What is the difference between S.T.I.M.™ and S.T.I.F.™ Therapy?

S.T.I.M™. therapy refers to the use of PRP (platelet rich plasma) to improve size and sensations of the penis.  It also aims to improve erections. It stands for super concentrated thrombocyte injection for male enhancement. It consists of anywhere between 1 and 3 sessions of PRP injections into the penis followed immediately by the use of a penis pump. For more on PRP injections to the penis click here.

S.T.I.F™. refers to the use of PRP along with fat to improve length and width of the penis.  It stands for super concentrated thrombocyte injections with fat.  It also aims to improve sensation.  It consists of 1 session.  Fat is harvested from the lower back or abdomen, filtered, and injected into the penis beneath the skin from the base to the glans. This is followed immediately by PRP injections.  No penis pump is used.  Generally, subsequent PRP injections are nor required.

The improvements in size are much greater with ST.I.F™. than S.T.I.M™. 

How does it work?

PRP stands for platelet rich plasma. Platelets are the repair cells inside blood.  When one is cut, platelets rush to the wound and act on the tissue to stop bleeding and initiate the tissue repair cycle.  The platelets release many different growth factors that aid in the creation of blood vessels and collagen.  Thus, when we deliver platelets in a concentrated form into tissues, we expect a tissue response.  In the penis, the response we aim to achieve is improvement in circulation and enhancement of the neurovascular elements.  This in turn should result in more blood flow to the penis and improved sensation.  Improved blood flow translates into larger, and more powerful erections.

With the addition of fat, Dr. Neavin also delivers volume and stem cells to the penis.  There is a direct addition of tissue to increase width and length. The stem cells which are abundant in fat also act on the neurovascular elements to improve circulation and sensation.  Thus, with PRP and fat grafting, the penis receives large volumes of fat, stem cells, and PRP. 

How much length should I expect to gain from fat injection with PRP (S.T.I.F.™)?

Everyone has a different starting point in both circumference and length of the penis.  In addition, these measurements vary with flaccid and erect states. Temperature and arousal, too, can affect size.  Thus, precise measured increases are very difficult to predict.

While it is impossible to know just how well the fat and PRP will affect every one’s tissue, from our experience sizable differences in length and width are routinely the result. Measurements are more easily obtainable in erect states since in this state temperature plays less of a role.  However, arousal will influence both circumference and length.

In the erect state, it is not unusual for patients to report increases in length of an inch or more. Circumference gains can be up to 25% more more.  While not everyone will measure their penis, most men will report that condoms feel tighter or have to increase condom size.

How much width should I expect to gain with fat injection with PRP (S.T.I.F.™)?

Both length ad width changes are a result of a number of factors.  Because everyone has a different starting point and has different tissue properties, it is impossible to quantify width (or length) increases.  Increases in width are better considered as a percentage, not definitive measurement.  It is difficult to measure circumference in the penis because there are many factors that determine the girth.  These include blood flow, tissue volume, fat integration, activity level of PRP, arousal state, and temperature. 

Most men will state that their condom feels tighter or have to increase their condom size after the procedure.  It is not unusual for men to claim that their width is 25% greater or more.

Is it possible I won’t see an increase in length or width after PRP with fat (S.T.I.F.™)?

While it is unlikely one won’t see a sizable increase in both length and width, it is always possible.  As surgeon scientists, we can at best set an optimal stage for results.  Some of the factors within Dr. Neavin’s control include identifying good candidates from poor candidates, fat harvest, fat injection, PRP injection, post procedure dressing and wraps, and good communication with patients. Things he cannot control is the integration of fat into the tissues, PRP’s influence on the tissues, ones native blood flow to the penis,  and one’s arousal state. And while he prefers communicating often with patients, he cannot control if patients obey post operative instructions which influence results.

What makes a god candidate for fat injection with PRP (S.T.I.F.™)?

Good candidates for fat injection into the penis with PRP are men who wish to increase both the size and length of their penis in both flaccid and erect states.  They should be healthy.  Ideally, they should not smoke, but smoking itself is not a contraindication to the procedure.  Smoking, in there, can interfere with the microcirculation which plays a role in fat cell survival.  Thus, patients are encouraged to cut down or quit smoking prior to the procedure. 

Candidates should have reasonably good erectile function.  PRP and the stem cells in fat may very improve blood flow capacity to the penis, but penis engorgement is related to more than capacity.  Penis engorgement is related to psychological factors which are generally not addressed with PRP or fat injections.  That is, if erections are achievable with stimulation or arousing thoughts, then PRP and fat are in a far better position to influence penis size than than men who are incapable of erections. 

If erectile dysfunction is strictly related to inadequate circulation, PRP and the stem cells may certainly improve the conditions, but the outcome is far less predictable than in men who do not have erectile dysfunction.

