TOPIC: 3-Year Progress Report: HA Filler With PhalloFILL Network

Hi Everyone,

I'm providing a 3-year follow up to my HA filler procedure done with Dr. Gonzales (in Los Angeles), then with William (the founder of @PhalloFILL ) in Dallas. Overall, I'd say I'm satisfied with the procedure.

• Surprisingly, the filler has basically entirely stayed. I could be mistaken, but I don't think I've noticed any loss in size even after 3 years.
• I've gotten many compliments from women on the girth and size.
• My only (slight) dissatisfaction is that the filler is relatively uneven, with it thicker closer to the head than it is at the shaft and also a (tiny bit) lumpy, and I now want to go back to even it out. I don't think this is either Will or Dr. Gonzales's fault. The filler just tends to migrate. I wore the post-op sleeve and even the helmet (which prevents retraction and keeps it in place) but I guess it still migrated after the 3-week period.

My only question is what's the best path forward to fixing this.

• Who's the best provider in or near SoCal? Is it Dr. Tsay?
• Is there anyone in the network that is an expert at aesthetics / crafting and shaping to make it look as even as possible?
• PhalloFill uses Versa by Revenesse. Dr. Tsay uses Juvederm. Is there one that's better than the other for preventing filler migration?

Please note this should NOT to construed as a negative review of Dr. Gonzales, William, or PhalloFill. I'm still very much a fan of theirs and their expertise as well as commitment to ethics and customer service. It would just be better to not have to travel to Dallas again if there's someone here locally that would do a great job of maximizing aesthetics and symmetry.

@Skeptical_One , would welcome your thoughts. Thank you.

Pictures would help in coming up with some recommendations. Can you share? thanks

rayjamesmith wrote: Hi Everyone,

I'm providing a 3-year follow up to my HA filler procedure done with Dr. Gonzales (in Los Angeles), then with William (the founder of @PhalloFILL ) in Dallas. Overall, I'd say I'm satisfied with the procedure.

• Surprisingly, the filler has basically entirely stayed. I could be mistaken, but I don't think I've noticed any loss in size even after 3 years.
• I've gotten many compliments from women on the girth and size.
• My only (slight) dissatisfaction is that the filler is relatively uneven, with it thicker closer to the head than it is at the shaft and also a (tiny bit) lumpy, and I now want to go back to even it out. I don't think this is either Will or Dr. Gonzales's fault. The filler just tends to migrate. I wore the post-op sleeve and even the helmet (which prevents retraction and keeps it in place) but I guess it still migrated after the 3-week period.

My only question is what's the best path forward to fixing this.

• Who's the best provider in or near SoCal? Is it Dr. Tsay?
• Is there anyone in the network that is an expert at aesthetics / crafting and shaping to make it look as even as possible?
• PhalloFill uses Versa by Revenesse. Dr. Tsay uses Juvederm. Is there one that's better than the other for preventing filler migration?

Please note this should NOT to construed as a negative review of Dr. Gonzales, William, or PhalloFill. I'm still very much a fan of theirs and their expertise as well as commitment to ethics and customer service. It would just be better to not have to travel to Dallas again if there's someone here locally that would do a great job of maximizing aesthetics and symmetry.

@Skeptical_One , would welcome your thoughts. Thank you.

I have a couple rules I stick by -- firstly, I try to remain impartial when & where I can if it involves multiple Sponsors -- my goal is to foster a Network of the Leading Innovators in the field while simultaneously encouraging healthy competition, which in turn breeds innovation & value for my Readership and the overall Online PE Community.

Secondly, there are few times I do get involved with helping determine the "best fit" for a fellow Member -- one of them being the rule that: if you are satisfied with your original Practitioner & Results, stick with them. It's akin to having a regular Barber or Bartender, they appreciate you as a regular, while also having the most recent information on your Medical File in terms of where you started, what your goals are, where you are now, and what you need moving forward.

So with that being said, William of PhalloFILL Dallas would be the obvious go -- you are happy with your results, you have an unbelievable retention age for Hyaluronic Acid (HA), and while I can't know for certain if the filler and/or technique played a role, it's safe to say that if it did, you'd be guaranteed comparable results with William.

