CONFIDENCE CHANGES EVERYTHING!
This is one of themost frequently asked questions. A comprehensive study was published in 2014 in The British Journal of Urology by David Veale, Professor of Psychology at King’s College, London Medical School.Professor Veale reviewed published studies of adult males (over 15,500 men), with the following “average” results:
- Flaccid length of 9.2cm (3.7 inches)
- Erect length of 13.1cm (5.25 inches)
- Flaccidcircumference of 9.3cm (3.75 inches), and
- Erect circumference of 11.7cm (4.7 inches).
These figures were slightly smaller than what were previously quoted in some studies.More importantly, the vast majority of men’s erect length was between 10 and 16cm (4-6.4 inch) and an erect circumference of between 9.5cm to 14cm (2.8-5.6 inch).
CALIBRE is able to produce quite noticeable increase in the girth of the penis. The product used is a volumizer, so 1ml of product results in 1ml increase in size. The more product the bigger the size, however, we are also aiming for aesthetic symmetry so your CALIBRE doctor will recommend a sensible volume based on natural size and shape.
The amount of product required to achieve a specific increase will depend upon your natural erect length and girth. The product is a volumizer so 1ml product = 1 ml increase, but this needs to be placed evenly around the full length of the shaft. The recommended volume of product will be discussed and explained during your confidential consultation.
With a 15ml augmentation, it is common to achieve a 1-inch increase in the flaccid circumference, which results in around 0.5 to 0.7 inches increase in erect circumference. It is possible to have further top-ups every month after the initial procedure if additional size is desired.
* Patient results will vary based upon unique circumstances and should be discussed with your consulting doctor.
The dermal filler is injected into the Areolar Tissue of the penis, just below the skin and Dartos facia. This can be seen as the outer yellow ring in the image below. The Areolar tissue is external to the main anatomical structures of the penis, which is protected by the Buck’s facia.
Dr. Oates FRACS explains how the CALIBRE procedure is performed here: https://www.youtube.com
CALIBRE injection into the shaft is performed exclusively with a blunt tipped micro-cannula, via a small access point created with a small needle first. The penis is vascular and it is not a good idea to cut or occlude a blood vessel or other important organ such as the urethra – this can lead to infection and/or tissue death. A blunt tipped micro cannula is bendy and cannot penetrate a major blood vesselsmeaning it is much safer than using a needle.We may use a needle for injecting into the rim of the glans (head). The glans has a much thicker skin over erectile tissue. There are no major blood vessels to obstruct in this area.Dr. Oates FRACS explains the use of blunt-tip cannula over needles in this video: https://www.youtube.com
Yes, the products used for CALIBRE are volume fillers so for each 1ml injected you get 1ml of volume increase and the results are immediate. You may have some initial swelling, which can be impressive, but this will subside over a few days.It takes a couple weeks for the dermal fillers to stabilise, absorb water (or stimulate collagen) and look its best.
An important factor in developing the CALIBRE procedure was for minimal discomfort. It is possible to perform CALIBRE as a 1-hour, in-clinic procedure with only numbing cream for anaesthetic. The dermal filler is also laced with lignocaine. The procedure may be a little sensitive at times, but most patients report that it is not painful.
We have trialled a variety of TGA approved dermal filler products since 2014 in developing the CALIBRE technique. Our goal was to identify the safest dermal filler suitable for penile augmentation, with sufficient longevity to justify the financial spend.
After our trials, we recommend a biodegradable, highly bound volumizing product (within the hyaluronic acid “HA” family) that can be quickly ‘dissolved’ in the event of any complications or asymmetry. This product is a sugar-based gel already present in skin and tissue, which is broken down naturally by the body over 18-24+ months. Various viscosities of HA are available to address different areas of the penis shaft, neck and glans, as required.
We continue to evaluate other biodegradable dermal fillers (PCL) with longer duration e.g. 2-5 years. These products may be more appealing for some patients and we do offer PCL (instead of HA) for those patient who are informed and accept the properties and higher risk profile. PCL is a more expensive option given the higher cost price.
We do not mix different dermal filler types due to the uncertain interaction and potential risk of infection.
Note – we do not support use of permanent fillers (such as PMMA or Free Fat Transfer) for any cosmetic purpose. We have seen terrible complications with permanent fillers over the years and consider these too high a risk for penile augmentation.
WHATEVER YOU DO, MAKE SURE IT’S SAFE!
Most men won’t notice a significant reduction in the size of their CALIBRE augmentation over the initial 9-12 month period and then a gradual resorption over the next 12 months. A Korean study showed preservation of 90% of Hyaluronic Acid (HA) penis augmentation after 18 months, see this link: https://www.ncbi.nlm.nih.gov/pubmed/20233296
However, HA resorption rates do differ between patients depending upon their metabolism and how much Hyaluronidase enzyme is naturally in their penile tissue. Given the large volumes injected (10 ml+), the studies by Allergan have shown 80%+ retention after 18 months, with gradual full resorption up to 30 months. Please refer to the graph below, which measured resorption in the face.
