away - but eventually. In areas where it has space, it sits just fine. It\'s been 2 years in one spot and barely even changed.

I think there\'s also a clear difference between voluma and ultra plus. Ultra plus is all gone at 2 years. Voluma seems to stay.

Hi,

Sorry not been on for a while. It can be difficult. It is often a bit scarred and stuck down. There is a risk of getting a blob and a low spot next to it. As suggested I do use a slightly thinner HA there. Sometimes the very base of the penis can have a ring where less filler wants to sit.

Restoration wrote: I\'ve seen Morgenstern\'s name mentioned but I haven\'t followed it that closely. He specifically works with post-PMMA patients? I gave up on urologists here because nobody would work on the situation or had any ideas for how to improve things without creating even more complications (the stiches I had from the lump removals kept coming apart and creating more problems).

No, not specifically post-PMMA patients... I\'m just saying that they have very good credentials in Urology, and have been doing PE for a long time, so if you have issues you don\'t need to go to someone else to deal with them.

My doctor here took out PMMA (and skin) in some sections - where it was most prominent, but he left other sections. It isn\'t as uneven as before, but it\'s still odd to have big pieces cut out - next to raised areas.

I\'ve seen Morgenstern\'s name mentioned but I haven\'t followed it that closely. He specifically works with post-PMMA patients? I gave up on urologists here because nobody would work on the situation or had any ideas for how to improve things without creating even more complications (the stiches I had from the lump removals kept coming apart and creating more problems).

HA every few years seemed to be the least invasive and less risky way to go.

Hey Restoration, I\'ve looked over some of your posts, and seen pics and read parts of the problems you\'ve dealt with, but it\'s quite hard to put together a clear picture of where you\'re at and what you\'re trying to accomplish. Did your Urologist remove basically all the PMMA? Are you looking to add any bit of Girth, or just looking to \"smoothe over\" things at this point? If I were in your position I would consider a consult with Morganstern before making any decisions (I\'m assuming you\'re in the US because I saw you talking about Giunta in NY). I say this because they\'ve been doing PE (mostly FFT previously) for a long time, but also have really strong creds in Urology (peyronies, ED which you mention, reconstructions...) and especially given your issues I think that\'s probably the kind background needed?

I\'ve been rather impressed with belotero, though perhaps I should be cautiously optimistic given my history.

But, this is a more liquid-y filler which is known to be very effective in thin-skinned areas like those little \"smokers lines\" above lips. I believe it may be effective in the circ scar area. It is $257 / cc from Merz directly (I\'m sure there are cheaper websites but I prefer to order from my doctor who gets it from the mfr rather than online).

See this:



It can also be easily dissolved with hylenex if it goes lumpy or whatever.

I just spent $3200 to look \"normal\" again. And then I have to go through probable 2-3 sessions of meticulous injections, avoiding and yet covering the nodules - while filling in the voids without making the nodules look bigger. The last session (2 years ago) was nearly 6 hours. Ugh. Am I going to be doing this every 2 years for life.

My Dick didn\'t even look all that spectacular. It just didn\'t look like beef jerky. Part of the issue is the overzealous resection of PMMA and skin by my Urologist. I don\'t know why he went so overboard. Oh not to mention those wounds that wouldn\'t close cost me a lot of skin. It doesn\'t really stretch out. I had a consult about skin expanders but they said they are too prone too infection for my issue. risk/reward wasn\'t there.

M8 had major complications with Silikon1000, check out his thread. It was suggested that Dr C stopped using it, but then some one had a session at Dr C\'s office and they injected it without his knowledge. At least this is my understanding. I guess they really stopped now.
Hope M8 is doing better now.

Dr. C does not offer the Silicon micro droplets any more. Diana (the office lady) tries to make it sound like they dont offer it because no one wants it. I played dumb. i asked several times because i really wanted a little more in my glans, but she said they dont have any and wont do it anymore.

I\'m sorry i\'m out of the loop but...

what are the complications \'Miracle\' had with the silicone?

Thank you.

I am wondering if Belotero might be a good idea for this area since it is supposed to be one of the more \"thin\" fillers, as opposed to Voluma which is rather thick. Belotero doesn\'t last very long in the face, but things seem to last longer in the penis for some reason .

Multiple sessions of very small amounts makes sense. It\'s so damn hard to get in there. The cannula we were using with juvederm ultra started to fail during the process. The filler was coming out of the junction between the syringe and the cannula. It was so frustrating, and I was surprised dermascult cannulas were this \"weak\" at that point. Maybe a needle is a better way to go - especially with hylenex available. Cannulas are so difficult to work with.

I had read a thread here recently that Dr C\'s office is still using Silikon1000? I asked them this question on a different thread but never got an answer.
Can anyone confirm either way?

Restoration wrote: Have people had success getting rid of \"the ring\" in this area with HA? Is voluma too thick to go up here? Are any other fillers or techniques (tiny needles?) recommended? Voluma was a pain to inject - I think I used a 22 g cannula even though most people use 27 gague needles. So that tight area is even harder to deal with.

If Dr Oates is reading this, what do you use to get it in there - a needle or microcannula? Does it stay? I\'ve just experienced HA wanting to leave tight areas for more space...not always right away - but eventually. In areas where it has space, it sits just fine. It\'s been 2 years in one spot and barely even changed.

I think there\'s also a clear difference between voluma and ultra plus. Ultra plus is all gone at 2 years. Voluma seems to stay.

Through anecdotal accounts, it seems the Silikon1000 micro-droplets were highly effective in that (circ/ring) area, but has also come under scrutiny since Miracle\'s complications. I know that it\'s still used legally for facial filling but has been discontinued by Dr. C\'s office (I\'m not aware of any other PE clinic offering it, nor would I recommend it). I almost got it but chose against it because I wasn\'t really all that hung up on my aesthetics.

I managed to somewhat fix the ring appearance through multiple Revision rounds aimed specifically at hitting that area with PMMA. It would clump and be irregular since the skin wasn\'t very compliant but after enough small sessions of breaking up clumps and adding ever-so-small bits of product, it became manageable aesthetically. I should also point out going for a tapered-shaft look helps offset the ring\'s prominence. I suspect the same method can be applied to HA. Maybe Dr. Oates can chime in.

Good luck!

Thanks Dr. Oates. The thinnest is probably belotero (not sure what it is called in your area - it\'s a Merz product). I suppose 1 cc can be conservatively injected and then monitored for a while and if it goes ok, more can be added. The stuff only lasts 8 months in the face.. not sure how it\'ll do in the penis. Voluma is living up to its 2-year promise. Juvederm Ultra plus definitely goes away faster, but it also is known for that too. My only complaint with all these is that it\'s softer and more gel-like than PMMA. PMMA felt more natural and integrated. However, my case is fairly complex since I have both products in there, including hardened PMMA lumps. I wonder if a guy got 12 cc voluma, it might feel a bit more natural than having 4 (or 6?) cc like me - just to smooth out things where the lumps created little canyons and irregularities. I had another 4 cc of ultra plus but that went away pretty fast. (I forgot exactly how much I had by now. I\'d have to go back and see the receipts.)