Avanti Derma

Hello members,

My name is Luis Casavantes, known as “DrC” by my patients.

I am a Dermatologist and Medical Director at Avanti Derma, a private practice that offers Clinical, Cosmetic and Surgical Dermatology, as well as Nutrition through five on-site Physicians, one Nutritionist, and several Cosmetricians. 

Dr. Palmira Morales and I specialize in Nonsurgical Phalloplasty with leading soft tissue fillers such as Ellansé (PCL), Juvedérm Voluma (HA), Linnea Safe (PMMA), and Radiesse (CaHA).

It is my pleasure to participate with the Phalloboards Forum which has been the leading online source of information for male genitalia enhancement for almost 10 years!

Phalloboards is present at a time when most surgical options have been left behind, and have given way to more effective nonsurgical in-office, minimally aggressive alternatives; the future is here.

My experience with soft tissue fillers goes back to the epidemic of HIV-related facial lipoatrophy when reconstructing faces of young men was an everyday task. Between 2002 and 2007, I performed more than five thousand facial reconstructions procedures, helping thousands of patients from around the world return to social interaction without the stigma of a gaunt face. Those patients required a permanent solution, and we discovered what I still consider the best option: PMMA.

The use of permanent fillers in the most delicate area of the body (face) made it easy to transition to another indication that was unheard of by most and rarely offered at this time: nonsurgical penile enhancement. In September 2007, one of my patients asked if I would perform phalloplasty with PMMA on him... it was such a success, that before long I had nothing but phalloplasty patients lining up outside my door. Many of them used Phalloboards to communicate, and the rest is history; they continue to do so, and it has been the best unbiased advise that is available online.

Our office resides in the financial district of Tijuana (Mexico), around 20 minutes south of the International Airport of San Diego CA; here we offer a professional shuttle service to and from the airport direct to our door.

Accommodations are also comfortable and inexpensive; our twin-tower building complex includes the Grand Hotel Tijuana, where patients can stay and then return to Avanti Derma without exiting either building.

In few words, Avanti Derma offers phalloplasty services through two dedicated physicians with twelve years of uninterrupted experience on thousands of patients, four available products (three of them temporary, one permanent),  bilingual personnel, and modern facilities just around the corner of beautiful San Diego.

Just grab your passport!

Stay tuned! As part of our effort to have well-educated patients, we will be sharing information and ideas such as our “Case of the Week” with uncensored details of treatments that we perform with patients who authorize the use of their data while protecting their identity. We will also respond to questions based not only on our experience but mostly on peer-reviewed articles when available.

One of our primary concerns, because it happens everywhere, is to maintain alertness about counterfeit products or misrepresented substances that can damage naive individuals that believe in false claims.

Best regards,

Image 7-30-19 at 12.44 AM.jpg 

Dr. Luis Casavantes / Dr. Palmira Morales
https://www.avantiderma.com

Reception: info@avantiderma.com
US Phone lines: +1 (619) 308-7268 & 308-7269
Mexico: +52 (664) 687-4848 & 686-5636
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briceb
Hey, Dr. C.  Looking forward to seeing what you have to say.  
A clear conscience is the sign of a bad memory.
CURRENT: EL 8"  EG 7" midshaft  FL 7-7.5"  FG 6.25-6.5"
GOALS: EL 9"  EG 7"  FL 8"+  FG 6.5"
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Reklaw
Avanti Derma
Your work is impressive, you really are pioneers in that field.
Every few years there seems to be a new better PMMA on the market. At first there was Metacrill, then Linea, then Linea 2.0 etc
Are there any newer PMMA’s on the horizon?
Have you researched PMMA brands that are available in South Korea ?
If a new and improved PMMA were to come on the market many of us would be willing to pay extra.
Thanks for your time.
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Texas
@Avanti Derma  
Thank You for the post,  we appreciate your contributions here and opinions.  
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Avanti Derma
Thank you for your comments, guys.
Reklaw, yes... I visited Dr. Cho in Seoul a few years ago. He developed two products with microspheres: Dextran and PMMA. Back then I was interested in his Dextran option, but it turned to be that the registration process was too complicated and his price for distributors was beyond excessive. As for new brands of PMMA, the only new product is Biosimetrix, a clone of Metacrill and Linnea Safe... nothing new.
On the other hand, I am not too fond of jumping on new arrivals since we have hit the wall a couple of times, like what happened with BioAlcamid, an Italian product that we used for facial lipoatrophy correction back in 2002-2003. It had terrible late reactions and it was discontinued worldwide (hopefully).
Dr. Luis Casavantes / Dr. Palmira Morales
https://www.avantiderma.com

Reception: info@avantiderma.com
US Phone lines: +1 (619) 308-7268 & 308-7269
Mexico: +52 (664) 687-4848 & 686-5636
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Reklaw
Thank you for your comments, guys.
Reklaw, yes... I visited Dr. Cho in Seoul a few years ago. He developed two products with microspheres: Dextran and PMMA. Back then I was interested in his Dextran option, but it turned to be that the registration process was too complicated and his price for distributors was beyond excessive. As for new brands of PMMA, the only new product is Biosimetrix, a clone of Metacrill and Linnea Safe... noting new.
On the other hand, I am not too fond of jumping on new arrivals since we have hit the wall a couple of times, like what happened with BioAlcamid, an Italian product that we used for facial lipoatrophy correction back in 2002-2003. It had terrible late reactions and it was discontinued worldwide (hopefully).