Other reports indicate that repeat injection of HA tend to last longer, most likley due to the stimulation of collagen where the filler is placed, which is called fibrogenesis.
We are generally seeing a slightly slower resorption in penile tissue. So far, our patients are showing good retention after 12 months and most only come back within this time frame because they wish to be larger. However, we anticipate most patients will want a top-up of 5-10 ml every 18-24 months, to maintain the size.
There is minimal downtime with CALIBRE, most patients return to work the next day.
After the procedure, a stretchy bandage will be wrapped around the penis to minimise swelling and assist with product placement. We ask that you leave this on for 24-48 hours and you may re-wrap if the bandage comes off sooner.
With HA’s, there is some initial malleability to the product for 2 weeks after injection. You may use this time to massage any bumps or smooth irregularities, but please don’t over do it. The dermal filler will integrate with penile tissue after 2 weeks, so any residual bumps after this time will need to be dissolved or naturally resorb over time.
Post Care: we advise patient’s to keep the area clean for a week, avoid sexual activity for 5 days (and unprotected anal sex for 7 days), shower daily and after exercise, take any prescribed medications and follow our post-care instructions carefully.
We provide after-hours support line if anything concerns you and ask that you return after 3-4 weeks for review.
Whilst complications are rare, you may experience:
- Some bruising and tenderness. Avoid Vitamin E, blood thinning medications, anti-inflammatory drugs, steroids and St John’s Wort for a week before and after the procedure.
- Swelling for a few days that may be quite impressive, but will settle. If excessive swelling remains beyond a few days, please contact your treating doctor or clinic.
- Due to natural tissue bands under the penile skin that are difficult to identify, we may not achieve perfect symmetry in a single session. For this reason, we prefer to inject in a 2-phase program, with corrections made during the 2nd session.
- Possible hardening of product forming a lump (granulomas). These can occur after a few weeks/months and it is important to resolve quickly. Please contact your treating doctor or clinic for review and advice.
- Possible infection, which is the most serious concern. We perform CALIBRE in a sterile field and we may prescribe you precautionary antibiotics after CALIBRE, please ensure you complete the full course. If you feel any significant pain, heat or difficulty passing urine, please call and speak to your doctor or clinic as soon as possible.
We advise patients to abstain from sexual activity for at least 3 days and from unprotected anal sex for one week to allow the tiny injection points to fully heal and minimize the risk of infection.
We initially thought the CALIBRE procedure would be a “locker room” confidence boost as the biggest change was seen in the flaccid penis girth. Further, men get less “shrinkage” so it looks longer in the flaccid state too.
However, what we have found that (especially with larger volumes > 15ml), the sexual partner will definitely feel the increase in girth. Girth is generally believed to be more important than length in satisfying a partner because the vast majority of the sensory nerves are at the opening rather than at the depth of the vagina or anus.
There are no reported changes in erection, sensation or orgasm after the CALIBRE procedure.
Yes, when erect, most patients will not notice any substantial difference in the firmness of the penis.
However, some patients say that when flaccid the penis feels slightly more “squishy” than normal. This is generally related to the starting size and the volume of filler used.
The CALIBRE technique has been refined and improved over 3 years using different products and injection methods/programs.
So long as patient’s follow their treating doctor advice and return for reviews, the CALIBRE technique produces consistently reliable and smoothly distributed product throughout the penis with no lumps or bumps.
* The results do vary between patients, so if any asymmetry or lumps are observed, please return for a review with your treating doctor who may be able to resolve.
For CALIBRE we generally use a highly cross-linked, dense hyaluronic acid called Voluma(by Allergan). This is injected with a very precise technique and the product is carefully placed and moulded for even symmetry and to minimise the chance of pooling or migration towards the base or glans. Our Doctors also like to inject larger volumes in 2+ sessions to optimise product placement.
Whilst Voluma is soft enough to gently massaged for up to 2 weeks after injection (which is useful to smooth any residual bumps), it will integrate with penile tissue after this time and remain in place.
However, we have had one early patient with product migration issues, which we believe was due to a combination of too much product, medications and excessive swelling. With changes to the technique and limits per session, we have not seen this occur again.
To minimise swelling/bruising, please stop taking Vitamin E, anti-inflammatory drugs, St John’s Wort, Aspirin and other blood-thinning medications at least 1 week before the procedure.
Yes, it is possible to inject the glans (“head” of the penis), however, it does not respond quite as reliably as the shaft of the penis. In the glans, the erectile tissue is bonded directly to the skin of the glans. Injecting into this thicker skin can cause some compression of the erectile tissue so although it may feel firmer, it might not get he same proportionate increase that we see in the shaft.