I do want to stress that (1) that isn't to say other Providers can't achieve similar results and (2) I can't know for certain what played the most significant role in your HA retention (in other words, how much of it was PhalloFILL or how much of it was your own body's physiology; likely a mix of both if I were to make an educated guess) -- but given that you observed a proven Provider with @PhalloFILL , it would make no sense to go with anyone else as of now.

Since you asked, if logistics were of extreme importance and Dallas wasn't feasible (at least in the time frame you're looking at), then yes, Dr. Tsay would be the best Provider for HA that I would vouch for in Southern California. I can see you certainly being satisfied with Dr. Tsay's work (he's well reviewed as an Injector for all areas of the body), but since I can't know for certain what is responsible for this remarkable HA shelf-life you're experiencing, and Dr. Tsay does have his own HA preference (as well as the possibility of proprietary factors like methodology and technique varying Clinic-to-Clinic), I can't say your end results with Dr. Tsay would be the same, more, or less better than your last session (with PhalloFILL) -- but worst case scenario I don't think it would be less better by much, and best case scenario, you'd get comparable results.

So to summarize, I would try and make PhalloFILL Dallas (William) your target destination, even if it means waiting a certain amount of time to make the logistics work. And if there are reasons Dallas simply won't work for the timeframe you need fulfilled, Dr. Tsay would be the best alternative for your given situation.

Thanks so much for this detailed reply @Skeptical_One . You make a good point about sticking with my current provider.

Does my comment about desiring more symmetry and aesthetics (with less lumpiness) change anything? Is Dr. Tsay particularly good with that, as far as you know?

Is there anyone else (in SoCal or elsewhere) that is known to have an "artistic / magic touch" in this respect?

I should also say that I was hoping to just go to the PhalloFill provider in LA (Dr. Gonzales) but he actually (kindly) turned me down because I guess he felt I was bit too high of a risk due to the previous post I made that was somewhat critical of him. If he read through the entire post, I'm sure he would've seen that it was not intended to be very critical. But I still respect him. He was kind enough to call, share his concerns, and refer me to other providers.

Why not go to William again? Didn’t he fly you out and do 5 syringes for free just by reason you weren’t happy with your initial 6 syringes? And the syringes William done made you happy?

Why risk going to another provider and getting an unknown result when you know you have gotten good results in Dallas and more than that have had some perks granted to you as well.

I guess your post about wanting aesthetics changes that I would low and slow, if you had the time to fix I would do like 2-4 units per sessions, tapering down units until you get your unit completely symmetrical. I am on the symmetry stage myself and think it might be good to fire-go a 5+ during session as you risk more asymmetry.

@melon , thanks for your advice on going slowly over multiple sessions. I think that's a good idea. And if I'm going to be doing multiple sessions, then I definitely need someone local I think...

Also, an update that I went for a consultation with Dr. Tsay today and here's my feedback.

He agreed that there was asymmetry that needed fixing. He recommended dissolving some areas and adding more filler in others, which I agree is the best approach. The asymmetry was caused by migration of the filler after the procedure itself. To prevent this from happening again, he recommends injecting with botox to freeze the muscles and prevent retraction which would hold the penis in place, then adding the filler in. Using botox in the penis is a new concept to me. Does anyone have any experience with this? Does anyone have any other ideas to prevent migration? Dr. Tsay doesn't use a post-op sleeve like PhalloFill does to keep the penis in place, so I'm curious if anyone else has any thoughts on migration.

Dr. Tsay recommends Juvederm because it's a bit firmer whereas PhalloFill recommends Versa by Revanesse because they believe it has a feel that more matches the penis itself. Anyone have any thoughts on this? I think I may have no choice but to go with something more similar to Revanesse because that's what I already have in there and having different consistency with different fillers might defeat the whole purpose of going for a natural look and feel, right?

Most importantly, PhalloFill is very careful about where they inject: they only do the sides of the penis to avoid the urethra on the bottom and the vascularity on the top. This has the unwanted side effect of creating a "flatter" looking penis. Dr. Tsay agrees with staying away from the urethra (but he goes a little bit closer to it) but doesn't shy away as much from the top (while saying he avoids the key veins). Anyone have any thoughts on this? The most important thing is safety of course.

Thank you!

