TOPIC: Guy123 - HA Questions

Hi, I’m hoping I can get some advice as well. I’ve had 2 HA treatments in Miami now, each 3 weeks apart and my next visit is scheduled for 2 days from now. I was pretty disappointed with the results of the first treatment. When Flaccid, there was a significant bubble on the left side. It mostly goes away when Erect, which is good, but it makes my penis point to the right at a 45 degree angle, which makes me very uncomfortable. The doctor put in 8 units in the first treatment, which he then decided was too much and put in 4 units for the next treatment to help even it out. He also said only where the sleeve for 3 days and that it’s not necessary after that. I’m now 3 weeks after the 2nd treatment and not only is there a 2nd bubble of smaller size on the left side, continuing the pointing to the right that I never had before, but also a knot on the under side of the penis next to the circumsission scar. He’s put in quite a bit of filler at the base to where my Erect Girth has increased by an Inch or more, but the rest of the shaft has only increased by maybe a third of an Inch, making it look a bit odd. I’ve also found that I may be allergic to the latex in the sleeve. I can tolerate the discomfort during the day because I’m moving it, but when I try to sleep in it, I wake up to burning pain all over from it sitting against the same portion of skin for too long. Could anyone recommend what is causing these issues? Should I try to get a different sleeve that I’m not allergic to and wear it more than 3 days, should I massage the penis after the treatment (which he told me not to do) to get it to settle better and not form these bubbles, is there any way to add more filler to remove the abnormalities on the left side or is the only option to dissolve and restart? The right is ok, at least smooth, but still not as enhanced as I was expecting and he’s very hesitant to go close to the head of the penis which makes for an awkward looking Flaccid state. Would appreciate any advice or guidance anyone could provide. Thanks

@Guy123 I moved your post to its own topic so that can get the appropriate advice.

Also, by "bubbles" I assume you mean nodules perhaps? Without photos it will be a bit challenging to provide the best advice, so that would be helpful.

It isn't unusual to see minor aesthetic irregularities from dermal filler injections (especially after the first round), and typically requires a subsequent round or two to achieve your final size & aesthetic goals. At least this is true in general.

While PhalloFILL Miami is not a Sponsor here, their Primary Branch (the ones that developed their proprietary method) @PhalloFILL Dallas might be able to chime in.

Thank you. Sorry, new to this forum, so wasn’t sure how to do that. Including 2 photos that were 3 weeks after 2nd treatment. The inconsistency and lack of smoothness is pretty apparent, as is the irritation from the sleeve. I would have classified Nodule as something very small, like the hard knot at the Circumcision scar. These are so big and pronounced that I called them something different, but yes, I suppose they could be nodules as well. Just a bit disappointed in how it looks 3 weeks after 2nd treatment and after 12 units, with the doctors attempt to fix it only making it worse. Definitely not what I expected to get with all the positive stories I heard about this procedure.

Definitely seems correctable, do you happen to have fully Erect shots by chance? I don't see the nodules per-se, but I am not doubting you, as often times they are more palpable than they are visible, especially depending on how the photo is taken.

The Nodule is less obvious when Erect, but I’m more concerned with how it looks when Flaccid. I was hoping to get more Erect Girth, but my bigger issue is the amount of time I spend naked Flaccid between locker rooms on sports teams, spas, etc. was really hoping this would be symmetric not only Erect, but Flaccid as well, and turn me into a bit more of a shower than a Grower, but haven’t seemed to get much in a Flaccid state in terms of constant extra size and reduced shrinkage. Just shrinks selectively in the places where the doctor hasn’t injected enough, which leads to the asymmetry

I wonder if the sleeve pushed a lot of the filler to the base, and maybe some towards the glans, because I can't see the doc placing all that filler there on purpose. Like squeezing a toothpaste tube in the middle.

