Enhance Male Confidence: Vital Aesthetic Procedures Explained

I see the inquiries come in from all our clinics across the country. People will text, email, or leave messages, and you see some of these stats. Whereas, like, please help. My girlfriend laughs at me or my wife laughs at me or says I'm inadequate. And I mean, one, I just think that's incredibly cruel. But I see it again and again so clearly. If you're a guy on the receiving end of something like that, it's absolutely going to be devastating. And so being able to improve that, it literally changes a person's life.

Hello. Hi. Welcome to the Dr. Dracul podcast. Today I have a distinguished guest, Dr. Freelander, to come to talk with us about nail aesthetics. So I want to welcome you. Dr. Freelander, thank you so much for being here with us.

Great to hear.

Yeah. So this. Yeah, this is a subject I have not covered. So I want to introduce you just a little bit, Dr. Jack Freelanders. So Dr. Jack is a founder of NorCal Liposculpture & Co founder of Upsides is a national network of clinics specializing in safe and effective male enhancement procedures. And Dr. Philander is at the forefront of a growing shift in. In men's aesthetic medicine, where more men than ever are seeking cosmetic enhancement treatments without any stigma. So I want to. Yeah, I want to dive into this subject, Dr. Freelander, so tell me a little bit. Why did you even get interested in this? I understand that you are not a plastic surgeon. Right. You trained as a general surgeon. What happened in your path?

Well, kind of a long story, but I. I practiced general surgery since 06, and it's kind of funny, but I. When I moved to California out of residency, I had a neighbor, was in a new neighborhood, and my neighbor across the street was an executive with a medical device company that one of their core products was for liposuction. And we talked for years, and it was just something I never even thought about. However, you know, he had some of his staff over, and one of his staff, this was in probably 2011 or 12, asked me why I wasn't doing with, you know, liposuction. And I said, well, I'm a general surgeon and not even close to what I do or what I ever pictured myself doing. But he showed me a letter from a general surgeon who kind of jumped ship and started doing liposuction. And this was. The surgeon was up in Idaho. So I looked him up, I gave him a call, and he told me how great it was and that he still, you know, takes call at the hospital just to keep his privileges. But he was kind of raving about it. So kind of went down the wormhole and looked into it. I tried it out and was just very impressed with the results. I had a couple of guinea pig patients, so to speak, and you know, really enjoyed it and was just really blown away by the, the immediate difference. And so I started doing both for a while. I was doing, you know, from about 2012 or 13 on, I was doing both general surgery and liposuction. And at, in 2018, our three partners in our surgical practice, we all kind of went our own ways and I just kept on and focused more on the cosmetic surgical aspects, focusing primarily on, I do vasoliposuction, so kind of a niche liposuction, which is more high def or allows more definition than other kinds. So I've been doing that, you know, essentially as my main focus since 2018. And then along with Dr. Pash a few years ago, we were kind of thinking, what else can we do that's more male focused? Obviously there's a lot of, of things in the market for women. Men have been kind of left aside in the, you know, the recent aesthetics revolution. So we kind of happened upon male enhancement, did some training, did some collaboration, and then came up with our own technique. And we've been doing that for the last three, four years and, and growing that. And so, you know, really delved into the male side of things. And even though we're talking about aesthetics, this is something that's kind of hidden. However, it does have a huge impact on, on men when just from the standpoint of having more confidence, it really kind of shows in all aspects of their life. And you can literally see the, the change in their face when they come in for a follow up after having a procedure. It really makes a huge impact on their life and, and lets me know that there's clearly a lot of things that can be done for men out there if we can overcome the stigma that's been applied or it's not necessarily applied, it's just kind of inherent in, in our social roles. Male are much more reserved. Men are much more reserved as far as doing things like Botox, filler, et cetera. So hopefully things will start to change.

So what kind of stigma is around male. So when you mentioned male enhancement, do you mostly refer to the sexual organization, Correct?

Yes. Without putting up so fine a point on it. Yeah. So we do, we use dermal filler and inject it down in the penis to make it bigger and basically the big result is girth. However, there is Some added length, typically from the weight, but essentially we just make it bigger. The stigma, for the most part. One is a lot of men, and a lot of just people in general don't even know that this procedure exists. If you've seen the ads over the years for, you know, supplements or pills that can supposedly grow, you know, a single part of your body, they're. They're clearly not, you know, it's clearly not true. And so people think it's either a gimmick or you have to undergo surgery. So very few people know that this is a, you know, it's a real choice. It's right in between the two and it actually works immediately. So.

Okay, so how, how much of a. When using filler, you actually inject where in the penis.

So we put it under the skin. There's some nuance to, depending on what we're dealing with, circumcised, uncircumcised. But it goes, you know, a plane under the skin, really. There's essentially no side effects. There is bruising and swelling, however, just, you know, as you put filler in your lips or cheeks, it works instantly and it makes things bigger. So it sounds frightening. And a lot of men come in very scared about having needles put in down there. But we do use a local anesthetic. So apart from a little, you know, two second pinch of lidocaine, there's no pain at all. There is swelling that occurs typically within the first week and some bruising, but within a week everything is kind of back to normal, except bigger. There's really no downtime. The only restriction we typically have is no sex for a week. Apart from that, there's really no aftercare. It's very straightforward and again, the results are immediate.

