Dr Oates
Hi,

I am posting here just in case members don't go over to latest topics - maybe it is unnecessary.

Below the intro is basically a copy of the first post there.

We have clinics in both Perth, Western Australia and Sydney, NSW. Dr Steve Crimston is our lead injector in Sydney and I dont think it will be long before he has done as many as I have (Hyaluronic Acid - Voluma - microcannula injectable phalloplasty).

It has been very interesting interacting with members of the forum. Everybody has their story, experiences and hangups (me included). Skeptical one has been a voice of reason - remember it is always more important to you (the size of your penis) than it is to your partner. Everyone want to be richer, fitter, bigger, better in some way - just dont let that define your life.

If you decide you want to do something about the size of your penis - BE SAFE. Start with stretching exercises/devices. They probably do work, if you work at it consistently (like everything dont over do it and get hurt).

If it comes to medical intervention, then the only thing I think is safe long term is microcannula Hyaluronic Acid injection. It is not perfect. It is not permanent (although there are a number of studies suggesting there is some tissue growth stimulation - a bit like traction - that does last). It is expensive. It makes a nice increase in flaccid/erect girth and flaccid (unstretched) length. It does not make you huge (maybe with repeated sessions it can be pretty big).

But it is the safest option there is. No permanent side effects. No need for surgery to correct. Totally reversible with Hyalase. No down time. Painless. Hopefully no/minimal bruising.

But get it done by a doctor with a known/regulated product. Dont buy it off the internet. Remember - if you dont like your uninjured but 'unsatisfactory' penis how are you going to cope with an infected, granulomatous, necrotic penis that no doctor want to help because they dont want to be responsible for the complications caused by someone else. Unfortunately that is how it works in the industry.

I think over the next few years HA microcannula injectable phalloplasty will become common place. While I was developing my technique the question we kept asking was - "How many men would have a procedure to have a bigger penis if it was safe, potentially reversible, painless with no down time? Estimate 99%"

Here is what i wrote before -

I am a doctor providing injectable penis augmentation with HA in Australia. So remember to take anything I say with the understanding that I will probably write to support what I do. But I will try and explain why i do it and why I don't think there is anything better available at the moment. When I find something better, then we will look to change.

I have been working in the area of cosmetic surgery for 17 years after originally training in ENT surgery. Yes this is a significant career change. I mostly did facial plastic surgery for 15 years but had occasional requests for phalloplasty. After seeing how the surgery was done I did not really want to take it up - I did not think I would want it myself. But there were a number of articles published in the medical literature using HA's that interested me.

I began injecting cosmetic fillers (Collagen and Hylaform) back in 2000. I have seen a number of permanent fillers come and go. I have seen some significant complications of permanent fillers. I have also seen complications of temporary fillers - but the complications were temporary as well.

For any cosmetic surgery safety is the most important thing. It is not like cancer surgery where scars or significant issues are accepted. This is why I have avoided the permanent fillers. I have also avoided stimulatory fillers (Newfil, Elanse, Radiesse). Stimulatory fillers may be fine - but the risks are somewhat increased and not acceptable when we were starting a new procedure.

The issues to overcome were making sure it was painless, did not risk obstructing the penile artery or urethra, being smooth and even and minimal down time.

We are happy that we can get the penis nice and numb. Without needles.

The injecting layer (essentially just below the skin, between the Dartos and Buck's fascia) is easy to get into and stay in using blunt cannula. By using blunt cannula and staying in the right layer there is no risk of blocking a vital structure.

Getting it even is usually not difficult. The advantage of a cosmetic doctor over a urologist for this procedure is that we are experienced and skilled in performing cosmetic injectables. We know how to get it nice and smooth. But even then there is the occasional penis with (circumfential) bands which can be difficult to even out completely.

Injectable phalloplasty is a walk-in/walk-out procedure. We ask guys to give it a rest for a few days - but guys love to come back and tell us how they put it to use that night. Preferably give him a rest.

One of the great advantages of HA's is that they are completely reversible with a medication called Hyalase which is an enzyme to dissolve HA. This is one reason why it is our main injectable filler anywhere - you can get rid of it if you need to. In the penis the great thing is that if, for any reason, you were not happy we could do a few small injections and get rid of it all in a few minutes.

Obviously the main problem with HA's is that they are not permanent. We use Voluma (part of the Juvederm range) made by Allergan. This is the world number 1 HA by the biggest company in the business with the most research to back it up. They(Allergan) are intrigued by its use in injectable phalloplasty but it is strictly off-label. That means the company has not researched it and had it approved for this use in Australia.

After reading all I could, trying to get in contact with the Korean doctors (but failing), we tried our first patient in 2014. With just 5 ml of a different HA (initially tried a different HA because HA's are really expensive in Australia and the other company was willing to let me have some at a discounted price for the trial). He was happy - as was his wife. We did another 5ml.

Then I honed the technique on number of friends (quite an unusual experience, handling your friends penis's - and sticking a needle into it). We gradually improved the early results and waited to see how it would last. The Korean's had 90% retention after 18 months with what I feel is an inferior HA. Even in the last 6 months we have made further refinements to technique to improve results.

To improve longevity we have switched to Voluma. I have it in my face and it has lasted over 2 years. Voluma has the best researched longevity of any HA. HA's always last longer when injected in large amounts. HA's should have good tissue integration when injected correctly. That is it should not be injected in 1 big blob. With correct technique there are lots of fine collagen bundles around and it will not move. There are places in the face, such as the tear trough, where HA's last much longer (routinely years). It is hoped the penis will be another of these locations where there is less local, natural hyaluronidase (the dissolving enzyme) so it will last a decent time.