It’s actually kind of painful to wear the sleeve, so maybe that’s why. He gave me one that’s too small. Hopefully he has a larger one available this next time. This doctor is supposed to be an established/ approved doctor by phallofil. I’m surprised he would make a mistake like that by giving too small of a sleeve. My Erect Girth by the middle of the shaft is 4.25, while Girth at the base is 5.5, which is so disproportionate. I use to be a symmetric 4 inches throughout the entire shaft. I’m concerned that his mistake is going to cost me financially now because I have a massive excess amount in the base and a huge deficit in the rest of the shaft, and now I have to buy a lot more units just to even it out. Is that kind of mistake from the doctor really the responsibility of the patient to pay for to fix? How long would you suggest wearing the sleeve after each treatment? 3 days, 3 weeks, sleep with it? I definitely can’t wear the same size after this next treatment. It’s just too painful

You'll find different protocol from doctors because this is a relatively new field. I would think that mass of filler at the base should kind of block any new filler, so maybe just a somewhat loose sleeve or even none at all is needed. But I'm not the practioner, so definitely discuss it with him. Hopefully he can give you a better taper towards the base. I wouldn't get anything dissolved at this point.

Sorry I’m late to the game. I’m traveling out of the country and I’ve been off the grid since last week. Back to work today.

You have a condition in which your phimotic ring (the same band of tissue that causes phimosis) is creating constriction. It’s actually phimosis in a circumcised patient that is now presenting since your penis is larger. See a photo here. This patient doesn’t have dermal filler but he has a tight band like you do. Ignore the procedure in this page that talks about how to correct it. You don’t need that.

en.m.wikipedia.org/wiki/Preputioplasty

I can clearly see the tissue boarders in the center of the shaft of your penis. Basically this constriction band is tight and your penis is getting larger around it and it’s causing dermal filler to be pushed forward and back. In my clinic I use a neurotoxin such as Botox or dysport to relax these bands and they disappear for 9-12 months.

The sleeve may be causing sensitivity because of an allergy. I would like to discuss with you on the phone. I’m going to direct message you and try to get your phone number in privacy and call you about the sensitivity.

But the curve in the flaccid penis you see is from the constriction band. My guess is it relaxes when you are warm or stimulate and looks better.

It just presents an extra challenge to your procedure but it can be addressed.

Here are 3 examples of patients that have it. One of which I included the after photo after I injected him with neurotoxin to relax it.

Thank you Mr. William Moore for your insight and taking the time to talk to me even though I’m not your client. Your advice and post treatment care instructions were very helpful and I think has helped correct the issues I was having with the previous doctor. I’m now using a better sleeve that doesn’t irritate my skin and that I’m able to sleep with, so hopefully this next treatment is more successful.

@Guy123 How are you doing now? Did you get more phallofill to correct the lumps? How much have you gained total?

Yes, doing better now. Was able to go from 4” EG to 5” EG. I had to do quite a bit of dissolving after the initial failure and used disport to loosen the skin to help allow filler. I’ve now put in another 10 units with Dr Amy Pearlman and she has been great. It looks good when Erect, but I did this more for Flaccid appearance. When warm and relaxed, it looks great, but I still get quite a bit of retraction when it’s cold, which causes distortion that makes it obvious that work has been done, which I’m not a fan of. I may try more disport or Botox soon to keep it in a relaxed state. Let me know if anyone else has tried this approach before and if it was successful / how long it lasted

Hi, GUY123. I had a similar experience to you with the other PhalloFILL location in Miami. I have some questions about your experience with Dr. Pearlman. I am going to message you directly.

Can clarify or add details to what disport is? This is a new term to me.

Also can anyone identify how you can spot the potential for the phimotic ring to cause this issue prior to enhancement so the negative results can be avoided?

Thank you

Disport is similar to Botox. They are both used to loosen the band/ring and reduce penis constriction to keep the skin more loose and smooth. They seem to help if done a few weeks prior to filler, so you can heal in a relaxed state. I can’t say how to tell if you’re likely to have this problem, but I know I have a hyperactive retraction reflex (shrinkage), so I wouldn’t be surprised if the two are related. Before filler, the retraction was uniform though, so it never really caught my attention, but after filler, tight bands become more pronounced leading to asymmetric retraction, so it becomes more important to use dysport or Botox to reduce the reflex if you care about your Flaccid look. This is a non-issue for Erect appearance, as the band tightness is overpowered by blood flow. The doctors can explain better the nuances/purpose of each treatment option.