TOPIC: New HA filler claiming to last up to 5 years

Aleksk, I am very glad that you're back on the forum. While I am often credited for being the most prominent supporter of Ellanse on this form, it is you who truly deserves it. Your early research work on Ellanse was compelling, and prompted further research on my part, the result of which led me to deem it superior to all fillers. In your absence, my focus has been on imparting the results of my research and focusing attention only on documented cases of Ellanse in the penis. More doctors have started using it for this application, the most prominent of which is Dr. Oates in Australia. Morganstern in Atlanta is a name that has popped up of late, but to date, he has not produced any documented cases. I continue to process all fact-based information related to Ellanse that comes through, but in the meantime, I'm thankful of your return and hope you stay on board to see how this unfolds.

Hi Everyone,

What a great discussion - I have not been on the site for a while.

So much I need to catch up on and comment on. I routinely use 4 access points and inject 360 degree around the shaft. I don't think that HA migrates that much, but it can be moulded into shapes - especially by shrinkage. HA has much more mould ability than Ellanse.

I love the results of Ellanse as do the patients. It worries me every time. Quite a few of these patients travel from overseas which would make sting issues more difficult. Fortunately things have all been fine so far. As I have mentioned before I have seen granuloma from Ellanse in the face. Big granuloma. They were manangable with injections of steroid but would hate to seem in a penis. I discuss this at length with patients. But it is very easy for patients (anyone one on any subject really) to gloss over the risks that are uncommon.

I don't really believe in external compression of blood vessels by filler (maybe in the tip of the nose) especially by HA in the penis. If there is a vascular problem it has been placed intravascular. At least with HA it can be rectified.

I will check back in again and see if there are specific questions I can answer.

Keep safe everyone.

You're not really listening. I made a reference to Dr Oates, so rest assured I didn't get a fake product.

If it is Dr Oates who gave you this bad result did he explain what he thinks went wrong?

I am someone with average length, average girth and average amount of foreskin without any anatomical or otherwise irregularities. I got Teosyal Ultra Deep, which on paper should have been a good filler. I had an excellent injector.

If you had had filler injected well and your instructions in regard to aftercare were good, this would not have happened.

What you had (in regards to lumps under the foreskin) is either filler injected too far into the foreskin region, or too superficially or both.

If during the recovery, the penis is not supported (if the penis is hanging down loose in boxers) then filler can migrate down with gravity.

Did you use a thin bandage specifically for behind the glans?

In regard to your accordion issue, this is different from a filler under the foreskin issue. The filler was likely injected without sufficient taper so that rear filler supports the front within the layer; or was not injected deep to dartos, or both.

By taper I mean as in patient A at the following link, and it is important not just to resist accordion but also to minimise the risk of adding to phimosis in uncut patients
www.androfill.com/penis-enlargement-before-and-after/

Are you getting any further ideas as to what might have happened reading this information?

Despite all this, my result was exceptionally bad - extremely pronounced accordion effect and filler that felt as soft as shit, both flaccid and erect. It was so bad I couldn't have almost any sex at all. My report here is corroborated by other men who had their HA dissolved. This is especially true for uncircumcised men. I can't stress this enough.

I believe you, I know costas had his HA dissolved which was really disappointing, I think he had the accordion effect on an occassion after he subsequently went to Moorgate. For our part I think Dr H could have injected his filler with a better taper and with more filler deep to the dartos, which is why I offered to do it again for him at no cost, even after he had additional filler injected elsewhere.

For mediatps, I think he started this thread asking about a 5-year version of HA, so it does not seem he was particularly unhappy with HA. His Androfill results seemed good, and I understand he was mainly after a longer duration substance.

If there are men there who are happy with their HA, we need to find out what this means. Do they have a superior result? If so why? What's different?

As described above.

What about Dexterphall? and others.

For accordion issue.
- Taper to the glans so rear filler supports forward filler within the layer
- Inject deep to the dartos in the layer between dartos and bucks
- Don't inject too much, maximum 1.0 inch gain really should be the goal with HA.

For filler migration, lumps under foreskin when pulling it back.
- Don't inject too far into the under foreskin area
- Wear supportive underwear, don't let it dangle after the procedure
- Compress bandage behind glans
- Hyalase spot-dissolve if that still occurs

Or are they SUBJECTIVELY happy? Because I chatted on this forum with men and the conversation would go like this:

ME: Hey man, I hear you're happy with your HA.
HE: Yes, I am very happy.
ME: I had it as well and had these type of issues....blah blah blah...
HE: Oh, I have many of those issues as well. My filler also bunches up like that. It also looks weird when I pull my foreskin back. Yes, it's definitely detectable when I retract my foreskin.

