The Penis Podcast – Episode 9

Transcript – Episode 9

DATE: December 9, 2020

DURATION: 21m 6s

START OF TRANSCRIPT

 

 

[00:00:14] 

Hi everybody, I’m Dr. Gavin Scriven, people call me Dr. Gav, and with me is the founder of the non-surgical penis augmentation procedure we call Calibre, Dr. Jayson Oates.

[00:00:14] 

Thanks Dr. Gav, and together we are the dick doctors and we are going to be talking about all things penis. Our area of expertise is injectable penis augmentation. There’s a lot to talk about penises and together myself and Dr. Gavin will be doing that.

[00:00:31] 

Dr. Jayson, how are you going?

[00:00:34] 

Yes, good to speak to Dr. Gav Out Together obviously, we are the the dick doctors and we’re going to be talking all things dick today. And today we’re sort of looking at a different sort of topic, it’s the problems, the complications that we’ve seen with injectable penis augmentation, problems that we’ve created ourselves, problems that we’ve seen patients come in from other clinics, and it’s an important thing for guys to understand that medicine isn’t this perfect thing where we can create a perfect, gigantic penis every time we do a treatment. There are things that guys have to understand where they’re coming into this treatment. And the more guys understand about what they’re getting into, the better. And for us, it’s very important to be open about it and we’ve spent six years now learning this procedure, getting better at it so that we can minimise any of these problems. So, Doctor Gav, have you ever had a problem with a penis augmentation?

[00:01:47] 

I would love to right now say absolutely not. And everything is perfect, but yeah, you’re right, medicine isn’t an exact perfect science all the time, there is aspect to it as well and we have been learning over the last six years, as you said, and refining the procedure and perfecting it. So yeah, I have seen a couple of issues that we see patients come back with that we help them along with and obviously, you know, help them get a good result in the end, but I guess some some of the things I’ve seen just quickly, definitely asymmetry would have to be out there is probably the main the main issue that guys have after an injectable penis augmentation procedure. But having said that, I really do talk to my patients about this beforehand, so it’s not something that is really that surprising. It’s about as part of the procedure we are putting in a decent amount of dermal filler, there’s a little bit of swelling in the beginning, during that time, the dermal filler migrate and you can end up with some asymmetry. So and it is something that they should know about before the procedure, so they’re not entirely shocked, and as part of our protocol, and I’m sure you do the same thing, we do the procedure over usually two treatment sessions for this reason so that we can actually have a look to see if there’s any asymmetry and then address it by topping it up with a little bit more filler and correcting the symmetry, or we always have the option of dissolving small bits of dermal filler as well. So that’s probably the number one thing or minor complication or and risk that guys have is is some asymmetry afterwards.

[00:03:35] 

Absolutely, and the great thing is that we’re able to blame the patient for a lot of these issues. So guys who have a nice tight circumcision, especially one closer to the to the glands, it holds the product in position better. Some guys have a very loose circumcision and that can allow a little bit more mobility. Obviously, guys who haven’t been circumcised at all and that can allow more mobility of the product and even the circumcision itself, some guys have more scarring down of that of that circumcision down to that deeper layer of of of fascia, the fibrous tissue. And depending on when we made the circumcision line is and sometimes it’s right up close to the to the head of the penis and I’ve seen it like five centimetres down like mid shaft, and then that can can cause some some difficulties in getting the filler to go past it because you want to have this nice even taper in the in the product. So some of these things are sort of patient sort of characteristics and then the other one is shrinkage, so guys have got a lot of

shrinkage, they’re a grower rather than a shower, then when their penis sort of shrinks up, it can fold and create an irregularity in it. And then, as you say, that’s why we do it as a two step procedure and bring them back and even things out a little bit. And that’s also then to the advantage of having a hyaluronic acid filler where you can tune it with the medications to to address that. So yeah, those are a minor sort of things, but they’re the sort of things that because we’ve been doing it for years and done, hundreds of cases are pretty good at avoiding those sorts of issues.

[00:05:44] 

And often guys are asking me how they can avoid that happening in the first place, and I guess I’ll quickly mention what I sort of talk about with them. But yes, he’s trying to avoid any severe retraction, which often is difficult, obviously, if it’s out of your control, but we do have medication that we can give and that we’ve talked about in one of our other episodes that helps prevent some of the more severe retraction in some guys, but also just making sure in those first couple of days when the filler hasn’t fully integrated into that space and when there is a bit of swelling and there’s more risk of the filler moving, making sure they’re checking the penis regularly, that it’s straight, it’s not folded up in one side of the pants in one direction and squashed up, and they’re driving six hours somewhere, they need to stand up at home, stretched out, make sure that it’s straight, and we offer a Crepe style bandage that’s fairly elastic, that can help keep it in a straight line and also some gentle massage. if there’s no tenderness in the swelling is not too significant, then some gentle massage to help keep the product in place in those first couple of days. And certainly I’ve seen some guys come back with some amazing, perfect symmetry after one treatment and I talk to them about what they’ve done, and this is a lot of what I just said is what they have done is kept it straight, they’ve been meticulous about, you know, just gently massaging it in those first couple of days.

