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Non-surgical penile enlargement: Questions and Answers
REJUVALL® is America’s longest running men’s sexual health clinic, and we have been doing male engagement procedures longer than anyone else.
In other words?
We practically wrote the book on how to safely and effectively perform male enlargements.
General Questions about REJUVALL Injectable Penis Fillers
What is the average size of a man's penis?
What is the most common size of a man’s penis?
“Six inches” is the most common “pop culture” response to this question. However, this result was derived from investigations of self-reporting conducted more than fifty years ago. In other words? It’s not accurate.
Numerous updated studies on penis size have been conducted over the years, but the most reputable in terms of truthfulness was published in 2014 in the British Journal of Urology by David Veale, Professor of Psychology at King’s College, London Medical School, and involving 15,500 men.
The following are the “average” penile length and circumference according to the BJU study:
Average Thickness
3.75-inch mean flaccid circumference
4.7-inch average erect circumference
Average Length
Length on Average: 3.7 inches
Average erect length is 5.25 inches
These results are smaller than some studies you may encounter. However, analysis of protocols from other studies revealed that a large number of variables that can influence measured measurement, such as clinical conditions, medications the patient is taking, arousal level, age, and weight, were not adequately controlled. Ironically, a retrospective examination revealed that the source of a variance was the patient’s influence on the measured measurement, either through self-reporting or by badgering the researcher.
Urologists consider the study results published by Dr. Veale in the British Journal of Urology to be the most accurate.
How big can I become from a non-surgical REJUVALL® enlargement?
Most patients can become as big as they want.
The key to achieving a lasting and high-quality enlargement is directly related to the quality of the initial foundation. That’s why we perform a pair of initial foundational layering sessions to start.
The very first time an injectable filler is injected under the skin, the body’s immune system often reacts most violently, resulting in more significant swelling than occurs in follow up procedures. The fact hyaluronic acid is the safest and most benign among all dermal fillers, this response is minimized.
That’s one reason we insist upon at least a six-week window before the first and second foundational layering. We need the body to have grown accustomed to having HA within the shaft skin and all inflammatory reactions to have subsided.
Even if a patient is certain they only desire a permanent result from PMMA injections, we require that they commence with at least one layer of hyaluronic acid (HA) as the starter foundation. Since the primary challenge of using PMMA in the penis shaft is its propensity to clump together and form granuloma, we discovered starting augmentation with PMMA will almost always result in the immediate formation of granuloma, which makes for a less than ideal foundation to establish symmetrical penile thickness.
Once a proper foundation is established, patients can continue to add more thickness based upon their size goals, or they can simply choose to maintain their existing new bigger size.
Everything related to a bigger size is directly tied to the quality of the foundational layers.
How is a REJUVALL® non-surgical penis enlargement performed?
An expert, board-certified urologist who is widely regarded as one of the country’s leading reconstructive penile surgeons performs all in REJUVALL® non-surgical penis enlargements.
Using numbing ointments and local anesthetics, the majority of non-surgical REJUVALL® procedures are concluded in less than an hour. Additionally, the injectable filler contains a local anesthetic that numbs the injection site immediately. Occasionally, the procedure may be mildly uncomfortable, but the vast majority of patients report that it is not “painful.”
No incisions, sutures, scalpels, or general anesthesia are used during these procedures. All patients must undergo a brief urologic evaluation prior to treatment.
Who performs Rejuvall's non-surgical penis enlargement procedures?
Founder Steven L. Morganstern, MD and co-founder Kenneth J. Carney, MD, PHARM, FACS developed Rejuvall’s procedures through a decade-long collaboration. Together, they have more than seventy years of advanced urologic experience.
Dr. Carney now performs all the enlargement procedures at REJUVALL®.
How much bigger will I be after my REJUVALL® non-surgical enlargement?
REJUVALL® is capable of creating almost any increase in penis circumference.
The injectable products we employ are known as “volumizers”, thus for each one milliliter of product results in an increase of one milliliter. The greater the amount of product, the larger the size.
However, aesthetic symmetry is also usually an objective thus our REJUVALL® surgeon will recommend a sensible volume based on your natural size and shape.
Are there men who are not good candidates for a REJUVALL® non-surgical penile girth enlargement?
Before increasing penile thickness securely, a patient should be circumcised.
We offer non-surgical girth procedures for men of all shapes, sizes, and health conditions. However, we discovered that there are two types of males who will usually not benefit from a penile thickening procedure.
1. A patient with an enlarged suprapubic fat pad that obscures a section of the flaccid penis shaft is almost never a good candidate for penile thickening as a first-line treatment. It will visually shorten the larger penis, sometimes significantly. These individuals should first have body contouring and lengthening procedures performed. Any other path almost always yields unsatisfactory results.
2. A patient with Micropenis is usually inappropriate for beginning with a girth enlargement. A thicker micropenis creates the appearance that the penis is even shorter. These individuals should begin with a lengthening surgery.
Where can I view authentic "Before and After" images of REJUVALL® non-surgical penis enlargements?
