TOPIC: BBC IPLAYER: The penis extension clinic

jogift wrote: T One person's opinion is not enough to doubt a practitioner ...

I don't really, I was trying to politely say , you're in direct contradiction with somebody who knows what they're talking about.

Does Dr. Gitt in Arizona use a micro cannula when he injects voluma?

The clinic promoting surgery on BBC in the UK is Moorgate, not Androfill.

Doctors performing the Androfill HA procedure (including the Penoplasty surgeon who appears frequently on the BBC), are free to provide surgery to other clinics if they wish to.

No patient has been sold surgery by Androfill to date. The Androfill site aims to dissuade people from taking unnecessary surgery, steering them towards safer and more effective non-surgical options.

Thanks hoddle, that's what I meant by "perfecting the techniques (currently) available" ...

So my questions weren't properly answered I want to you and everyone else that I'm not being unreasonable with my concerns.

The whole point of using HA is for it's safety profile. Its much more expensive and only temporary, yet many of us are prepared to accept that because we want optimal safety.

The risk of arterial embolization with HA is small, but it's still there and everything possible should be done to keep that risk as low as possible. Using a sharp needle for this procedure most definitely doesn't do that and it's very easy to demonstrate this.

Most HA procedures use only one or two injection points. Yet as the Androfill video us, over 40 injections are made. So straightaway that small risk is increased by 30 to 40 times! That's a major reason why a needle shouldn't be used. Everytime it goes in, there is the risk of it entering a vessel. The more injections the more risk, it's as simple as that. So the needle method clearly doesn't optimise safety and the small risk associated with using HA are dramatically higher when injecting the penis.

When using the needle, great care should be taken to reduce risk. Proper technique is key. Here is a video where a well respected British surgeon demonstrates injecting HA with a needle. Please skip to 2.20 and watch from there.:



As you can see, to minimize the risk, when he injects the needle he holds it in place for a while, to check if a vessel hasn't been hit. He then injects slowly. Now compare that with the Androfill video. The difference is night and day. I'm not being unfair here. Anyone can watch the 2 videos and see why the Androfill technique is much riskier as Dr Horn jabs in out very quickly. No caution is taken at all. It's not my opinion, it's there for everyone to see. Androfill posted the video to be critiqued and thus I'll leave it up to thise viewing this thread to decide if it demonstrates a technique of optimal safety.

Then we need to consider the added risk of the dorsal nerve. When I went to Gordon Muir, one of the most respected urologists in the UK, to have some scar tissue released from the skin directly above the dorsal nerve, he refused to try and free it with a needle. This was despite the fact he could lift the skin a good Inch away from the shaft. He simply wouldn't risk sticking a sharp needle in the area, as the risk was too great. On the screen shot from the carverject website, they also clearly highlight that area as somewhere that shouldn't be injected into. When discussing injecting over the dorsal nerve, even with a blunt cannula, Dr Oates said the following:

"Initially I was a little reluctant to inject directly over the dorsal (upper) surface because the dorsal penile artery (nerve and vein) run midline on the dorsum. But once confident that the cannula was not going to pierce deeper through the fascia I am totally happy to do that now."

And that is when using a blunt instrument. Yet in the Androfill video we clearly see Dr Horn jabbing away in the area above the dorsal nerve. IS that really optimizing safety? I can't see how anyone could argue it is.

At the end of the day this isn't a cheap procedure. A 10 ml enhancement costs '3600 and it's only temporary. The only reason guys would even consider paying that kind of money is because they want to ensure the risk they are taking is as minimnal as possible. I'm not being unreasonable here, I think I've demonstrated quite clearly that Androfill aren't doing that. Surely for that kind of money guys should expect the highest standard of care possible, whilst it seems to me that Androfill are focusing more on doing things that easier and quicker for them, rather than optimizing patient safety.

"It really made me wonder what the people on this board are like! It's odd seeing how out of whack some guys priorities are"
Are you referring to the fact that they were already a good size and that all they cared about was being "huge" or having a "monster"
Cos if so I agree, if i had an average Girth I would never of persued Phalloplasty.
Or were you referring to the fact that there partner already seemed happy with their Girth? because if I had a partner who was happy with my penis I wouldn't touch it.
Also it absolutely blows my mind that in 1st world countries like ours their still offering such backwards techniques, by now all these doctors should have switched to PMMA or HA. Their fucking useless, it's unreal that a bunch enthusiasts like us know more about what works than all these urologists who have PhD's.

smalljay wrote: Dexter, if you haven't heard of this long term inflammatory response effect, you need to search the boards for 'FBG' or Foreign Body Granuloma - it is a known (albeit somewhat rare) occurence with PMMA.

