FusionThick™ Permanent Girth Injections

MacroSculpting™ technique

FusionThick™ isn’t simply about adding a permanent underlayer—it’s about creating a result that looks intentional, balanced, and stable over time. That requires more than product choice. It requires a planning framework that accounts for anatomy, symmetry, tissue behavior, and how results evolve as swelling settles.

MacroSculpting™ is Dr. Carney’s approach to penile girth enhancement planning and placement. The technique is led by Kenneth J. Carney, MD, PHARM, FACS, whose background includes urology, advanced reconstructive training, and formal education in pharmacology. That combination matters in procedures where precision, soft-tissue behavior, and product characteristics influence both safety and cosmetic outcome.

MacroSculpting™ emphasizes:

• Proportion-first decision-making (so results fit your baseline anatomy)
• Controlled, anatomy-guided placement to support even contour
• A stepwise strategy when appropriate, rather than overcorrection
• Follow-up planning to assess settling and decide whether refinement is needed

Because FusionThick is designed for patients who already have HA, MacroSculpting also focuses on how to transition responsibly—so permanence is built on a stable foundation rather than guesswork.

About Dr. Kenneth J. Carney

FusionThick™ and MacroSculpting™ were developed by Kenneth J. Carney, MD, PHARM, FACS, a urologic surgeon with advanced training in reconstructive urology and additional background in pharmacology. His work focuses on anatomy-based planning and technique-driven outcomes, which is especially important when a patient is transitioning from a reversible HA foundation to a permanent underlayer.

Dr. Carney’s MacroSculpting™ framework emphasizes conservative planning, precise placement, and follow-up strategy—so permanent enhancement is approached as a medical decision, not a one-time cosmetic purchase.

Cannula-free placement: why it matters

MacroSculpting™ uses a cannula-free approach to support controlled placement and contour planning. Technique selection is individualized based on anatomy, prior filler history, and safety considerations.

MacroSculpting™ is performed using a cannula-free approach as part of Dr. Carney’s technique. The goal is controlled, anatomy-guided placement and a more precise contour plan.

Some clinics prefer cannulas for certain soft-tissue procedures. At Rejuvall, the technique is designed around specific placement control and predictable contour shaping, with physician-led decisions about where material is positioned and how symmetry is managed over time. The exact approach used is individualized based on your anatomy, goals, and treatment history.

Why the “foundation” matters for permanent girth

Establishing symmetry with HA first helps reduce the risk of building a permanent result on an uneven baseline.

Achieving a long-lasting, natural-looking result is tied to the quality and symmetry of the starting foundation.

When injectable filler is placed beneath the skin for the first time, the body may respond more noticeably—often with more swelling (edema) than it does during later treatments. That early phase can temporarily affect appearance, which is one reason we plan conservatively and prioritize follow-up.

For patients who are new to girth enhancement—or who want permanent girth from the beginning—we typically recommend starting with at least one HA session, and often two, before introducing a permanent underlayer. The reason is not marketing; it’s planning:

• HA helps establish a smoother, more uniform baseline to build on
• It lets you confirm you like the proportions and contour before permanence
• If refinement is needed, HA can often be adjusted (and in some cases dissolved when clinically appropriate) before moving forward

If the penile shaft is uneven from prior HA injections (or from baseline anatomy), we may recommend refining the HA foundation first. A permanent underlayer can reinforce existing contour—so the goal is to make sure the surface finish is stable and even before permanence is added.

Once a strong foundation is established, patients can either proceed with FusionThick™ as a transition to permanence, or decide they’re satisfied with HA and maintain their result with periodic touch-ups.

What to expect with a FusionThick™ plan

1) Review your HA foundation

We confirm:

• What product was used (and when)
• How the tissue looks and feels now
• Whether the contour is stable enough for a permanent underlayer
• Whether any refining steps are recommended first

2) Plan permanence conservatively

Permanent filler is approached differently than temporary filler. Your plan is based on:

• Starting anatomy
• Desired proportional change
• Safety limits and tissue considerations
• A staged approach when appropriate

3) Placement and follow-up

You’ll receive aftercare guidance and follow-up planning to monitor how the result settles and to decide whether additional staged enhancement makes sense.

How long does FusionThick™ take from start to “settled”?

There is usually an early phase (when swelling is settling and tissue is adapting) and a longer phase (when your result feels stable and predictable). Timing varies depending on your baseline and the number of stages involved.

A consult is the safest way to get a realistic timeline for you, based on:

• Your HA timing and condition
• Tissue characteristics and goals
• Whether staging is recommended

FusionThick™ is designed for patients who are confident in their HA-based proportions and understand that permanent filler is a long-term decision. A consult is required to confirm candidacy and set realistic expectations.

Risks and permanence considerations

Because PMMA is intended to remain long-term, decisions about permanence are approached more conservatively than HA-based plans.

Any injection procedure carries risk. With permanent filler, risks may include:

• Nodules or firmness
• Asymmetry or contour irregularities
• Inflammation or delayed reactions
• Infection
• The possibility of revision treatment

Permanent means fewer “undo” options

HA can often be adjusted or dissolved when clinically appropriate. PMMA is intended to remain long-term, which is why FusionThick is structured around careful decision-making and conservative planning.

We would rather a patient take longer and feel confident in the result than feel rushed into permanence.

Who FusionThick™ is for (and who it isn’t)

FusionThick may be a fit if you:

• Already have HA girth enhancement and want to consider permanence
• Want a medically guided plan and follow-up
• Prefer an approach that prioritizes proportion and contour, not extremes
• Understand permanence is a serious decision

FusionThick may not be a fit if you have:

• Active infection or uncontrolled medical risks
• Tissue factors that require a different plan
• Goals that are not medically realistic for safe enhancement

Circumcision note

At Rejuvall, circumcision is required prior to girth enhancement to reduce the risk of contour issues and foreskin-related complications after girth is added. Your team will explain what this means for planning and timing.

Rejuvall offers a girth-optimizing adult circumcision (GirthCirc™) for patients who need circumcision prior to enhancement. This approach is planned with future girth goals in mind, so the skin transitions can settle more naturally once additional circumference is added.

Some men who were circumcised as infants have a scar line that’s more prominent or “pinched” behind the glans. When that scar line acts like a tight ring, it can interfere with normal lymphatic drainage during healing and contribute to persistent swelling or a thicker-looking area near the glans while the tissues are settling.

Because FusionThick™ involves a long-lasting/permanent underlayer, Rejuvall may recommend circumcision revision in select cases to improve the baseline anatomy and reduce the chance of contour issues during the healing and settling phase.

Aftercare & follow-up

You’ll receive clear, written aftercare instructions and a follow-up plan so we can monitor how swelling settles and how contour stabilizes. Because FusionThick™ is a transition to permanence, follow-up matters—it’s where we confirm healing, address questions early, and determine whether any staged refinement is medically appropriate.

Cost and next step

FusionThick is individualized. The amount of product and staging (if recommended) depends on anatomy, goals, and the condition of your HA foundation.

Most patients start with a free phone consultation with our Patient Education Manager, then schedule a medical consultation if appropriate.

How much Bellafill® (PMMA) will I need?

The amount of Bellafill® PMMA needed for a FusionThick™ transition varies based on your starting size, the condition of your existing HA foundation, tissue characteristics, and the proportional result you’re aiming for.

If you’d like a ballpark estimate for education purposes, you can use our Penis Size Calculator and review the chart examples above—then confirm what’s medically appropriate for you during a private consultation.

Calculator note: estimates are educational only. Your final plan is individualized and must be confirmed by a clinician.