Follow this link to view our “before and after” gallery of non-invasive REJUVALL® enhancements. The minimum age required to access the gallery is 18..
Will non-surgical REJUVALL® injections lengthen my penis?
No.
Comparing our before and after images of REJUVALL non-surgical penile enlargement, it may appear that the penis grows longer as a result of filler injection. Nevertheless, this optical illusion is caused by the additional weight of the injectable filler.
REJUVALL® is the leading clinic in the United States for penile lengthening technology offering non-surgical penile lengthening, the only clinic to guarantee at least one inch of additional penis length with our surgical penile lengthening procedure, and our mind-blowing two inch length guarantee when patients combine our non-surgical lengthening with our surgical length procedure.
Surgical vs. non-surgical girth: Which path is right for you?
We offer both surgical and non-surgical options for augmenting penile thickness. The primary advantages of our dermal filler alternatives for non-surgical augmentation are rapid recovery and minimal or no work absence.
Additionally, you can be a cigarette smoker, be diabetic with an elevated A1C, have a cardiac condition – you name it. Nearly all males are candidates for non-surgical dermal filler enhancements. We offer a variety of non-surgical, injectable dermal filler enhancements that are FDA-approved. It’s a fantastic method to “test drive” a larger penis. If you enjoy it, you can decide on a subsequent visit to pursue a longer-lasting path. Nevertheless, if you do not like it, it will eventually be reabsorbed by the body and be gone. Additionally, hyaluronic acid can be completely reversed with a few injections of diluted hyaluronidase.
The only men who are not good candidates for non-surgical dermal fillers are those with an enlarged suprapubic fat pad in which a portion of the penile shaft is buried and those with a micro penis. As a result of the added circumference, the penis will retract further into the adipose pad, resulting in a penis that is typically half its current length. Due to the change in proportion, a micro penis appears visibly shortened when its circumference is increased. Before contemplating the addition of thickness, we strongly advise that these patients undergo a lengthening procedure and complete all associated aftercare to optimize their case.
The benefit of REJUVALL’ PERM® surgical girth procedure is that it is all-natural and yields the most significant, permanent results.
Do you offer silicone implants for enlargement?
No, we do not.
However, we are one of the leading clinics for repairing men whose silicone penile implants for enlargement have caused damage.
Silicone, whether in the form of injections from the black market or FDA-approved formulations, is, in our opinion, the utter worst product for penile enhancement. Some are attracted to injectable liquid versions due to their affordability and durability.
However, unlike injected PMMA, which can be chemically or surgically removed if the patient is dissatisfied with the results, injected silicone remains in the body for life. Similarly, if you begin with silicone, you cannot switch to another form of penile girth enhancement – you’re stuck. Silicone impedes ultrasonic sonography, so a urologist will never be able to examine your interior penile health if the need arises. Remember that everlasting can also refer to your ability to endure a lifetime of problems.
Similarly, we believe a silicone implant to enlarge the penis is a bad notion. The manufacturers of penile prosthetic implants for severe erectile dysfunction attempted this decades ago in an effort to preserve the original penile length. They discovered that this led to an unacceptable number of cases of infection and many men who developed a fibrotic buildup at the base of their organ (a result of intense sexual intimacy), and in some cases, severe Peyronie’s disease.
Implants made of silicone used to augment the breasts of women live a carefree existence atop the rib cage. The journey of a penis between sexual activity and masturbation is significantly more violent. We believe that the hazards and complications outweigh the benefits.
We strongly advise all new patients to begin with procedures that offer the greatest number of future options in case they change their minds.
For this reason, we do not advise a novice to use the only FDA-approved PMMA product (Bellafill). Once PMMA is injected into the subcutaneous tissue surrounding the penis organ, several other potential future girth enhancing options, such as a Fat Tissue Transplant or Dermal Graft Transplant, can no longer be used because PMMA permanently restricts the necessary blood supply in the outer shaft tissue to support any type of transplant. Also, as indicated previously, it impedes a urologist’s ability to see inside your penis using duplex Doppler ultrasound technology should you experience a penile health event in the future or require PGE injections to improve function as you age.
What is the cost of REJUVALL®?
The cost of REJUVALL® is wholly dependent on the quantity and type of product chosen. Please refer to the Prices page for the most recent.
Can I increase the size of the head of my penis or just the shaft?
Yes, it is possible to inject the glans (“head” of the penis), however, it does not respond as reliably as the shaft of the penis. Injections of hyaluronic acid into the glans of the penis are effective for enlargement, but patients should not expect the consistent and long-lasting results observed in the penile shaft. In the glans, the erectile tissue is directly adhered to the glans’ epidermis. Injecting into this thicker epidermis can cause some compression of the erectile tissue, so although the erection may feel firmer, it does not increase proportionally as much as the shaft.
As the glans contains your “orgasmic” nerve endings, we must be extremely cautious about what agents are utilized. Enhancing a penis that cannot achieve orgasm defeats the purpose of the endeavor, no? There are currently no permanent bulking agents that are deemed harmless for the glans.