[00:07:09] 

Yeah. Although the funny thing is you get some guys who just don’t want to touch it, don’t want to look at it, is like they’re scared of it afterwards. Guys to sort of say, well, you know, it’s our job to to get it all smooth and even which but it’s not a great way of going into it. And, you know, you’ve got to be working with us so that we can achieve that, that best outcome. That’s the irregularity sort of side, then there are some issues that are potential problems with the product itself. And the thing that we tend to think of, obviously, something called a granuloma. That’s when the body reacts to a foreign substance. And we’ve been injecting these fillers in the face for up to 20 years now and we have found that the occasional patient will react to to a filler. And when it reacts in the penis, then you can get get a lump and I know that you’ve seen these sort of problems yourself as well.

[00:08:17] 

Yes, I have. Yep. Yeah, exactly. Yeah, whether it’s a granuloma or a post inflammatory type nodule, I guess unless you biopsy the the lump itself and send it off for analysis, we’re not entirely sure, but it is definitely some kind of inflammatory immune response that’s causing a hard nodule and it’s a reaction to it, as you said, the foreign substance and the person’s body. And that is often unfortunately out of our control, how that happens and how the body reacts, and it is a risk that we have to tell everybody about before we do the procedure. And again, the good news is if you’re using hyaluronic acid, you know that it is reversible, the filler can be dissolved, but there are other things we can do to help stop this reaction, to reduce the reaction, reduce the inflammation by giving certain medications early on. And we’ve seen I’ve seen personally some really good response and actually almost being able to get it back to a normal type outcome using these medications. If we if we’re on top and if guys are aware of it and actually contact us and we we work together to fix it.

[00:09:25] 

Yeah and that’s great that we we have the ability and we keep close contact with our patients so that if they have any worries, they can come back and discuss these things with us. And we’ve seen these reactions in the face, in the lips and these sorts of things. And that’s where we’ve learnt how to to manage these sort of lumps and bumps.

Never quite had a guy come back and say, oh, I’ve got a great big lump on my penis and it’s fantastic, you know, my partner loves it. But I was always waiting for somebody to say that. But personally, it’s been a long time since I’ve seen one of these granulomas and that’s something that we’ve changed over time as well, just with the experience, you know, what we thought was the best product for doing penis augmentation, and then you find you getting some reactions to it. And it may be because we put 15 or 20 mils in, as opposed to only putting one mil in a cheek, maybe there’s something about that that tends to make it more likely to happen. Yeah, but yeah, for me, it’s been a long time since I’ve seen sort of a granuloma reaction, which is which is great. Of course, there’s the stimulatory fillers as well, which then last a lot longer. I’ve never seen a granuloma in the penis from that, but I haven’t seen it in the face. And and that was an interesting thing, because she did like it, because it just increased the the amount of of augmentation she got in her cheeks. But we managed it with steroid injections and that sort of kept at bay. OK, so another thing that we need to think about is infection. And certainly we don’t want an infection in this area, it’s why we do it as a sterile procedure, so the guys we, we wash the area with antiseptic, we lay blue towels all around, there’s no touching once everything is blue, we use sterile gloves and we keep the process sterile because the last thing we want is infection. Now, I have seen a significant infection, it wasn’t one that that I did myself, but it was a full on infection and initially treated with antibiotics, but it was swelling up to the point that it actually had an abscess, an abscess is where there’s a collection of pus. And I to take this guy actually to to theatre to knock him out. And he had this weird thing with a bridging band of tissue on his circumcision scar, and there was a drainage point for the for the abscess sort of bare. So open up, drain this pass out, flushed it all out and

then with antibiotics very quickly got better. It certainly reinforced to us the importance of of keeping things clean, telling guys to keep it really clean afterwards, and we’ve not had any further issues like that. But cleanliness and this is what sort of worries me when I hear about all the doctors starting to do this and, you know, hear about it on YouTube or something, and then they’ll just go and do it and I’ve seen videos of people doing it on on YouTube, I’m thinking, well, there’s no sterile drapes, they’re not sterile gloves, touching all sorts of things and everything’s fine until it’s not fine. So doing it sterile, I think is very important.

[00:13:18] 

Yeah. And as you mentioned, we do it as a sterile procedure, but dermal filler in itself normally is not a fully sterile procedure in the face. For example, you’d see nurses and doctors injecting in the face and the cheeks and the lips not as a sterile procedure. And yes, normally there’s no infection, dominant minute, barely ever see an infection in

the face, it it can happen, infections happen in the face as well. But I think in this area, in the penis, the consequences of an infection is a little bit less of an outcome, and of course, there’s some some risky infections that can happen that can have quite bad consequences in that area. So we, as you said, treat this as a as a sterile procedure to try to avoid that ever happening in the first place. But we also have a particular aftercare regime and we ask that guys follow that after care and very closely to minimise any risk of infection. So they do have to take it seriously.