So yes we do have clinics on the east and west coast of Australia. I believe we do more injectable phalloplasties than anyone else in the country - but we have really only been doing it a relatively short time. We focus on safety first.

Free fat transfer can give good results. But I have also seen infections, resorption, unevenness. PMMA/Megafil/Silicone/Articol etc are too great a risk. I am sure there are guys with great results they are very happy with. The question to ask yourself is "If I get one of these minor/major problems how am I going to cope?". Surgery with lengthening and dermal fat grafts can be successful, with the right surgeon. But is major surgery, very expensive (>$30K in Australia) and has protracted down time.

I am happy to answer questions - but remember again - I have a commercial interest in this. But that commercial interest requires happy patients.

The Effects of Penile Girth Enhancement using Injectable Hyaluronic Acid Gel, a FillerTae Il Kwak MD1, MiMi Oh MD1, Je Jong Kim MD2 and Du Geon Moon MD2,
The Journal of Sexual Medicine Volume 8, Issue 12,  3407–3413, December 2011

Use of Macrolane VRF 30 in Emicircumferential Penis Enlargement
Giuseppe Sito, MD,Sergio Marlino, MD,Adriano Santorelli, MD
Aesthetic Surgery Journal February 2013 vol. 33 no. 2 258-264

Human glans penis augmentation using injectable
hyaluronic acid gel
JJ Kim1, TI Kwak1, BG Jeon1, J Cheon1 and DG Moon1
International Journal of Impotence Research (2003) 15, 439 - 443
What ever you do, make sure it is safe.

Google calibreclinic .com.au
(+61) 1300 105 505
Quote 0 0
dys7830
Dr Oates,

What have you learned about glans enlargement?  There has been a lot discussion about increasing the shaft size, but very little about the glans.

Dys7830
Quote 0 0
Giddyyupjoe
Dr Oates
Thank you for all of the information. Have you ever injected HA into the sac? Very interested in filling that out as well. Would love your thoughts.
Thank you
Quote 0 0
Skeptical One
This is not a discussion thread. Please keep inquiries to Dr. Oates in the appropriate thread.


Forum Rules!

Please message me directly for donation information!

Both valid email contacts:
(Commercial & Membership inquiries)
phalloboardsofficial@gmail.com

(All other inquiries)
phalloboards@gmail.com
Quote 0 0
Dr Oates
dys7830 wrote:
Dr Oates,

What have you learned about glans enlargement?  There has been a lot discussion about increasing the shaft size, but very little about the glans.

Dys7830


Hi Dys 7830,

I have done glans injections. Mostly into the flare(corona) of the glans.

It looks good flaccid and is firmer but does not seem to make as much difference erect.

More recently we have been injecting HA after using Caverject to produce an erection. It makes it easier to get a well distributed shaft injection. But have not injected the glans since then - which would be interesting as otherwise I dont get to see the 'after' erect.

It is a lot more bloody as well, doing it.
What ever you do, make sure it is safe.

Google calibreclinic .com.au
(+61) 1300 105 505
Quote 0 0
Dr Oates
Skeptical One wrote:
This is not a discussion thread. Please keep inquiries to Dr. Oates in the appropriate thread.



I understand now - this thread is about me, not for me to discuss.

OK - questions over to HA Phalloplasty for Safety thread.
What ever you do, make sure it is safe.

Google calibreclinic .com.au
(+61) 1300 105 505
Quote 0 0
Dr Oates
I was told this is locked, no further posts. just checking.
What ever you do, make sure it is safe.

Google calibreclinic .com.au
(+61) 1300 105 505
Quote 0 0
Skeptical One
Dr Oates wrote:
I was told this is locked, no further posts. just checking.


The thread isn't locked but it isn't a discussion thread. All pertinent posts need to reside in their designated threads. Thanks.


Forum Rules!

Please message me directly for donation information!

Both valid email contacts:
(Commercial & Membership inquiries)
phalloboardsofficial@gmail.com

(All other inquiries)
phalloboards@gmail.com
Quote 1 0
Dr Oates
Here is a before/after of a patient done 4 weeks ago, 15 ml Voluma, increase girth from 9.5cm to 13 cm (increase 1.4").
What ever you do, make sure it is safe.

Google calibreclinic .com.au
(+61) 1300 105 505
Quote 0 0
Dr Oates
Recent uncircumcised patient, 10 mth out - coming back to be even bigger
What ever you do, make sure it is safe.

Google calibreclinic .com.au
(+61) 1300 105 505
Quote 0 0
Dr Oates
Oop - still not good at adding photos -
What ever you do, make sure it is safe.

Google calibreclinic .com.au
(+61) 1300 105 505
Quote 0 0
sexy beast
results look good, do u have any photo's that have 30 ml's injected? 
Quote 0 0
Dr Oates
Soon
What ever you do, make sure it is safe.

Google calibreclinic .com.au
(+61) 1300 105 505
Quote 0 0
Dr Oates
Some More Photos - 35244_PP_CalibreF_PW copy.jpg  35244_PP_CalibreROB_PW copy.jpg 
What ever you do, make sure it is safe.

Google calibreclinic .com.au
(+61) 1300 105 505
Quote 0 0
sexy beast
hey there doc, results look good but still would like to c an erect photo with the HA. just want to c how how the HA molds in..

on a side note, have u ever seen or demoed BTL Exilis elite system?
Quote 0 0