In addition, due to the blood flow within the erect copora tissue of the glans and the amount of friction the head of the penis glans endures during intercourse and masturbation, glans enlargements only last approximately six months, and typically only half that long following the initial layering session. Our objective is for patients to be pleased with their aesthetic results and filler retention. We do not believe that the majority of patients will be satisfied with the results in the glans, whereas we can attain years of longevity using the same filler in the shaft.
Questions regarding REJUVALL® Hyaluronic Acid (H/A) non-surgical enlargement PRODECURES
What is Hyaluronic Acid?
Hyaluronic Acid (HA) is a naturally occurring sugar chain found in the epidermis and tissue of all animals, which is rapidly degraded and regenerated by the body. Laboratory replications of HAs used for cosmetic purposes have been created. Once injected, they are generally cross-linked to increase their duration. The greater the cross-linking, the firmer and more durable the product. Hyaluronidase, the enzyme that breaks down Hyaluronic Acid into carbon dioxide and water, is naturally present in body tissue. Other variables, such as natural metabolism, excessive exercise, and medications, may also impact the rate at which HAs are degraded.
Given the premium HA products used in the REJUVALL H/A procedure, the majority of men will not detect a significant change in the size of their augmentation over the course of a year; however, this varies.
Are there any risks with hyaluronic acid?
As HA is a sugar and contains no protein, there is a very low risk of allergic reaction; however, there is still a small risk, particularly for individuals with an autoimmune disease. Hyaluronic Acid has a tremendous capacity to retain water (10,000 times its own weight). This can occasionally lead to issues with edema and product migration. Any injection carries a small risk of vessel occlusion (if needles are used and not a cannula), infection, or delayed granuloma (a firm lump). However, sterile procedures, antibiotics, or dissolving product with synthetic Hyaluronidase can mitigate or manage these risks.
Please contact your REJUVALL® doctor or clinic immediately in the event of any anomalous results or complications. The sooner you seek review, the simpler it will be to effectively resolve complications.
How does REJUVALL® for girth enhancement last so long in the penis last so long in the penis while hyaluronic acid (HA) filler injections only last up to 12 months in the face?
Utilizing a space between two dense layers of connective tissue or fascia, the technique that led to the development of the REJUVALL® enhancement was employed. Our enhancement creates a cavity for the filler within these fascial layers. This pocket’s limited lymphatic and blood flow is what allows the filler to last significantly longer than facial injections of hyaluronic acid. Because the face is rich in lymphatics and vascular flow, fillers typically degrade within one year. The same principles apply to the glans or “head” of the penis, which, due to vascularity, degrades hyaluronic acid filler over several months, whereas the compartment along the shaft allows the same fillers to last for several years..
How much does a non-surgical REJUVALL® H/A penile enlargement cost?
The cost of a non-surgical REJUVALL® enhancement is determined by the number of layers applied, which is dependent on the existing length of your penis.
Our preferred approach is to administer two sessions of HA filler foundational layering to each patient. In the initial session, 97% of patients receive eight foundational layers, which corresponds to 9.6 mL of H/A and a cost of $5,950. At least six weeks after the initial session, a second foundational layering session can be scheduled with an additional eight H/A layers for a total of 19.2 mL of HA from the foundation procedure. The cost of the second foundational stratum is also $5,950.
Men with an average-sized penis will typically experience a one-inch increase in thickness once these two foundational layers are established.
On our pricing page, the reduced costs for additional layering sessions or switching to permanent filler are detailed.
Where is the REJUVALL® H/A product injected?
H/A injections are administered right under the epidermis and Dartos fascia of the penis within the Areolar Tissue. Buck’s fascia protects the basic anatomical structures of the penis, which are protected by areolar tissue.
If and when a patient chooses to switch to a permanent filler like Bellafill PMMA, those injections are placed beneath the HA layers
How is the REJUVALL® H/A Product injected?
REJUVALL non-surgical filler injections are extraordinary in that we don’t use clump-inducing blunt tip cannula. REJUVALL’s MacroSculpting, cannula-free injection technology allows for more precise placement of the dermal filler and optimized outcomes.
What if I don’t like my REJUVALL® non-surgical H/A filler?
Should you want to remove the filler for any reason, a simple solution can be injected that will dissolve the hyaluronic acid or any portion causing a visible irregularity to your dissatisfaction. This is rarely the case, in fact most men choose to add more over time.
After the first treatment, you’ll usually experience a noticeable size reduction after a couple of weeks due to the fact swelling is most common during the initial layers due to the heightened inflammatory reaction at that time.
The proven REJUVALL® enhancement and the optimal placement of filler allow for minimal absorption and maximum retention while maintaining the aesthetically pleasing results you desire within the limitations of your individual anatomy. REJUVALL HA patients have reported filler retention in excess of five years.
Should I be concerned about H/A filler migration?
During your REJUVALL® non-surgical enhancement, strategically placed filler will be injected along the shaft of your penis, from the base to the tip, to increase its circumference. If one of your objectives to your correct irregularities in your natural shaft design, we can adjust the placement to specific areas.
After the filler has been injected, you will be fitted for a compression sleeve to keep the penis extended and the filler in position during the encapsulation and bonding process with your natural collagen and elastin.