The sleeve would prevent migration. It’s basically doing what the Botox would do but manually. It also compresses your penis which Botox won’t do, so it’s most likely better with migration. You could do both with PhalloFILL.

As far as filler firmness, search G prime. From what I understand the firmness of the filler does not matter so much as the where it’s injected. I think they pick Versa for safety profile and affordability, it’s cheaper than Juvederm and has 20% more filler per vial.

As far as the flat penis, I like it. I don’t think it looks weird. Honestly it’s my preferred shape as the POV from blowjobs looks insane. It also allows blowjobs with a bigger size as as a mouth is wider that is is longer.

If you do go with another provider, whoever it is, go slow.

Thanks for your thoughts @melon .

@Skeptical_One , any feedback on my follow up questions? Thanks as always.

rayjamesmith wrote: Thanks for your thoughts @melon .

@Skeptical_One , any feedback on my follow up questions? Thanks as always.

Regarding your questions, there isn't a whole lot I can add that wasn't detailed in my original response --
If it is Hyaluronic Acid (HA) you want, my recommendation remains to try and make time for a Dallas visit (for both procedure and some days of recovery if possible), if any way possible logistically (for reasons I outlined above).

As for Southern California, there are only two vetted Sponsors in the region, Avanti Derma and Ageless Medicine (Dr. Tsay). Avanti Derma specializes in PMMA and Ellanse, which is quite different than HA, and generally don't take patients that have prior work done. That leaves Dr. Tsay, and like I stated in my original post, he would be your best alternative if for whatever reason William & Dallas PhalloFILL couldn't work out.

I wouldn't recommend anyone who wasn't going to provide you optimal "artistic" results -- given what you're looking for you have two options, it's as simple as that. While I generally remain impartial, I am of the belief that if your original Injector did a great job, you should remain with them if at all possible (i.e. William of PhalloFILL Dallas), and if for whatever reason not even a concerted effort can be made to make a return to Dallas, you have your other option (i.e. Dr. Tsay in Orange County). I don't see any reason to juggle any other choices, you'll either get someone with a big question mark, or just add needless complexities to what is a rather simple Option A & Option B scenario.

Hope that helps.

@Skeptical_One , thanks for the response. I've pretty much decided to go with Dr. Tsay since I want someone local going forward.

What I was more specifically asking about was:

Whether you have any thoughts on botox as a means to prevent migration and whether it's safe.

Whether I should stick with the same filler, or I'll be fine if I have more than one filler in terms of maintaining a natural look.

Regarding safety, are there any instances that you've seen of Dr. Tsay causing issues to penis functionality given that he gets closer to the urethra and goes on the top of the shaft as well where there's more vascularity?

Is there anyone else who has a lot of experience with HA fillers on this site who we might want to ask to chime in?

Thank you.

Ah I see. See answers in bold:

Whether you have any thoughts on botox as a means to prevent migration and whether it's safe.

I'm not sure how Botox would prevent migration, then again, the risk of migration with Hyaluronic Acid (HA) has never been discussed because it's a non-issue. Not only would a skilled & experienced practitioner know where to inject it, but the very filler itself is just a more cross-linked version of the compound that already occurs naturally in your body. Furthermore, a few Clinics have been using Botox in the penis for quite some time now, and just like its use in the face, it has been shown to be safe and effective for improved Flaccid hang and/or mitigating retraction (i.e. Turtling). The only thing you have to account for is how long it will last, since with any Botox application, routine maintenance (i.e. follow-up injections) will be required to retain its benefits.

Whether I should stick with the same filler, or I'll be fine if I have more than one filler in terms of maintaining a natural look.

If Dr. Tsay happens to offer the original filler you had, I'd go with that only because we already know this iteration of HA has a proven track record with you; if Dr. Tsay does not offer your original filler, I don't think there will be much in the way of significant differences if all you are doing is fixing aesthetics & symmetry. This will be a conversation you will need to have with him, but working with different brands of the same kind of filler (HA) is going to be easier to manage (I would imagine) than mixing different TYPES of filler in the penile shaft (example: PMMA + HA, or Fat + Ellanse, and so on). Not that other combinations aren't effective or safe, but rather, the same TYPE of filler is more likely to play nice with what's already there.

