Before the Day
Treatment begins with a consultation, not an injection. Dr. Daniel Moghadam examines and measures you, discusses what is realistically achievable for your anatomy, and explains the material options — see the material comparison.
You will be asked about medications and supplements. Blood thinners, fish oil, high-dose vitamin E and NSAIDs all increase bruising. Never stop a prescribed medication without speaking to whoever prescribed it, but do tell us what you take.
You will receive the exact product name, planned volume and total cost before anything is booked.
The Procedure
- Preparation and marking. The area is cleansed with antiseptic and entry points are marked. Published technique typically uses two points at the base of the shaft, positioned at roughly the 10 and 2 o'clock positions.
- Anaesthesia. Topical anaesthetic first, with local anaesthetic infiltrated at the entry points. Most fillers used also contain lidocaine. The great majority of patients find this comfortable.
- Cannula entry. A blunt-tipped cannula — not a sharp needle along the shaft — is introduced through the marked points. A blunt cannula pushes vessels aside rather than piercing them, which is the main technical safeguard against vascular complication.
- Placement. Filler is deposited in the plane between the dartos and Buck's fascia. This depth matters enormously: too superficial risks visible nodules and irregularity; too deep risks the structures beneath. Published technique places 5 mL in a single session as a reference volume.
- Distribution. Product is spread evenly and moulded to avoid focal collections. This is the step that determines whether the result feels smooth or lumpy.
- Review. Symmetry and contour are assessed before you leave.
Thirty to forty-five minutes for most treatments.
Why we stage larger volumes
Forcing a large volume into a single session does not produce a better result — it produces contour irregularity and nodules, which are the most common complications in this procedure.
Where a bigger increase is the goal, we stage it across two appointments. A clinic promising a dramatic result in one visit is describing a technique that raises your complication risk.
Immediately Afterwards
Expect swelling and tenderness, with bruising common at the entry points. The area will look larger than your eventual result — this is swelling and not your outcome. You will go home the same day with written aftercare.
The key restrictions: no sexual activity for the specified period, typically around two weeks; no strenuous exercise or heavy lifting for at least the first week; no saunas or hot baths; and do not massage the area unless specifically told to. Full detail in the recovery timeline.
Ultrasound Guidance
Some published techniques use ultrasound to confirm the tissue plane during placement. It is not universal practice, but it is a reasonable question to ask any provider — knowing exactly where product is going is the difference between a smooth result and a nodular one.
Follow-Up
We review you once swelling has settled, at around four weeks, which is when the settled result is assessable. If an adjustment is warranted, that is when it is discussed.
If a nodule or asymmetry develops and hyaluronic acid was used, it can be dissolved — which is a substantial part of why we recommend it for a first procedure. See safety and complications.