Once bonded, the filler remains in position and provides long-lasting, natural results.
The small number of lymphatics in the area where the filler is inserted allows it to last significantly longer than in other areas of the body. While Hyaluronic Acid and other fillers adhere to natural tissue, they are not indestructible and can shift over time contingent on the patient’s care, sexual lifestyle, and filler metabolism.
A significant advantage of starting with Hyaluronic Acid filler as opposed to more permanent options such as PMMA or fat tissue transplant is that we can easily soften, correct or dissolve almost any irregularity using a dissolving agent as opposed to having to make a minor incision to correct migration, nodules, and granulomas associated with permanent thickening agents.
With Hyaluronic Acid, an injection of the enzyme Hyaluronidase can be used to dissolve any unwanted area of filler, and touch-ups with additional filler can be conducted at any time to replenish areas that have shifted or been metabolized over time.
REJUVALL®, unlike many others, provides a highly customizable, non-surgical approach that requires no downtime and minimal recuperation. It is crucial for patients to adhere to their provider’s post-treatment care instructions, which may vary based on their individual anatomy.
Are results from REJUVALL® H/A injections instant?
Yes, the H/A product used by REJUVALL is a volume filler, so for every 1ml of filler injected, there is a 1ml increase in volume, and the results are immediate.
After your first layering session, swelling will usually be more significant than with follow up sessions, but it will subside over the course of a few days.
It takes a few weeks for dermal fillings to stabilize, absorb water (or stimulate collagen), and achieve their optimal appearance.
How much injectable H/A product will I need?
Your natural erect length and girth will determine the quantity of product necessary to accomplish a desired increase. We find it safest and best suited for achieving foundational integrity to start with the stand 9.6 mL (8 layers) of H/A product distributed evenly along the entire length of the shaft. Men with larger natural size (over 7” in erect length) will often be recommended for 15.6 mL (13 layers) during their second treatment session in order to ensure a larger and more natural looking outcome.
Men with an average-sized penises (between 5.0 and 5.8 inches when erect) will most commonly become about 1” thicker after these first two rounds of H/A. Those men can typically escalate to our 15.6 mL jumbo layering after their first two foundational rounds of 9.6 mL are complete, resulting in typically two inches of added thickness.
How many H/A layering sessions will I need?
The REJUVALL® H/A layering program is typically divided into two sessions spaced approximately 6-8 weeks apart. This tends to improve the ultimate symmetry and aesthetic appeal following the initial more inflammatory based round and the subsequent “fill & smooth” round.
How long does a REJUVALL® H/A non-surgical enlargement last?
The majority of men will not observe a significant reduction in the size of their REJUVALL® augmentation during the initial 9-12 months, followed by a progressive resorption over the subsequent 12 months. Other reports suggest that repeated injections of HA tend to have a prolonged duration, most likely due to the stimulation of collagen where the filler is injected, a process known as fibrogenesis.
90% of Hyaluronic Acid (HA) penis augmentations remain fairly well preserved after 18 months, according to a Korean study evaluating longevity of H/A injected in the penis. So far, REJUVALL® patients have demonstrated excellent retention after 12 months, and the majority of them only return within this time frame because they desire to be larger.
To maintain optimal capacity, we anticipate that the majority of patients will require a top-up of 5-10 ml every 18-24 months.
Will the H/A filler reabsorb after the girth enhancement?
Yes.
The body will eventually eliminate all H/A dermal fillers.
If you wish to maintain your larger penis circumference, you may require approximately one-half of the initial volume of filler in a subsequent treatment 12 to 24 months after the initial treatment
Results will vary from patient to patient.
If a reversible filler like H/A is used, it can be promptly dissolved by injecting hyaluronidase an enzyme.
This is an important additional safety feature of a reversible filler that is sometimes requested if the added circumference is causing your partner sexual difficulties.
In our experience, partner dissatisfaction is uncommon, with the vast majority of patients reporting improved sexual relations after girth augmentation.
It is important to note that, although extremely rare, it is possible for the filler to be reabsorbed within a few months, particularly if the immune system mounts an attack on the filler.
This is neither expected nor likely, but it is conceivable.
What’s the recovery after a REJUVALL® non-surgical H/A filler?
With REJUVALL®, there is minimal delay; the majority of patients return to work the following day. A stretchable bandage will be draped around the penis after the procedure to reduce swelling and facilitate product placement. Please leave this on for 24-48 hours and rewrap if it falls off earlier.
With H/A, the product is initially malleable for up to two weeks following layering. We will guide you on how to massage any lumps or bruises during this time. After two weeks, the dermal filler will integrate with penile tissue, so any residual lumps will need to be dissolved or resorb naturally.
Patients are instructed to keep the shaft area clean for one week, and refrain from sexual activity for about seven days, shower daily and after exercise, take any prescribed medications, and closely adhere to our post-operative care instructions.
We offer an after-hours support line for any concerns and request that you return in 3 to 4 weeks for a quicky review as needed.
Will I have lumps/ bumps from H/A?