The filler under the foreskin issue is a flaw in the injection and aftercare and easily addressed. In the injecting, do as described above.
In the aftercare what can help to prevent filler migrating into the region under the foreskin (visible when you pull it back) is:

1. I know it sounds basic but wearing supportive underwear (Y-fronts) so it does not dangle down loose while it is integrating (gravity pulling the filler down if dangling loosely in boxers).
2. Thin compress bandage wrapped behind the head.
3. If any lumps at all after 1 and 2 (unlikely) dissolve with HA

ME: And you're happy despite this?
HE: Yes, you see I don't care about aesthetics. I really don't. I love the extra volume and weight in my pants. My wife of 25 years also loves it.
ME: Ah, ok. I see. Well my situation is different because more than anything else I care about aesthetics and the filler being undetectable. I am dating a lot.

You see, "i am happy with my result" is very fucking subjective.

Yes I get you.
The aesthetics are important which is even more so why HA should be used over Ellanse (because HA is alterable if there ever is a problem).

Imagine little lumps of stray Ellanse in the under foreskin region you describe, not able to be dissolved. It is less likely to happen because Ellanse is thick (less liquid and possibly less likely to migrate with gravity), but it can happen.

My exceptional analytical skills however (if I may say so myself) have led me to conclude that those of us who are not happy are men who care about aesthetics (we also tend to care about our faces and bodies as much as our dicks), are likely single and dating, and have social and sex lives where we actively pursue sex with different and often new partners.

In other words, HA (and very likely other fillers) doesn't work well in uncircumcised men (and very likely in circumcised as we have reports of those who have dissolved it on this board as well). However, if your expectations are low/different in terms of aesthetics and you have a shitload money to spend on top ups, you will be happy.

You are mistaken about being uncut meaning you will have a bad result... only if the technique and aftercare were poor.
If your injector injects HA too superficially and /or/ too close to the head and the aftercare is poor, then you will have exactly the result that you describe you had.

i am happy to be proved wrong. I would be delighted. Let me see reports of happy men who are happy because their result is OBJECTIVELY good. Let me see their dicks with the foreskin pulled back. Don't show me pictures of dicks with the foreskin over the glans. These are useless.

HA under the foreskin is something that we addressed back in late 2015 after around 30 cases. Inject deeper, further from the glans, wear supportive underwear (don't let the penis hang down while the filler is integrating), and compress behind glans.

We hardly ever see this issue anymore... I almost never see what you are describing unless they are patients coming to us from abroad or elsewhere in the UK. If it did happen in our clinic then we would spot dissolve the filler under the foreskin.

Because in real life, when someone gets on their knees to give you a blowjob, the first thing they do instinctively pull your foreskin back. When you are about to penetrate someone, your foreskin goes back as well. And that's when the filler bunches up in accordion and you look ridiculous. And you are lucky if you can penetrate.

Absolutely. It needs to perform well under real circumstances and be undetectable or almost undetectable unless one knows exactly what to look for.

In real life, you are not a statue like David in Florence with the static dick and the foreskin eternally frozen over the glans.
And yes, anyone would notice. Unless your partner is a 13th century nun from a medieval monastery who has never seen a dick. She is somehow transported in a time machine and it just happens that she is going to have sex with you for the first time. She looks at your accordion dick and thinks "Hmmm...so that's what dicks look like".

Guys, if you are uncircumcised take my word for it - fillers are obvious. It's your decision whether or not this is acceptable to you.

You had a poor result from. I am telling you what most likely went wrong. Give Dr Oates a hard time about what went wrong, he seems a very good doctor and can explain it to all.

The issues you describe (accordion and filler migration) also occur with Ellanse (but are then not reversible), however, you seem to be a supporter of Ellanse (despite 'benefiting' from a substance you could dissolve away).

The accordion effect can happen with either HA or Ellanse if injected poorly, as discussed above. It can happen in both circumcised and uncircumcised men.

Filler migration to the region under the foreskin is a different problem than the accordion effect and can also happen with both HA and Ellanse if the injection is poorly performed with poor distribution of filler and the aftercare/instructions are poor. Come to London and have the result fixed, or ask the doctor who injected you to give it another try.