Regarding safety, are there any instances that you've seen of Dr. Tsay causing issues to penis functionality given that he gets closer to the urethra and goes on the top of the shaft as well where there's more vascularity?

No, Dr. Tsay has no reports that would warrant questioning the safety of his approach, especially with respect to the penis. Dr. Tsay was brought on board because of his prolific reviews involving facial injections, perhaps the most difficult area to enhance because it's the most seen part of a patient to the outside world (as in, contouring female facial beauty without looking "plastic" is a testament to his proficiency in filler technique). He wanted to venture into Male Enhancement a few years ago and has put out great work and has had positive reception since. While it is unfortunate you couldn't stick with William of PhalloFILL Dallas, I can understand why some may opt to remain local, and I have every bit of faith in Dr. Tsay with handling your work moving forward. Make sure you set realistic expectations, be clear & communicative with your goals, and trust his recommendations if you wish to optimize future sessions.

Excellent, thank you so much @Skeptical_One

I used Dr Tsay and would highly recommend him

Hi All:

Posting a quick update that I had my first injection session with Dr. Tsay a couple of weeks ago. Overall it went well. I think I'll need 1-2 more sessions to fully even things out and get the symmetry I've been looking for. Will post a formal review a couple weeks after my last session once everything is healed.

@Skeptical_One , I had an idea I wanted to run by you. One of the challenges with HA fillers is that they are injected while the penis is flaccid, and so it's hard to know how the penis is going to look once it's erect with the filler in there. I had a thought of injecting trimix to force an erection prior to the procedure, so that the filler can be added while the penis is erect (and can thus be contoured according to an erect penis). Because the penis is fully expanded, it will allow for more even distribution as well. But based on my reading, there is a greater risk of hematoma or vascular injury (in addition to increased bruising) because of the increased blood flow. Actually the first time I got injected I had forgotten to skip my daily cialis which meant that my penis was partially erect during the procedure, but Dr. Gonzales said it would just cause some increased bruising but otherwise be fine (which is exactly what happened). Additionally, perhaps this increases migration risk when the penis ultimately retracts?

What do you think? Obviously safety is the #1 priority.

rayjamesmith wrote: Hi All:

Posting a quick update that I had my first injection session with Dr. Tsay a couple of weeks ago. Overall it went well. I think I'll need 1-2 more sessions to fully even things out and get the symmetry I've been looking for. Will post a formal review a couple weeks after my last session once everything is healed.

@Skeptical_One , I had an idea I wanted to run by you. One of the challenges with HA fillers is that they are injected while the penis is flaccid, and so it's hard to know how the penis is going to look once it's erect with the filler in there. I had a thought of injecting trimix to force an erection prior to the procedure, so that the filler can be added while the penis is erect (and can thus be contoured according to an erect penis). Because the penis is fully expanded, it will allow for more even distribution as well. But based on my reading, there is a greater risk of hematoma or vascular injury (in addition to increased bruising) because of the increased blood flow. Actually the first time I got injected I had forgotten to skip my daily cialis which meant that my penis was partially erect during the procedure, but Dr. Gonzales said it would just cause some increased bruising but otherwise be fine (which is exactly what happened). Additionally, perhaps this increases migration risk when the penis ultimately retracts?

What do you think? Obviously safety is the #1 priority.

I haven't seen any evidence or proof that having an erection during a procedure improves your results (even negligibly), and the potential complications that you mentioned certainly make it even less appealing.

Not saying it can't have some merit, but here is my main contention with this method: even if you get fillers injected while erect, you'll eventually go flaccid hours afterwards, and during the first few days of post-op recovery. This creates the same window where aesthetic irregularities can manifest themselves, where massaging is important, and you're still healing -- that is to say, the injections during your erection are seemingly pointless if you are only going to go limp soon after.

Is it possible it could help for some specific type of penis shape (or other unforeseen variable), maybe, but the sheer abundance of quality results on this Forum without the need for an erect penis, makes this additional step unnecessary.

Also, Dr. Tsay is a high-dexterity injector, this rules out the need for a forced erection even further. Unless a Practitioner believes your specific case (penis) warrants it for some anomalous reason, you're only adding extra time, cost, and increased risk of complication (albeit minor).