CALIBRE tends to focus on augmenting the glans corona (rim of the head), which creates the impression of a larger glans size.
There are some positive studies showing injection of HAs into the glans can assist with premature ejaculation symptoms and we have observed this with our patients. However, this is a specific procedure and less focused on aesthetic results. Clinical study results can be read here:
We generally split the CALIBRE injection program over 2 sessions approximately 2-4 weeks apart (especially for volumes over 10ml). This tends to improve the final symmetry and aesthetic results.
Yes, you may fly-in for CALIBRE treatment and it is possible to complete the 2-phase injection program within 7 days so long as all swelling has subsided. However, we request that you avoid flying for 24-48 hours after the final injection session and stay in contact with your treating clinic between sessions.
Yes, it is fine to gradually increase the size of the penis with progressive CALIBRE sessions, every month or so. However, this can make the overall program more expensive given the repeated preparation and post-care follow-up by doctors and staff.
Yes, there are limits! It is important to ensure the penis looks normal and in proportion with the glans (or “head”). Whilst it is possible to augment the glans too, your doctor will endeavor to keep everything in proportion. The primary purpose of CALIBRE is to increase the circumference of the shaft for personal confidence and sexual satisfaction. We are not trying to produce abnormally large “porn-star” members.
We also limit each injection session to max 15 ml. The more product, the more swelling, which makes it difficult to ensure even product placement and risks product migration post-procedure.
CALIBRE was developed over a several year period by Dr.Jayson Oates FRACS, based in Western Australia. Only doctors who are personally trained by Dr. Oates and certified CALIBRE Clinicians may perform the CALIBRE procedure.
See all certified CALIBRE Clinicians here
No, post-care is minimal. Please refer “Recovery after CALIBRE?”
Yes, we have many before & after images, however, most are not approved for public release. We will continue to upload further approved patient images over time and you may check our YouTube channel for updates: https://www.youtube.com
Hyaluronic Acid (HA) is a naturally occurring chain of sugars found in the skin and tissue of all animals, which is broken down and regenerated relatively quickly by the body.
HAsthat are used for cosmetic purposes have been replicated in a lab. They are generally cross-linked to extend duration once they are injected. The more cross-linking, the firmer the product and the longer it tends to last.
Body tissue has natural Hyaluronidase, the enzyme that breaks down Hyaluronic Acid into carbon dioxide and water. Other factors such as natural metabolism, excessive exercise and medications may also affect how quickly HAs are broken down.
Given the premium HA products used in the CALIBRE procedure, most men won’t notice any significant change in the size of their augmentation over a 12 month period but this does vary (refer FAQ: How long does CALIBRE last?).
As HA is a sugar and contains no protein there is very low risk of allergic reaction, however, there does remain a small risk especially for people with an underlying autoimmune disease.
Hyaluronic Acid has a great ability to hold water to itself (in fact 10,000x its own weight). Occasionally, this can cause issues with swelling and product migration.
There is always a small risk with any injection of vessel occlusion (if using needles, not with cannula), infection or delayed granuloma (hard lump). However, these risks can be mitigated or managed with sterile procedures, antibiotics or dissolving product with synthetic Hyaluronidase.
In the event of any abnormal result or complication, please contact your CALIBRE doctor or clinic immediately. The sooner you seek review, the easier it will be to resolve complications effectively.
We have only had a couple patients who felt that a lot of their product had resorbed within 12mths. We suspect this was due to very high metabolism, medications plus using smaller volumes (7ml). Unfortunately, there is a chance your body will break down HA faster than expected and it is not possible for us to know this prior to treatment.
We are currently researching and trialling other TGA-approved dermal fillers (Bio-stimulators), with potential to last 3 years or longer. These products have similar volumizing effects and will eventually resorb, however, we cannot immediately dissolve in the event of lumps or complications. These products are also more expensive.
We view these as an alternative for patients who do not respond well to HA or those looking for a longer-lasting option and willing to accept the higher risk. On the flip-side, these products tend to be firmer and produce good placement when injected by an experienced CALIBRE doctor.
Yes, it is possible to have the CALIBRE procedure with Peyronies and it can go some way to improving penile symmetry. However, CALIBRE is not designed to resolve bends in the penis.
It is possible to have CALIBRE after other penile augmentation procedures such as implant or Peyronies treatment, however, this should be discussed in detail during your confidential doctor consultation.
CALIBRE cannot correct major abnormalities casued by other injections (such as PMMA), and we prefer not to inject HA over another product due to unknown interactions and risk of aggravating an underlying infection. It can be difficult to treat if the cause ofinfection is unclear.
Note – we would not recommend injecting Biostimulator products following PMMA as they have similar biological affects and potentially contra-indicated.