@androfill - as noted, we go by actual accounts on the forum, otherwise you're wasting your time. Also, you should probably learn to quote properly, as it would make it easier to read (for anyone still listening):

www.phpbb.com/community/help/bbcode#f2r0

So he's switched to using a cannula and has now started using two entry points. You could say his technique is evolving! He wouldn't change things for a laugh, he's doing it to get better results. Technique and experience with the particular filler the Dr is using is clearly very important. With longer lasting or permanent fillers it's even more important than with reversible HA fillers.

I think there is more to it than safety profile (where HA is safer) or suitability for penis enlargement (where PMMA/Ellanse are better). You also have to combine the right clinic/Dr with the product. I don't think Androfill is the right place to get a longer term or permanent filler. That's not a slight on Androfill or Dr Horn, but I'm simply pointing out that with a non reversible product you need to to spend much more time with the patient and though it's technically non surgical, you pretty much go into theater. When I had PMMA, it was a 2 hour appointment. I had to get into a surgical gown, you get local anesthetic, Dr C has an assistant and it's done in a surgical suite. I think it's a similar situation with Dr Oates. It's because they have to get it right as the stakes are higher. They spend years honing their techniques. Whilst HA is just a case of applying some emla cream, then jumping on the table in a office and being done in 10 mins. If it doesn't go well it can easily be fixed. So the different types of products are more suitable to different business models. If you mix the the wrong product with the wrong business you end up with the type of Ellanse results you see posted on Moorgates website.

[There were other's who had women make comments as well, and I'm sure I can find the quote, so it's not just in his head. This was your patient and after reading his comments in total, including the part about it being insanely expensive to keep up, I just don't find it encouraging.]

It is '1,100 / $1,400 to try 6ml of Cutegel in the UK using the method in the video earlier in the thread. If you don't like it then you will have lost $1,400 - and importantly this is most likely all you will have lost (in other words no damage done to the penis).
The patient you refer to had a huge amount of filler in a very ambitious augmentation and the result looks impressive. But a big gain requires a lot of maintenance. You can stick to 0.25 - 0.75 Inch increase in Girth and it is more sensible, economical (initially and to maintain), and possibly feels slightly more natural with a thinner layer of filler. More than this and the % penis to filler ratio is going down.

We have had 1 or 2 complete dissolves over the past 3 years & 1,100 patients. One who had HA dissolved is mediatps
It is possible there are unsatisfied who simply let it all dissolve away naturally and don't inform the clinic.
The complaints I get are 1. It has gone too fast (often swelling subsiding). 2. Irregularity. 3. Underwhelmed by the size gain.

Ok guys, I feel the need to chime in here.

I have had work done with Dr H and I was very impressed. He can come across as a little moody but I trust him as an expert in his field.

I also think Francis is genuinely offering some good information here.

Having had 18ml of HA with Androfill over 2 years and not really having the accordion effect and now going to Italy and having 10ml of PMMA and having the accordion really badly I do believe it is all about where you inject. This is why I have been asking about how the different fillers bind/interact with the shaft. My assumption, based on my differing experiences had been that HA actually bonded to your shaft in someway which is why the skin moved more freely over it. I now believe that actually the PMMA I have is injected too superficially and so just moves wherever the skin goes. This is what I can gather from what Francis is saying here. Francis I may book an appointment to come in and see if Dr. Horn can look and judge what has gone on here, if thats ok?

I am very much regretting having taken the risk that I did. I think there is a lot of great superficial information about different types of fillers, their dangers, etc but not enough about the details of how they are injeced within the penile anatomy. I think for uncircumcised guys this is of paramount importance as we have lots of movement going on down there and so the correct layer is really important. This kind of information really helps us understand how we(uncircumcised guys) should go about our PE

Below are four photos. The two orange ones demonstrate the effects of the accordion effect right now after 10ml of PMMA. The other two are towards the end of 8ml of HA there isnt a huge amount left but you can see that even with the tight forekin pulled back the HA still remains high up the shaft. You can vaguely see it on the top left. I wish I had taken photos like this after the extra 10ml of HA as the effect was the same. The larger quantity of HA stayed higher up the shaft. Now this i believe has nothing to do with the filler but where it was placed.