Men with diabetes often have erectile problems.  Men with diabetes are also more likely to develop infections.  Thus, diabetics with poor control of their sugar are not good candidates for this procedure.

Men who wish to have unrealistic gains in length and width are not good candidates for this procedure.  Or, men who refuse to accept the fact that results are unpredictable should not proceed with the procedure.  That is, good candidates are those that understand that Dr. Neavin will do his very best to deliver a reasonable improvement in size and length but no guarantees in length or width can be made. 

To determine reasonable expectations, Dr. Neavin will have an in depth discussion with each potential candidate. If he deems that a man is not a good candidate, he will not proceed with the procedure. 

How much does it cost?

PRP therapy  (S.T.I.M.™ shot) costs $1,500 a session, or 3 sessions  for $3,800.  The procedure includes a penis pump that the patient keeps for home use and for subsequent sessions.  Fat grafting with PRP costs $5,600. It is one session.  Any subsequent session of fat grafting to the penis is reduced to $4,000

Do I need to buy a penis pump?

A penis pump will be provided for PRP injections (S.T.I.M.™). They are not required for fat grafting with PRP (S.T.I.F.™)

Do I need to be asleep for it?

No. Both PRP and PRP injections with fat grafting can be performed with the patient comfortable awake.  After oral sedatives and narcotics, the area is anesthetized by regional nerve blocks above the base of the penis for fat grafting. Generally, just topical anesthesia and a nerve block is necessary for just PRP injections.

Will it help me achieve erections?

It is impossible to know if PRP or fat grafting will improve one’s erectile function without taking a complete history and physical.  It is the goal of both PRP and PRP with fat to improve the ability or one to achieve erections. It is also likely that the erections will be larger since PRP and stem cells will exert their influence on the tissue responsible for erections.

Does it improve sensation?

PRP, as well as the stem cells in fat, act on the microcirculation and nerves within the penis.  In turn, we expect sensation to improve.

Is it OK if I still have foreskin?

Yes.  Having foreskin does not affect the procedure.

How long do the results last?

PRP therapy can last from months to 6 months or more. Unfortunately, it is unpredictable how each man’s tissues react to PRP. Fat grafting will have permanent results.

What if I don’t see much of a difference?

If you had only one PRP session to the penis, you may benefit from 1 to 2 more to optimize results.  While PRP to the penis is unpredictable, it is unusual for a man to not notice improvements in erections or sensation within a couple of weeks after injection.

It would be most unusual to not appreciate an increase in length or width in the flaccid or erects states after S.T.I.F.™  However, subsequent fat transfer cases can be performed at reduced rates.

Will I need multiple sessions?

PRP tends to exert its most powerful effects after the third session.  However, most men will appreciate improvements in size and sensation after the first session.  After fat transfer with PRP, it is unusual for a man to not appreciate a size difference.  However, subsequent fat grafting sessions can be performed at reduced rates.

Does it hurt?

PRP injections are performed comfortable with topical anesthesia and nerve blocks.  When fat grafting is added, patients are given oral sedatives and narcotics.  This is because the procedure is more invasive.  The abdomen, flank, or lower back is also anesthetized for the harvest of fat. The entire procedure is very tolerable.

When can I resume sex after the procedure?

It is recommended that one wait 72 hours after PRP therapy to engage in sex. After fat transfer with PRP, one should wait at least 10 days to engage in sexual activity assuming that the small incision is completely healed.

How much fat is injected?

Dr. Neavin will inject anywhere from 4 cc to over 40 cc of fat depending on desires, the penis “starting point”,  and patient expectations.

Does all of the fat live?

No. Many of the fat cells will die and become absorbed in the body. PRP improves fat cell survival. While we never expect all of the fat cells to live, it does not take a significant amount of volume to create significant improvements in size.

What are the risks?

Like any procedure, there are risks. The main risks from PRP are bruising.   However, even bruising is a rare event.  Fat transfer involves a donor and recipient site.  At the donor site, the potential complications that exist include bruising and infection. The recipient site is the penis.  Potential complications to the penis include bruising, infection, poor fat survival, asymmetrical fat survival, and lumps from the fat.  Asymmetry and lumps have historically been known complications of fat transfer with older techniques. To reduce these risks, Dr. Neavin filters the fat and injects the fat with a very fine cannula.  In addition, he wraps the penis with a special dressing that uniformly applies pressure to the penis in 360 degrees from base to glans to prevent fat migration. To date, Dr. Neavin has not had a single complaint of lumps or asymmetry.

How long does it take to see results?

Improvements in sensation and erections with PRP are often sen within 48 hours. Significant improvement in size from PRP generally takes more than one session.

How long do the results last?

The effects of PRP may last several months or more.  In some men who have had 3 or more injections, improved sensation and increases in size have permanent to date.

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