Using our proprietary MacroSculpting injection technique, the REJUVALL® H/A procedure has been refined and enhanced.
As long as patients adhere to our doctor’s instructions and return for follow-up, the REJUVALL® technique produces consistently reliable and evenly distributed product throughout the penis without lumps or ridges.
If any asymmetry or tumors are observed, please return for a review by our surgeon, who may be able to remedy the situation.
What products are used for non-surgical H/A enlargements at REJUVALL®?
Since 2014, we have tested a variety of dermal filler products approved by the FDA in order to develop the REJUVALL® technique. Our objective was to identify the safest dermal filler that is appropriate for penile augmentation and has sufficient longevity to justify the cost.
In the event of complications or asymmetry, we recommend a biodegradable, highly bound volumizing product (within the hyaluronic acid “HA” family) that can be rapidly ‘dissolved’. This product is a sugar-based gel that is already present in epidermis and tissue and is degraded by the body over 18-24 months or more.
We also offer off-label use of FDA-approved Bellafill for permanent non-surgical enlargements. We insist patients first get a foundational layering round of H/A injections before Bellafill to help reduce the likelihood of unsightly granuloma (clumping together of PMMA spheres). Bellafill is more expensive per mL than H/A injections.
We do not combine different varieties of dermal fillers during injection, it’s akin to trying to mix oil and water based paints: all positive properties become suspect and it increases risks of infection.
Patients insistent on a permanent enlargement will likely find the biggest safest and best outcome with our proprietary Fat Tissue Transplant” surgical penile thickening.
We fell compelled to warn patients about clinics injecting a concoction of raw silicone into the penis. We’ve had to treat several patients in the hospital who unknowingly received these injections that were advertising as “permanent collagen inducing injections”.
Please make safety your highest priority in everything you do with male enhancement.
What can I do if I absorb HA quickly?
Unfortunately, there is a possibility that your body will break down HA faster than anticipated, and we cannot predict this prior to treatment. Currently, we are researching and testing additional TGA-approved dermal fillers (Biostimulators) that have the potential to last three years or longer. These products have similar volumizing effects and will eventually resorb; however, masses or complications prevent us from dissolving them immediately. Additionally, these items are more costly. We view these as an alternative for patients who do not respond well to HA or who desire a longer-lasting option and are willing to assume a greater risk. On the other hand, when injected by an experienced REJUVALL® physician, these products tend to be firmer and generate optimal ease of placement..
Am I a Good REJUVALL® H/A Non-Surgical Enlargement Candidate?
Rejuvall® non-surgical enhancements are the least restrictive enlargement procedures REJUVALL® offers in terms of any pre-existing health conditions or lifestyle contraindications.
For instance, you can continue to consume cigarettes or have an elevated A1C level and still undergo the non-surgical REJUVALL® procedure.
The only “macro” requirement for both surgical and non-surgical penile hypertrophy procedures is circumcision.
How much thickness can be added to my penis with a REJUVALL® Non-Surgical procedure?
When most patients decide to undergo penile enlargement, they frequently feel compelled to grow as large as possible as quickly as possible.
This is a nightmare yearning to come true. Some men dislike the change in penile texture caused by certain girth enlargement agents. If you begin more slowly, you can readily modify your optimal path.
Most commonly, penile thickness is increased by injecting a bulking agent into the subcutaneous tissue layers surrounding the penile organ. Observe how minuscule the subcutaneous layers are in the illustration. To assure a successful outcome, initial contributions are limited.
The good news is that human tissue and epidermis are highly extensible. Changes in the size of women’s buttocks over time are a classic illustration of the malleability of fat and epidermis. Unfortunately, it requires sufficient time to securely expand.
Given sufficient time between procedures for the skin to stretch, it is ultimately possible to add an almost unbounded amount of penile thickness. There is a limit to how much penile girth can be added at once. You can safely add one inch of circumference at a time. Unfortunately, we typically do not recommend adding width beyond a certain point because it can cause the penis to appear unnatural as the width proportion in relation to the glans (head of the penis) becomes misaligned. In extreme cases, it transforms the appearance of a circumcised penis into one that is not circumcised. Due to the intensifying response from intimate partners, some males are accepting of this change. Others do not find it attractive
Questions regarding REJUVALL PMMA permanent injection filler
What are BellaThick™ PMMA injections?
Rejuvall® BellaThick™ is a non-surgical, off-label injection of the only FDA-approved version of “PMMA” or polymethyl methacrylate. This injectable synthetic composed of smooth, round microbeads of polymethyl methacrylate, suspended in a bovine carrier, stimulates tissue inflammation and collagen stimulation to replace bovine agent and encase polymer beads that are too large for the body to naturally reabsorb.
BellaThick™ augments both erect and flaccid penile circumference or thickness. BellaThick is a three-step procedure that increases penile thickness more slowly than H/A.
1. Collagen carriers initiate inflammatory response
2. Collagen is deposited around PMMA microspheres
Injecting collagen agent causes its dissipation.
There has never been a documented change in a patient’s erection or sensation; however, the sexual partners of our patients have reported significant differences.