Ellanse may or may not be more likely to cause complications than any other Dermal Filler.
But dermal fillers do cause complications.

Filler migration is one specific risk in the penis that happens not infrequently.

A patient called me after 1 year saying that a piece of HA had 'broken off' and moved to the underside of the shaft and was now causing him pain during sex, so he had just stopped having sex. He asked if anything could be done and was relieved that the HA could be dissolved away, as he thought he had to wait until all the HA went on its own.

Had it been Ellanse, I would not have felt good reminding him that there is nothing that can be done for 3 more years.

I hope Dr Oates does write more about addressing complications. I don't think Dr Oates is a Urologist, but I see one Urologist and a surgeon on the Morganstern website.

Dr Ralph in the UK would be an excellent Urologist to ask because he does a lot of work removing fillers from the penis (mainly self-injected paraffin but also other substances), and he has no penis enlargement business so he should be impartial. I will write to him asking specifically for his views (I already know Dr Horn's view that Ellanse is high risk).

A fundamental problem I don't see a clear solution to is how some of the basic issues associated with dermal fillers, of any type, can be dealt with when the filler can't be dissolved. Hyalase is a useful safety net for many of these problems, but only with HA.

Further, most of the discussion and formal study of Dermal Filler complications is in the context of small volumes, and not in the penis. But the context here is 10-30ml in a sensitive organ which no one wants a problem with. To be able to dissolve away many of the complications changes the risk profile significantly.

HA = safe (in large part because it can be dissolved), Ellanse / PMMA = less safe (in large part because you are stuck with some of the same problems, but this time they can't be dissolved).
The distinction is obvious but worth repeating ad nauseam.

Androfill wrote: Filler migration is one specific risk in the penis that happens not infrequently.A patient called me after 1 year saying that a piece of HA had 'broken off' and moved to the underside of the shaft and was now causing him pain during sex, so he had just stopped having sex. He asked if anything could be done and was relieved that the HA could be dissolved away, as he thought he had to wait until all the HA went on its own.

You're giving one single example, but you must have stats on how many patients you treated in total, and how many had this issue? I have not heard this before, and would like to know the stats. Everything has risk, but people decide to proceed or not based on statistics, not a single anecdotal case. If that were the case, people would read darkstaff's pmma experience and nobody would have it done!

Androfill wrote: I hope Dr Oates does write more about addressing complications. I don't think Dr Oates is a Urologist, but I see one Urologist and a surgeon on the Morganstern website.

I hope he does as well.

Androfill wrote: I already know Dr Horn's view that Ellanse is high risk.

Yes, but he still does the procedure if patients request it, and has had good results (as has Dr Oats). Does he tell patients in advance that if something goes wrong he can't do anything? Or does he discuss with them what the specific odds are and actually have a some plan to treat possible outcomes?

Androfill wrote: HA = safe (in large part because it can be dissolved), Ellanse / PMMA = less safe (in large part because you are stuck with some of the same problems, but this time they can't be dissolved). The distinction is obvious but worth repeating ad nauseam.

Everyone knows that, but you're on a forum where for years guys are opting for pmma (which is permanent) on a daily basis, based on a long history of good and some negative outcomes. Saying HA is safer is not going to convince a lot of guys to opt for it after doing years of research, and realizing that many guys spend a lot of money on HA and have it dissolved because it's "squishy" and feels like a "padded dick" ... yes there are some lucky guys who are OK with it (and have the $$$), but there are a lot of guys who are not, and in some locations guys are paying 10K USD for 15 ml ... which last 1.5 years, and which they may not be satisfied with.As long as there are alternatives like pmma or ellanse that last longer and feel more natural (I take this as confirmed), then people will opt for these over HA unless it is shown by reported / documented cases (with pics), clinical studies, and other real data that it's not worth the risk. Note that in Gary Alter's editorial comment on the pmma study, his main concern was what may happen "a decade" down the road ... at least for ellanse that's not a concern.

www.jsm.jsexmed.org/article/S1743-6095(16)30328-9/abstractI'm not arguing there is no risk, I'm just asking you to contribute actual data and stats on those risks, if you have them.