[00:14:19] 

Yep, yeah. OK, let’s quickly touch on a few other things, actually, something else that can come from the treatment is occasionally we’ll use an injectable medicine for a guy to have an erection while we’re doing the procedure. Years ago, I used to do it every time we did a treatment and there was some advantage of having that penis sort of stretched out to its full length for injecting. But as we’ve got very experienced with a fine, you don’t need to do that very often now unless a guy particularly comes in for that second session and says, it looks fine, flaccid, totally happy, but when it’s erect, there’s this one area where there’s a little bit of a dip and you just and actually grab the penis and really stretch it out off and you can see it, but sometimes they really keen on you creating an erection for them, sounds a bit funny sometimes when I said out loud and then, yeah, so you use this, this medication and an erection is great for 15 minutes or an hour, maybe a couple of hours, but an erection for four hours, six of twenty four hours is not so great and I’ve had one experience with a guy who was a bodybuilder and, you know, potentially using various medications to help with bodybuilding any way really fit guy, and he had this prolonged erection. And again, we’ve got medications and protocols for it, but I had to call in the middle of the night, midnight, telling me that he still had this erection and saying, well, have you taken the tablets? Have you done all these things? He said, no, he hadn’t. So I say, so I said, well, there’s instruction sheet that we gave you and these medications, do all of that, would have been better if you did that four hours ago.

[00:16:17] 

Yeah.

[00:16:19] 

But yeah, a prolonged erection is painful and a really prolonged erection beyond twenty four hours is damaging, so we don’t we don’t want to have that.

[00:16:29] 

Exactly right. And I haven’t had that experience myself, but I’ve heard no other patients that had that experience after receiving one of those injections to correct an erection to do this procedure and actually ended up having to come back into the clinic and deal with it in the clinic by injecting another medication to help reduce that erection.

And so as you said that that is a medical induced complication that can happen as a result of injecting this substance to cause an erection that we sometimes use for the procedure.

[00:17:10] 

Yeah, yeah. So, again, from years of experience, at least we now have protocols so we can manage that and avoid it. And yet it’s not something that I’ve seen the years. Then I’ll think about some of the problems I’ve seen from injectable penis augmentation coming in from elsewhere. I had a patient who had PMMA injected in Korea, so PMMA is poly methyl metabolite. It’s essentially like ground up acrylic plexiglass, but medical sort of version of it. And it can be used for permanent penile augmentation. There’s only one doctor in Mexico who I would suggest it is is worth seeing for that procedure, he’s got a vast experience, but this guy had a penis that’s just full of lumps and bumps, and and it was a worry because this PMMA is plastic injected in under the skin, and the only thing that we had was to inject more filler around it to try and hide the lumps and bumps, but you never keen at all to inject when there’s this permanent filler in there, so I was concerned doing it, and fortunately, we didn’t have any issues, it did hide those lumps and bumps. But that can be the problem with permanent fillers, especially if you’re having it done by somebody who’s not a real expert, is that you get permanent complications.

[00:18:49] 

And a similar story I have is on that same line, along the same lines is after some clients have had the fat transfer or fat injections. I’ve seen these clients a few years down the track that had long lasting results, but some

significant asymmetry and lumps that had formed after some of the fat had been resorbed or in the first place the fat grafting hadn’t been done in a very symmetrical way. And really, this guy’s just been living with pretty significant asymmetry and an unusual looking penis for a few years.

[00:19:28] 

And it’s really hard to hide it, isn’t it? It’s obvious that this is not a natural penis and that’s not what we’re aiming with, an injectable penis augmentation, which is sort of natural, but just big.

[00:19:42] 

Exactly, but in a similar way I was able to help these guys with using hyaluronic acid to straighten out the penis, and it worked actually quite well. So there are things we can do sometimes to help with these issues, but we’re probably running out of time. But really, I think that it covers, I think, most of the things that we’ve seen, but certainly if there’s anything else that we think of, we might bring it up in an episode later down the track, but the most important thing is to have a chat to us. We have the experience of the past, as you said, over the past six years, we’ve seen hundreds of penises and hundreds of results and understand the risks involved and how to avoid any complications. So just come and have a chat to us and we can talk about mitigating any of those risks.

[00:20:29] 

Yes. So, guys, you you can leave a comment, but if you if you’re not wanting to leave a comment publicly either on that on the YouTube channel or on the podcast, then you can just email us directly. There’s a link there that comes back to us in the clinic and we will answer any questions. Look, good talking to you again, Dr. Gav.

[00:20:54] 

Always a pleasure talking to you, Dr. Jayson. Together we’re the dick doctors and this has been the penis show and I look forward to speaking to you soon.

[00:21:01] 

Talk to you soon. Bye.

END OF TRANSCRIPT