A comprehensive comprehension of penile anatomy and function, non-cannula injection techniques, and product viscosity gradient are required for optimal enhancement with a smooth, symmetrically enlarged penis.
All Rejuvall® procedures are performed by Kenneth J. Carney, MD, PHARM, FACS, one of the foremost reconstructive urologists in the United States
Is PMMA filler permanent?
We believe that Bellafill PMMA is largely permanent, but the clinical evidence to support this claim is still evolving.
Currently, Suneva, the distributor of Bellafill, has published its five-year, 1,008-patient research in which consumers experienced an 87 percent retention rate, indicating near permanence. As patients lose interest, lose contact, or move on, production of the ongoing ten-year study is becoming increasingly difficult. No form of PMMA has been evaluated clinically for more than five years.
Bellafill microspheres contain the active constituent polymethyl methacrylate (PMMA). It is a synthetic compound that serves as a structural support for the skin, similar to a building’s scaffolding, to hold the skin in place and restore lost volume. The diameter of Bellafill microspheres ranges between 30 and 50 microns. Above 20 microns, homogeneous microspheres are considered too large to reabsorb or degrade as part of normal human metabolic activity (like hyaluronic acid).
When appropriately administered around the penis, PMMA injections should be largely permanent, in our clinical opinion. We believe that the mechanical action of vigorous intercourse or masturbation, which carries the risk of dislodging the PMMA microspheres, poses the greatest threat to their loss. Therefore, we recommend that PMMA patients cultivate the habit of masturbating with a “flesh light”-type device. By design, it is more appropriate for the penis and improves penile performance during vaginal sex.
In Suneva’s five-year, 1,008-patient study, the retention rate for users was 87 percent, which is indicative of near-permanence. Bellafill is expected to disclose the results of a ten-year trial within two years. Such lengthy studies are extremely challenging to administer. The fact that patients migrate, lose interest, and undergo additional treatments makes it difficult to collect quality long-term data.
Note that no other version of PMMA in the world has ever conducted a clinical study demonstrating a lifespan greater than five years. Such investigations are extremely difficult to conduct and extremely uncommon in healthcare.
Why do I need to start with H/A filler when I know I want permanent PMMA?
Starting with PMMA rather than H/A infill produces a superior outcome. Granuloma (small nodules within the penile shaft) is one of the greatest challenges when using a permanent injectable filler such as PMMA due to its tendency to clump together. This is especially probable in the early stages, when the body’s inflammatory reaction is most active. After at least one round of H/A infill, this risk is greatly diminished.
We’ve designed our foundational layering procedure so that we can add PMMA filler after achieving the optimal size with H/A to create a seamless transition. This method is unique to Rejuvall.
In addition, the total number of milliliters of PMMA that can be safely administered at the beginning of the foundational structure is significantly less than at the beginning, which diminishes some of the excitement of growing larger.
We always advise a non-surgical patient to achieve his desired thickness with H/A before modifying his approach to permanence, if that is his priority. To reduce the likelihood of developing granuloma, we require that they receive their initial H/A treatment.
Questions regarding BOTH H/A and PMMA injections
If I have a large pubic fat pad can I still get a REJUVALL® non-surgical filler?
Large suprapubic fat pads (the area above the base of the penis), particularly those that hang over the penis or encompass the penis so that very little length is exposed, are not suitable for starting with an injectable girth enlargement.
If you have a large pubic fat pad encircling the shaft of your penis, it is likely that significant “lost length” is concealed beneath the fat. Before we can effectively perform a circumference enhancement treatment, we must first address the excess fat.
If the girth enhancement treatment is performed before addressing excess fat, the HA filler will often migrate to the end of the penile shaft as the penis retracts into the fat, leaving patients with an unattractive aesthetic result that typically goes from looking like a small penis to just a “button”. No man wants that outcome.
In this case, we prescribe a surgical procedure that includes surgical removal of the engorged pad, contouring of the stomach line with the newly reduced lower pelvis and penile repositioning to ensure a longer and more visible penis.
We have learned laser or freezing treatments for this condition never work. Lipo of the pad in men over the age of twenty-five usually creates an unsightly mess of skin hanging over and around the base of the penis, and even a monsplasty (a singular procedure to remove fat within the area) often fails because the penis usually needs some degree of reconstructive urology at the same time. Thus, the immediate positive result from a liposuction or monsplasty is often naturally reversed by the body within a year following the procedure.
Can I get a REJUVALL® non-surgical procedure if I already have had penile augmentation before?
REJUVALL® Non-Surgical can be performed after penile augmentation procedures such as fillers from other facilities, surgical girth from fat grafts, etc. However, you’ll need to schedule an in-office evaluation by our surgeon to determine which pathway is best suited for your case. It’s impossible to make an accurate determination via telemedicine in such cases.
REJUVALL® is one of the foremost clinics in the world for the repair and correction of major abnormalities resulting from problematic penile enlargement procedures. Our surgeon, Kenneth J. Carney, MD, PHARM, FACS, is one of the top reconstructive urologic surgeons in the United States for penile issues.