My personal experience with 10ml real Voluma within the first month was that it was only somewhat noticeable when not Erect. When Erect, it was hard and not noticeable at all. After the first month, I seemed to have metabolized most of it. That, or it moved deep in my groin due to repeat sex with a tight partner, I honestly don't know. Or maybe it's all there and my gains are just super slight? Sounds unlikely. I still have a very thin layer (maybe 1/8 to 1/4' in areas) that only I can feel, but it would take a highly experienced eye for anyone else to notice it. I am considering another round to see if my body will keep it longer this time (I'm only a few months out from my first procedure and have to say it was great initially). Otherwise, Voluma might not be for me.

aleksk wrote: If I were cut, i would go for Ellanse.

mediatps wrote: I've just had 10ml of PMMA with this italian dr and the accordion effect is really bad! I think there is a difference between how the two products attached themselves to my shaft. I dont think enough is mentioned about how these different fillers actually interact with the penis tissue. We only know that HA absorbs water and PMMA/ Ellanse promote collagen. There is soo much more about what they do in my opinion which effects results that we don't mention or know.

As @aleksk and @chester know, I opted for Ellanse because my take on HA is the same as @chester's and I didn't want PMMA. I had 12 ml and will go back for 8 more, and when I'm done I will document everything. I had a couple of minor issues that are being dealt with, and only then will I go back for 2nd round probably in January.The only thing I will say now, because it's related to what we're discussing here is about the texture. In both Flaccid and Erect states I literally cannot tell its there, except for extra Girth. When Flaccid at 4" length its feels the same as before and is symmetric, and when 6" Erect it's rock hard and symmetric. I'm at 10 weeks, so 80 percent of the CMC carrier should be gone, yet the Girth gain has been constant the entire time. I can't tell the difference from a week or two out when the initial swelling subsided to what it is now. It seems to have been be a seamless replacement of the carrier with collagen.Yes, there are lots of factors, and I think we need to factor out cut vs uncut, vs all the rest--type of filler, skin tightness, how its injected, metabolism, lots of other factors. But I would have thought that injected the same way in the same person, that PMMA and Ellanse would be very similar, and I know a lot of guys have said their PMMA feels natural. I can't speak for PMMA or being uncut, so I have no idea about the feeling that it's moving under the skin. I can only say that based on the 2 reports I read here (subtle77 and glam82) that Ellanse meets (actually exceeds) my expectations in terms of the way it feels and integrates.

You can't use that basic "sausage filler" technique with permanent or long term fillers! Otherwsie you end up with result like those on the Moorgate website. Why do you think so many of Dr N's patients don't look so great? She works alone, use one entry point and just molds the stuff. I know Dr Oates has his own technique that can't speak of, but Dr C divides the penis into 6 sections and uses a injection gun to more accurately measure the amount of filler being injected at each point. It's a much longer and more considered process than what is shown in the video above. It involves several entry points, requires an assistant and rolling instruments to smooth as he works. It's really not a case of making a hole, pumping it in and then molding it into place with hands.

Androfill wrote: For HA yes. From the first 1,000 we had:
- 7 granuloma
- 5 infections
- 1 allergic reaction
- 2 significant filler migrations

Thanks for the info!

Androfill wrote: It should not be squishy, if it is then it might not have been the right HA, or the filler injection or aftercare was poor.

Well, costa said it was, and you guys did his. He had it dissolved. The report of squishiness is "not infrequent" from all the cases I've read about, and guys I personally communicated with who had it. And this is voluma. This was also the major complaint in the original korean HA study. Dunno about ultra deep. Why are so many practices using voluma if this is so good?

Androfill wrote: No problems from Ellanse yet but the sample size is tiny. At least 100 cases in a sample over 2-3 years... would that be reasonable.

Thanks again for the info. Combined with Dr oats almost 2 years experience plus morganster 7 months, so far so good it seems. I hope it continues to go this way, because I believe like @chester that it is superior in terms long lasting and feeling 100 percent natural when Flaccid and Erect.

I think Dr Kim's website's concerns over Ellanse are total BS. No where in the world will you ever see so much real life data on PE as here. We've seen hundreds of patients with PMMA, which works exactly the same as Ellanse and Radiesse, yet as far as I'm aware, there has never been a case of a result which caused a problem similar to Peyronies. I'm not one of those guys who read some threads and asked some questions before getting my procedure. I read every single PMMA thread on both this and the old forum and I did this within the last 6 months.

Of course lumps are a potential problem, especially in an organ like the penis, but that's why good Dr's are conservative in their approach and advise post op massaging. Dr Oates doesn't inject 40cc of Ellanse at once for a reason.