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

Androfill wrote: It would be good if there was a discussion on how complications and bad results from Ellanse are going to be dealt with when it is injected deep in the penis and can't be removed for 4 years.

Would you expect this to be any different from dealing with PMMA?

'4-year PMMA', but at least you know Ellanse is fully bioabsorbable eventually.

4-years is a very long time to wait with a problem similar to that described by Upsize in the link above, if genuine (it sounds plausible).

Ellanse risks need to be explained properly including what the backup plan is for dealing with complications.

Yes, two entry points either side of the midline. It should be sufficient because the filler can diffuse through the layer although some areas may be difficult to reach. One entry point does not sound sufficient to get through both the left and right sides. How Ellanse is being marketed in the UK is a bit of a worry.

mediatps wrote: Too squishy? Hmm, thats interesting. I'll ask for more info from Androfil.

Yeah, bare in mind Dr Kim has a habit of injecting way too much.

[Right. The exact same considerations as with PMMA requiring good technique, multiple sessions with small amounts, detailed after care instructions, etc... and guys are reporting PMMA results on a daily basis...and a 10 year history.]

Yes I agree, similar considerations to PMMA.

I would have Ellanse over PMMA myself because I know where Ellanse is made and that it is eventually fully bioabsorbable. That said, I would not take the risk of either, personally.

Both are much higher risk than HA. The difference between HA risk and Ellanse risk is my focus, and not explained well in some of the marketing to new patients.

think wrote: My thoughts are that it would really be great to hear specifics, case reports, etc., rather than vague claims. PCL has a long history of safe biomedical usage. Are they referring to specific dangers with regard to usage in the penis?

Keep in mind, there are risks with everything. I just googled cutegel, and this was on the first page of the results:

openi.nlm.nih.gov/detailedresult.php?img...s-29-S176-g003&req=4

That case doesn't really tell us anything negative about Cutgel, that we didn't already know was a possibility with all fillers. I don't think there is any doubt that PCL, Radiesse and PMMA are more likely to cause a similar problem than any HA product. As at least with HA there is a chance you can dissolve the product that is causing the blockage that cause the necrosis. You can't do that with particulate based fillers. Personally I'd never take the risk of having filler in the nose with all those blood vessels. But if I had to, I'm choosing HA, even if the risk is only marginally smaller.

Dr Kim is a complete Fraudster, it's only temporary and won't last as long as it states but I don't see any harm in trying it for that price, although there was an Aussie guy who recently went to Dr Kim for HA and complained to was too squishy and had it dissolved.

mediatps wrote: Androfil have stopped using Ellanse as they think it is too dangerous.

[...]
Thoughts?

My thoughts are that it would really be great to hear specifics, case reports, etc., rather than vague claims. PCL has a long history of safe biomedical usage. Are they referring to specific dangers with regard to usage in the penis?

Keep in mind, there are risks with everything. I just googled cutegel, and this was on the first page of the results:

openi.nlm.nih.gov/detailedresult.php?img...s-29-S176-g003&req=4

Bottom line, make sure whoever does your procedure is well prepared to deal with complications.

Androfill wrote: The difference between HA risk and Ellanse risk is my focus, and not explained well in some of the marketing to new patients.

You make the risk clear on your website. But aside from it being non dissolvable, I am just trying to understand exactly what the risks are and what the incidence / likelihood of adverse reaction is based on any available data, not hearsay.

All we have to go on at this point is that dr oats has been using it for almost 2 years (I don't know how many patients he's treated, maybe he can tell us) and that Morganstern in atlanta, who are top notch urologists and have been doing PE and research on it a long time, has been using it for about 7 months. If either of them discontinue its use then I'll pay attention for sure!

Androfill wrote: 4-years is a ridiculous amount of time to wait out with a problem similar to that described by Upsize in the link above, and I hear of these issues with Ellanse not infrequently (in the face).

Yeah, I also "hear" it, like when Upsize suddenly registers on the forum the day someone starts the first Ellanse thread, describes his issue (with no pictures to document it), then vanishes. But where is the evidence that granulomas are high risk from Ellanse? I know the studies done by Sinclair are relatively small, but there are many studies done demonstrating the safety of PCL, so exactly how many documented cases or studies is the label high risk being based on? Do we have good reason to believe it is riskier than PMMA?

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.

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.

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.