Can I get a REJUVALL® non-surgical enlargement if I have Peyronies Disease?
Our clinic is widely regarded as the foremost authority on Peyronie’s care and effective treatment.
We strongly recommend starting with detailed urologic testing and evaluation of the underlying fibrosis for treatment before exploring any enhancement options.
Sadly, we’ve encountered patients where a previous doctor tried thickening the penis to help offset the visible symptoms of Peyronie’s. That’s akin to injecting filler around a tumor so it’s not as obvious and borders on malpractice.
Can I fly in for REJUVALL® Non-Surgical Enlargement?
Yes, you may fly in for REJUVALL® treatment, we only ask that if you intend to fly in and out on the same day, that you schedule your return flight with extra time to spare based upon guidelines provided by our scheduling coordinator.
Can I have a REJUVALL® non-surgical if I have erectile dysfunction?
Yes, it is possible to have a non-surgical Rejuvall enlargement if you have erectile dysfunction, but we do not recommend it. Having a larger penis will increase your desire to use it. Most men become more depressed if it’s not working correctly.
REJUVALL enlargements do not cause or resolve any type of ED.
Is a REJUVALL® Non-Surgical Enhancement Procedure Painful?
Minimal discomfort was an essential factor in the development of Rejuvall’s non-surgical procedures.
We provide multiple options to ensure patient comfort during their in-office enhancement.
Our non-surgical procedures are typically performed by first administering a penile block to numb any pain. The injectable filler also contains a local anesthetic that immediately numbs the area.
The majority of patients report minimal discomfort.
When can I return go sexual activity?
We advise patients to abstain from sexual activity for at least one week and from unprotected anal sex for ten days in order to enable the tiny injection points to heal completely and reduce the risk of infection.
Is REJUVALL® noticeable for my sexual partner?
While increased flaccid size is sometimes noticeable to long term partners, our studies discovered that sexual partners undoubtedly feel the increase in circumference (especially with larger volumes > 15ml).
The overwhelming majority of orgasmic nerve endings are located at the opening of the vagina or anus, as opposed to its depth.
Will my penis function normally?
No alterations in erection, sensation, or orgasm have been reported following the REJUVALL® procedure.
Will my penis feel normal?
Yes, most patients will not detect a significant difference in penis firmness when erect. Some patients, however, report that a flaccid penis feels slightly more “squishy” than normal. This is typically proportional to the initial size and total amount of filler used to get you to your targeted thickness.
The penis will operate ordinarily with regard to erection and urination. Due to the increased weight of the penis, the penis will hang thicker than before. The penis will have a greater circumference or thickness when it is flaccid and when it is erect.
Does the REJUVALL® girth procedure require me to visit a hospital?
No.
Using long established local aesthetic techniques, Rejuvall’s non-invasive method enlarges the penile circumference without incisions.
With only the administration of topical anesthetic ointment, the procedure takes less than 30 minutes to complete.
During the procedure, while you are awake, the doctor will inject the reversible H/A dermal filler beneath the epidermis of the penis around the penile shaft.
Patients may promptly walk or drive themselves home following their procedure.
The procedure leaves only microscopic injection points from the filler syringe, which recover within seconds.
What sort of post procedure precautions care with a non-surgical enlargement?
Although the non-surgical procedure itself is relatively benign, there will often be moderate swelling and occasional bruising for approximately two weeks, particularly after your initial treatment. The penis will be wrapped in a compression garment, and the patient will be able to resume normal activities soon after the procedure.
Patients should NOT engage in sexual activities, including self-pleasuring, for approximately one week after each treatment, as determined by our doctor.
Initiating sexual activity too soon or failing to adhere to the post-treatment care instructions may result in migration of the dermal filler, which may result in undesirable aesthetic outcomes and other complications. Patients should be aware that every penis is unique, and that due to the expansion and contraction of the penis, initial irregularities may occur, particularly in the flaccid state. This is normal, and any irregularities can be rectified during subsequent filler treatments.
Is a stretcher device required after a non-surgical REJUVALL® procedure?
No, post-care for non-surgical injections is not extensive.
Are there any stitches required?
No sutures are necessary.
Is penis filler toxic?
The reversible H/A penile filler we use is non-toxic and based on a compound that the body produces and contains naturally.
For a number of years, reversible dermal fillers have been used in facial aesthetics (for example, to augment the lips or define the cheekbones). This compound is also found in the joints, where it is an essential component of the fluid that cushions the joints, the synovial fluid.
I have a really short penis. Will a non-surgical filler do anything for penis length?
No.
While the weight of the filler can cause flaccid length to hang heavier in the flaccid state, men with overly short penises often get the opposite effect, making the penis appear even smaller.
We encourage such patients to start with surgical or non-surgical lengthening to ensure satisfactory outcomes.
What are the potential complications from a REJUVALL® non-surgical enhancement?
Whilst complications are rare, you may experience:
- Some discoloration and tenderness. Avoid taking Vitamin E, blood-thinning medications, anti-inflammatory drugs, analgesics, and St. John’s Wort for one week prior to and following the procedure.