Thanks
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lordoftorture
Hi, Dr C,
1. I am 6.7 BPEL and girth is 5.7 to 5.9 depending on the season, base and mid shaft are same measure, under glans is slightly less , non-circumcised , somehow loose skin because of pumping. My goal is moderate gain of 0.4 to 0.6 inch and keep very good aesthetic that I am told I have now. Can this be realistically done in one visit? I would be traveling from Europe and it is a long and expensive to be absent from work.
2. Do you have experience with muscle augmentation/enhancement? I have small deformity/cavity on both shoulders where my rear delt is sunken down and there is a gap over it. Is there a way to sculpt the shoulders?
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DinoXXX
non-circumcised in combination with loose skin will give bad post results (from what I've read if you are going for PMMA).
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Avanti Derma
@lordoftorture
In response to the first question, your risk of imperfections is high, especially if your skin has been stretched out. It creates too much room for the fillers to move around and for the known accordion effect to happen after only one session. Furthermore, if you have a redundant foreskin, the prognosis is even worst.
Most patients like you require a very conservative approach; also though half-inch seems to be moderate and realistic for your size, keeping the implant in place during the immediate postop is going to be a challenge.
I recommend you to consider three possible alternatives:
  • Try one of the temporary microsphere-based fillers (Ellansé or Radiesse).
  • Have a high/tight circumcision and then the permanent filler a few months later.
  • Start with permanent, but be prepared to have a circumcision (and a further touch-up session) if you end up with significant irregularities.
As for your second question, we don't offer muscle enhancement with PMMA.
If you have further questions or need a more personalized response, please contact us with close up pictures of your penis.
Thank you.
DrC
Dr. Luis Casavantes / Dr. Palmira Morales
https://www.avantiderma.com

Reception: info@avantiderma.com
US Phone lines: +1 (619) 308-7268 & 308-7269
Mexico: +52 (664) 687-4848 & 686-5636
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PhalloMe
Hello Dr C !

For uncircumcised men, what is your specific approach when inserting Ellanse compared to PMA ? I know you’ve recommended a conservative approach overall but is there a different percentage of Ellanse you use...and at what volume ? Max volume ? Multiple rounds ? 

Thanks for being available and helpful
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Avanti Derma
Hello @PhalloMe 
The approach is basically the same.
Physically, both Linnea Safe and Ellansé are identical, with the exception of the 30% concentration of Linnea which feels a little thicker.
Also, both products work the exact same way, by creating neo-collagenesis around the micro-spheres once the carboxymethylcellulose present in both products gets absorbed.
An uncircumcised penis is always a challenge independently of the product of choice, and it always requires a more conservative approach when compared with circumcised individuals.
Multiple rounds are also the best way to go, to allow collagen to "establish" one coat of soft tissue fillers before coming back with a new one. This applies for all the microsphere-based fillers, not to HA.
You're welcome, @PhalloMe 
Dr. Luis Casavantes / Dr. Palmira Morales
https://www.avantiderma.com

Reception: info@avantiderma.com
US Phone lines: +1 (619) 308-7268 & 308-7269
Mexico: +52 (664) 687-4848 & 686-5636
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toobigtofall
Hi Dr. C.    Thank you for all you have done in advancing safe and effective phalloplasty.  My question you is that 7 years ago I had a surgical degloving  to remove a previous deformed piece of alloderrm along the dorsal shaft.  It was replaced with a larger bovine type alloderm.  Since then I have not regained sensation along the dorsum despite multiple prp injection superficially and also deep into the cavernosum and also shockwave therapy.   Any suggestions? Thanks
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Avanti Derma
Hello @toobigtofall 
Sorry for my temporary absence; the beach and the long weekend were very tempting and fun.
First of all, thank you for your words! It is impressive to see the transformation of phalloplasty from the old fashioned surgical techniques to the modern nonsurgical era.
I am afraid that there is not much to do to regain sensation in the dorsum of your penis; the degloving procedure (especially the second time) could've had sectioned branches of the dorsal nerves, a situation that may be irreversible.
I hope that the ventral area next to the glans and the glans itself remain full strength!
DrC
Dr. Luis Casavantes / Dr. Palmira Morales
https://www.avantiderma.com

Reception: info@avantiderma.com
US Phone lines: +1 (619) 308-7268 & 308-7269
Mexico: +52 (664) 687-4848 & 686-5636
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toobigtofall
Thank you for donating your time to consider my question!
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