That is the one counter argument to the last two sentences of hoddle's post - we haven't seen the long term effects of PMMA in the penis yet. A lot of guys might get bad reactions, but also they might not. From the research so far, it appears that a small percentage (low single digits) might - but if Dr. C's theory that injecting it below the outer fascia results in less/no FBG's is true, then that's a good thing.

We do at least know that fat in the penis long term is a bad idea, ineffective at best, dangerous at worst. imo, PMMA is also not that great, and something better will come along (maybe it's already here, in HA). But that's just my spoiled 2011+ view of things - for people like the old vets here, PMMA was kind of a godsend - never has there been something like it which could give you permanent gains with so few short term drawbacks (assuming things go well during aftercare).

I took a read of the FBG issue, I focussed more on the literature from sites like pub med and so forth.

Interesting for sure but risk wise, we're talking less than 1 in 1000 and of those 1, these seem to be linked to people with existing conditions such as HIV, chronic renal fatigue or similar.

What's also interesting is, in a number of the cases, there's no guarantee that it was even PMMA injected.

I think , it's an issue to certainly aware of but I suspect on the list of things to worry about, of which there are many , it's way lower than other concerns.

Androfill wrote: @hoddle10

Happy to be critiqued. If the criticism is valid, we improve.

Have read back through your posts and you have personally had a rough time of it, I can see where with scepticism comes from - I would be very angry. 'Sometimes criticism is useful, sometimes it is misplaced.

In the case of the micro cannula - you may be a little out of your depth. 'But it is a moot point as we are happy to use a micro cannula.

It might be deduced from your comments that you have never personally injected filler into anyone yourself?'

Have you the training required in the UK for injectables, either a medical doctor, dentist, nurse, or beauty therapist aka aesthetic technician qualified to perform filler injections?

2 surgeons and 2 medical doctors (cosmetic injectors) have discussed, at length, injection technique. 'Yet, you think you know better. '

Our patients have included a dentist and a medical doctor, both of whom were cosmetic injectors, and who felt happy with the approach. ' '

On another subject, it is a little alarming that after all the damage that has been done to your own penis, you seem to almost'promote PMMA to guys.

Androfill could easily set up in some dodgy jurisdiction in Europe and offer PMMA. We never would, I am sure you know the reasons why. 'Yet while promoting, or at least being sanguine about PMMA, you focus in on a minuscule risk that you think you have identified with a safe product like HA.'

You risk doing more damage than good. 'These guys read your advice as if you are qualified to give it. 'They think they might suffer occlusion of the DDV by a penoplasty surgeon using a tiny 27G needle - which is frankly ridiculous. '

If anything you do more damage than good, these chaps read your advice, and instead head off to Moorgate, the Viel Butchers, or any of the other chop-shops in town.

I can understand why the Phalloboards member is exasperated with your pretence at knowledge. He has first hand experience, and a good result. 'From my recollection he did not even have bruising after the procedure.

If he had listened to your opinions, he might by now have been approaching us to have PMMA cut out of his penis. 'We have had 7 enquiries in relation to this, both requesting removal of the PMMA somehow, and asking if their bad results can be improved using HA.

My "pretence at knowledge". Did I pretend that arterial embolization can occur and lead to necrosis or that this risked can be minimised by using a micro cannula? Did I pretend that with a sharp needle one runs the risk in damaging the dorsal nerve and this unnecessary? Did I use photoshop to create the Carveject image and the screen shot of Dr Horn injecting? Do you think I made a video pretending to be a Dr showing how dermal fillers should be injected to optimise safety? Or is that a real Dr just pretending to have some expertise? Am I making it up when I say that with a micro cannula the injector can release the filler in more consistent streams instread of individual blobs?

From my point of view you don't seem prepared to accept reasonable criticism. Every point I've made is more than fair. If you really were committed to improving the service you offer you'd maybe take these points on board. Ultimately Androfill are responsible for their patients and for the money you charge it's not unreasonable for patients to expect you to do everything in your power to ensure their safety. Surely you understand the most attractive part of HA is it's safety profile and therefore patients want to know you are doing everything you possibly can to make it as safe as humanly possible. Can you honestly say you are doing that?

No skirting around the question, hand on which do you think is safer out of a micro cannula and a needle?