- Significant swelling for a few days that will eventually subside. If edema persists for more than a few days, please contact your doctor or clinic.
Due to difficult-to-identify natural tissue bands beneath the penile skin, we may not accomplish perfect symmetry in a single session. Due to this, we prefer to inject in a two-sessions program, with adjustments made during the second session. - Potential for product to solidify and form lumps (granulomas). These issues can arise after a few weeks or months, and they should be resolved soon. Please contact our clinic for evaluation and recommendations.
Possible infection is the greatest cause for concern. We perform REJUVALL® in a sterile environment, and we may prescribe you antibiotics as a precaution after REJUVALL®; please complete the entire course. If you experience significant pain, fever, or difficulty passing urine, please contact your doctor or clinic immediately.
What can I do if I don’t like the result?
If you have utilized H/A (a reversible penile filler), we can dissolve it.
This is one reason why reversible penile fillers are safer than other methods for penis enlargement.
Simply put, if you wish to return to your normal penis size, you can do so by waiting for the filler to dissipate naturally or by injecting an enzyme that dissolves it into water immediately.
Obviously, you would be responsible for the cost of the initial procedure. Unlike penis enlargement surgery and its associated complications, however, you and your partner would not be left with a permanent result that neither of you are satisfied with.
Is there anything else I should be concerned about with a REJUVALL® non-surgical enhancement?
In some cases, healing may be delayed due to a scar that is deeper than usual after a circumcision conducted shortly after birth. Approximately 20% of men with a surgical girth enlargement experience this issue, but it can also affect 5% of men with non-surgical enlargements.
The majority of circumcisions are performed by the delivering physician shortly after delivery. For the sake of expediency, infant circumcisions involve pulling the foreskin away from the glans and removing superfluous skin along the penile shaft.
If your circ was performed shortly after birth, the area of your penis closest to the glans (head) will have a “lighter” skin tone when your penis is either flaccid or erect. This is referred to as the “inner prepuce”; it is a dermis that is less dense and less resilient than typical penile shaft tissue because it was previously located beneath the outer foreskin before it was removed.
The Issue: A Hidden Circumcision Scar Line
Whenever an incision is made in the epidermis, a scar develops during the healing process. With deep incisions, the scar is frequently visible on the surface of the epidermis. With minor incisions, such as those made during circumcision of an infant, the scar becomes invisible but persists beneath the skin.
Prior to the introduction of penile circumference enhancements, none of this mattered. In the distal portion of the penile shaft, the prepuce skin has no effect on sexual efficacy or sensitivity.
In roughly 20% of patients undergoing penile girth augmentation, we discovered that infancy circ scar lines slowed the healing process. The degree of recuperation delay depends on how deeply the delivering physician cut into the surrounding tissue of the penis organ during the circ.
Unfortunately, infant circumcisions cannot be reversed, and there is no means to determine the original incision’s depth prior to an enlargement.
Consequently, it is something we’ve learned to navigate during girth enhancement procedures, but it occasionally requires the patient’s fortitude and dedication in following prescribed aftercare techniques or attending follow-up appointments at our clinic.
Circ Scar Line: Three possible sources of healing delay
1. Obstruction of lymphatic drainage
The most frequent impediment to healing from an infancy circ is when the residual circumcision scar line is substantial enough to create a barrier that prevents post-surgical edema fluids from leaving the area behind the circ scar line. Essentially, the scar line obstructs the lymphatic drainage required for proper healing.
This condition typically manifests as a narrow, “pinched” line around the penile shaft, between the circ line and the glans. Residual retained fluid from swelling that cannot be effectively reabsorbed by the body frequently appears as a thick neck region around the glans.
Complications with non-surgical enhancements from a heavier circ scar line are typically simpler to resolve than complications with surgical thickening procedures due to the fact that non-surgical procedures involve less swelling. This is also why we insist on beginning the first treatment with 10ML of the selected dermal filler in order to condition the inner prepuce. This is especially true with Bellafill PMMA, as it induces an inflammatory response following injection, resulting in sustained growth for 4 to 8 weeks after the procedure. Since we switched to using only five syringes of PMMA per administration, this issue has not been an issue
2. Circ Scar Line: Fat necrosis confined behind scar line (Only applicable to PermaLite enhancements). A Fat Tissue Transplant is exactly what it sounds like. To naturally thicken the penis, healthy, living adipose fat cells are extracted from a specific location and transplanted to the outer layers
We harvest “extra” fat cells in anticipation of the fact that a portion of the transplanted fat cells will perish during the relocation process (typically 30–35%).
Typically, dead fat cells beneath the circ scar line are readily reabsorbed by the body. However, fat cells that die in the area above the circ scar line can become confined and unable to reabsorb, causing the formation of fat necrosis (dead fat cells) nodules.
Resolving healing issues associated with circumcision scars from childhood
REJUVALL® offers both at-home and in-office treatment options for disrupted healing caused by a circumcision incision that is deeper than usual.
Please observe your provider’s instructions to aid in your recovery and schedule follow-up appointments if requested.