TOPIC: Restylane or Juvederm Voluma?

.

I dont really have a problem with Restylane - and that is a great price. It tends to get a bit more swelling initially, but I say go for it!

To Dr Oates: I'd like to hear your input on Ellanse since you agreed with Aleksk's assessment and also since you have injected patients with it. Do you have any follow up data with your patients and/or reasons to believe this filler may be problematic or is it just that nobody knows right now?

The one patient, so far, with Ellanse is very happy. He had a lot of swelling with HA and says to him Ellanse feels more like normal.

I have 1 patient with Ellanse in her face with granulomas....

I'm also very interested to hear comments for the post above as HA firmness questions seem to be the least defined/described attribute for the procedure or at least at this point in time. Ive read that it's a "little" firmer that FFT or that it doesn't "really" move around that much. I would personally be more confident making a decision for HA if the look and feel questions were addressed with more detail so I can picture what it will be like before forehand.[/QUOTE]

With all the guys we have done with HA, no one has complained about the feel of HA with an Erection, it is pretty much normal. HA gets tissue ingrowth and is not mobile so you can just push it anywhere you want at any time. When it first goes in with some swelling there is a little mobility.

There are some negative reviews of Ellanse on RealSelf. There seem to be issues with swelling that are common. I don't really understand why many web pages say it is approved in the USA, but it's really not. That's odd. Considering it is another immunostimulatory filler, it's in the Radiesse and PMMA category - so I am not that excited about it. Also, if it accidentally blocks a blood vessel, you can't reverse it with Hydase.

Thanks for your feedback Dr. Oates.

I am still in the conflict of not knowing if I should proceed with 10cc's of Restylane (Resyland Lyft) for $2200. It is the only thing the doctor here on the east coast provides. I don't know if I should continue with this option or travel for Juvederm.

I'll beta test and report data for Ellanse if someone else pays for it Lol.

Catching up here thanks for the replies to the questions I posed Thank you to Dr Oates as well.

Aleksk, certainly don't go out of your way to give information to people if you don't feel its reciprocal but I do sincerely appreciate the info you bring... Ive been following your posts and I missed the section on the guy down in Mexico that used to do Ellanse. I've done research on Ellanse but not searching specifically for PE injections but I will certainly keep looking and will share anything new that can be useful.

I am also very intrigued by this product but I don't yet understand if its a filler you can "top off" over time so to speak or if you only get 1-2 shots at it and then you have to wait. If the first, what do you guys think of doing a small amount say 5ml, do an assessment after 4-8 weeks then go from there?

Hoddle, your assessment of HA was exactly what I originally thought/was concerned about when trying to understand the firmness level. My skin is very thin and flexible, so I'm not sure if that's a bonus or a liability. Ive read both so I'm confused... For example skin too loose can lead to clumping/migration but skin too tight then it cant be injected evenly? (Not sure)

Despite skin types It seems that the results should be feasible to characterize in which (assuming) there just inst enough sample data yet. Certainly different skin types but I imagine groups/patterns would develop when 200+ patients are evaluated

I'm thinking it's cheaper ,or at least I want to believe that because it means offices will eventually reduce the price as they can get their # of patients up. Then HA would become a reasonable solution long term.


Check this out, it's only 1 reference but $359 for qty (1-5) 2ml

www.medicadepot.com/juvederm-voluma-with-lidocaine.html

I'm pretty confident that you've found a good solution with Voluma, Dr. Oates, through clinical experience. My only concern is the circ scar area, which you've already said you don't even inject anyway. I think perhaps belotero could work well there, though it wears off quickly.

Actually - a very reasonable assessment.

They appear to be in Australia, NZ and ZA.

If it was based in China I would totally believe But it seems that someone would go after them (legally) especially if they are operating in countries that have trade laws. They are showing photos of a Juvederm boxed on their pages.

Not to say that the internet is not fake, but seems like a lawsuit waiting to happen.

Regardless of the actual cost now, I do believe it has to come down for HA to be mainstream, no different than the bottleneck (cost) of Li-ion batteries for Electric vehicles.

Most people don't have enough money to enlarge their penis, At least looking at the median income in the USA, and assuming it will cost 6,000 usd/yr to maintain the HA. That's too much for most people, so that's a huge number of male clients priced out of the market.

Add HA to car payments, mortgage, kids, Heath insurance etc. There's not enough money left.

But I'm also assuming some Dr's have the vision to "go big" doing tens of thousands of patients/yr. which is possible if it only takes 30-1hr of time. 1 doctor could easily do 5,000 patients in a year assuming 3 per day and six weeks off a year. LOL.

If the costs can do down it will be just as profitable just a lot more revenue. There's operating cost in all legitimate businesses so I don't think that's the main factor. Manufacturing is brutal where capital equipment cost are extreme but they are mandatory and where a 20% profit margin would be considered stellar.

HA injections are profitable, but the cost needs to go down to get the number of patients up.

Good post aleksk... a lot of interesting variables to discuss. The article you requested is here.

docdro.id/IMBs0fO

I am gonna read it a little later. It looks interesting. Dr. Oates and a few others seem to like voluma the best for the penis, and this does last the longest for sure (2 years roughly) whereas belotero and restylane may only last year at best (belotero is even shorter sometimes, as it is very thin and often placed right in the dermis, not below). I remember Dr. Oates saying something about the thickness of voluma being a good thing for the penis... i forgot the context now. I'll have to find it.

We do inject under the circ scar. But it does have higher risk for looking slightly lumpy, especially if not massaged. So using a slightly less cohesive and softer filler like plain Juve or Volift (another made by the Juvederm group but slightly softer) may be the best answer towards the glans.

I posed a question in the poll section a while ago about doing radiesse augmentation but not too many people replied. I used the real prices of the product and what I estimated you'd gain from those prices. Some people would do it I guess... but it's a small poll and on a PE website. In the general population, I think what dirk digler said is what I agree with...who can afford it after everything else? It's a luxury like plastic surgery - and it's far easier for the filler manufacturers just to let people do it off-label. phalloboards.websitetoolbox.com/poll/pol...d=28192&forum=198401

The counterfeit fillers you see are no different than the counterfeit viagra or designer watches or purses. People in the counterfeit business know what they are doing. Their servers are well hidden (think Pirate Bay) and making a box look like it's the real restylane isn't that hard. The stuff inside is probably sterile too, but is it restylane? No. It might even be HA of lower quality, not cross-linked, or who knows. I've just been told by people at Merz AND Allergan that there is no second hand distribution anywhere in the world. Allergan (Juvederm manufacturer) is so nuts that they wouldn't even talk to me until I had an account set up and was verified to work in an MD's office (which I don't - but my friend just set up the account for me). So, how is their product going to get out there so easily? They won't ship anywhere but an MD's office, and neither will Merz (Radiesse mfr)

So I read that article aleksk... I don't know what to make of it. It's like they took 8 pages to say that thicker fillers with a higher g' are harder to inject...and likely slower to break down. Did I miss anything else useful in there?

Dr Oates wrote: With all the guys we have done with HA, no one has complained about the feel of HA with an Erection, it is pretty much normal.

I think I recall you saying in another thread that it is often difficult to follow up with some patients because they don't wish to be contacted. Can you give us an estimate on the number of patients you've had positive feedback from on the Erection quality? There was at least some negative feedback from the korean study of 40 something patients including partners--any chance it may have something to do with Restylane sub-q vs juvederm in your opinion?

Thanks,
LL

Thank you aleksk. You really bring a lot of valuable information to the board. When is your appointment with Dr. Oates. I hope you will keep us informed.