What is safer retrograde injection or not?

Do you think in the video posted Dr Horn is taking sufficient time to ensure he hasn't hit a vessel before injecting and if so why. I can show you several other training videos where the instructors all express the importance of that step.

I don't really understand why you'd have a problem with me highlighting any of those issues given the nature of the forum. Maybe should you start a poll asking whether our members find these kind of critiques valuable. As ultimately wouldn't you agree that is far more important that your nose get ting bent out of shape. In fact if you don't address any other point in this post, perhaps you'd do me the courtesy of thinking about that one. Let's be honest here, the forum isn't here to promote Androfill is it? It's here to try and help guys make an as educated decision as possible. So discourse of this nature is entirely necessary isn't it?

Also in 6 years of being on the forum I've only ever advised one person to get PMMA and that was SO. I get asked my opinion on what procedures guys should have a daily basis to put that is perspective.

Also, as for being dodgy, well let's just wait and see shall we!

Reklaw, read the comment I replied for context on the "it works" statement.

Androfill wrote: [Caverject (Erect) is a great idea.
It is interesting to see that men can self-inject Caverject into their penis at home without supervision - with a needle the same size as Juvederm supplied 27G.

Needle is'preferred'over the cannula, when there is a good reason to change we will.>

So a good reason to change is arterial embolization. If you use a sharp needle you can potentially'inject a thick gel into a vessel which can block blood supply and cause Necrosis. The risk is small but we are talking about the penis here. Any fool can inject the penis with HA using a needle. It's easy. There is a reason someone like Dr Oates has taken time to perfect a technique using the micro cannula and it's patient safety. Also it should give a better result as the needle has to come in and out all the time, whilst the cannula doesn't.

The comparison with Carverject is a poor one, as Carverject isn't a thick gel and the idea is to inject directly into the corpus cavernosum. With HA care must be taken not to inject into the CC, hence a blunt cannula is superior. Also, patients are clearly shown how to inject Carverject safely by their Dr and they also have an online tutorial on the Carverject website. In that tutorial they are clearly shown where to inject and where not to inject. One of the key areas not to inject is the top side of th penis above the dorsal nerve and where the blood vessels are. Look at this screen shot:

No I was referring to the fact they were both focusing on an issue that was the least of their problems. They were both "characters" shall we say. It's not like they had it all in life but we're just lacking a good sized penis.

[can i ask you how long you have been performing HA?]

Surgeons have 2 years experience.

Caverject (Erect) is a good idea, borrowed from Dr O.

It is interesting to see that men can self-inject Caverject into their penis at home without supervision - with a needle the same size as Juvederm supplied 27G.

Needle is preferred over the cannula, when there is a good reason to change we will.

In communication with Dr O. outside the forum. The goal is the same, to advance the procedure and promote it as a replacement for more invasive surgery.

the Androfill website sells lig cuts right off the bat. - We offer it, then dissuade anyone from taking it. No one has taken any surgical option. This is the most effective way of reaching prospective surgery patients.

Reklaw wrote: "It really made me wonder what the people on this board are like! It's odd seeing how out of whack some guys priorities are" Are you referring to the fact that they were already a good size and that all they cared about was being "huge" or having a "monster" Cos if so I agree, if i had an average Girth I would never of persued Phalloplasty. Or were you referring to the fact that there partner already seemed happy with their Girth? because if I had a partner who was happy with my penis I wouldn't touch it. Also it absolutely blows my mind that in 1st world countries like ours their still offering such backwards techniques, by now all these doctors should have switched to PMMA or HA. Their fucking useless, it's unreal that a bunch enthusiasts like us know more about what works than all these urologists who have PhD's.

I suspect the medical doctors don't have PhD's, they have a MD (or version thereof). PhD is a Doctorate of Philosophy - which Educators typically have.

I think smalljay is in the of things. PMMA was a godsend at the time and now maybe, something better (HA) has turned up. From what I've read so far, even without considering the long-term risks, it was not a godsend. Androfill's (hypocritical) website and others in the medical field are beginning to attest to this. The attention seems to be moving towards perfecting the skills of HA. Those using the older methods are those reluctant to give up what they believe that they have become experts in and for the still ignorant clientele. This is clear, as Reklaw pointed out, that Androfill could have such a website recommending what it has but carrying out the procedures brought out at the start of this thread.

Does anyone know whether Dr C uses cannula or needle for the Silkon 1000 microdroplets?

What is the implication for silicon micro droplet technique with a needle?