So it does not affect their sexual sensation or just function.

It should not. Now, you know, that's not 100%. Some people will have increased sensation from, you know, perhaps more contact. And some people may have a little less sensation, certainly in the first few days from swelling. But once the swelling and bruising have subsided, everything should be just as it was. Sensationalize.

I see. And how long would. Let's say the man is fairly sexual active, maybe three, four times having sex a week. I assume the more sex you have, then the faster is going to wing off in a sense that the filler is going to gradually dissipate and dissipate faster.

It should not. I actually had never heard it put that way. I think mostly we think the filler will metabolize quicker. If, you know, someone's a more athletic, higher metabolism, not necessarily sick. So, you know, someone who's a marathon runner probably not going to last as long as someone who's, you know, sits at a desk all day. I honestly don't know if sexual frequency would impact the life of the filler. I do not think it will. We expect. And another thing down there, it lasts longer than in the face. So we typically expect it to last almost twice as long, about 18 to 24 months before it's kind of mostly gone. But a lot of people just come in in the interim and we'll top off, so to speak, to add a couple of syringes.

Okay. So it's a pretty safe procedure and you have pretty high patient satisfaction rate.

Very high. Yeah.

I think really enhance. And it enhance their confidence, I'm sure. And also I assume sexual performance because I guess it's. I mean, do they, do they feel that enhance their performance?

Absolutely, yeah. And a lot of, you know, I have guys who come in and they talk about erectile dysfunction and a lot of them characterize it in that they can't keep it in certain situations. You can't keep an erection. I, I just had a gentleman tell me, you know, during the, during the day he can, and at night he seems to lose it after a while. And I said that sounds more psychosomatic than, you know, biological. Clearly things work if he can get and maintain an erection during the day. Sounds like he has some, you know, he did have confidence issues. And I do hear from a lot of men that it absolutely improves their performance because they're sitting there focused on maybe being inadequate. And, you know, when they start to think about that, obviously they're going to lose it immediately. So this actually has a huge impact on sexual performance, confidence. The other thing I hear from a lot of men is that, you know, this is more for me, my wife, my girlfriend or partner. We have both gay and straight. They say, there's no problem, you're fine the way you are. But. And I liken it frequently to women getting a breast augmentation, you know, and men may say you're perfect the way you are, but if you don't feel adequate or you feel that's what most men tell women. Yes, exactly. I hear it all the time. And it really does seem like it's a good analogy because, you know, and then they'll come back for follow up and they're like, my wife loves it, et cetera, My girlfriend loves it, my partner loves it. But when they come in, they're doing it more for their own confidence and their own feelings of inadequacy. And another thing is a lot of the guys. So when I. When I meet them for a consult, I say, before I even take a look, I'm like, do you consider yourself average, above average, less than average as far as size goes. And almost universally, men say they're either less than average or average. And they come in and they're well beyond average. But there's just something upstairs that. That tells them they're inadequate or they're too small. I don't know if Internet porn plays a part in that because Everybody's, you know, 12 to 15 inches and everybody feels small by comparison. But, yeah, no. So a lot of men are doing it.

So does that help maintain erection better? I mean, I know there's a psychological aspect, so there's a positive feedback. If you have a better size to start with, then you're gonna feel more confident. But do you think that actually helps maintain erection better?

I think the only way it would is if it's. If there's a confidence or psychosomatic issue. The. The act of just putting in the filler will not address sexual function, again, unless there's just a psychological component. Now, we also, and I assume you're aware, we do use Botox down there. We put it, you know, into the cavernosa, and it relaxes the vasculature and allows more blood flow in. And that does help with erectile function. So that is something we do frequently together as well.

To what relationship? So you do it once, and then it will stay effective for how long?

About six to nine months for the Botox. And it takes a while to kick in, not like in the face. It takes probably two to four weeks before it's fully effective. And we primarily recommend it for guys who have a problem with, you know, shrinkage or turtling or they get, you know, the. The growers, not showers. So guys who want to feel fuller, if they have, you know, it does improve erectile function. So. So if they have, you know, not very strong erections, Botox will enhance the firmness and ideally enhance sexual performance. But certainly, just putting in the filler alone will not affect erectile dysfunction. Unless, again, unless it's a psychosomatic issue.

So there's a little bit more controversy about Botox these days. Of course, fillers is always there, always new problems. A potential. Some people have some kind of reaction to fillers, and some people, the fillers migrate or they don't. They don't dissolve what are your take on these concerns?

We've had zero issues with reactions or no necrosis, which you can get in the face. You know, theoretically, you could get it down the penis, but we. We've not seen it. We've had none of those problems as far as that goes. For migration, we initially had a technique where we put it in the subcutaneous plane. There are several planes, and it did migrate. So before, when we initially started this, we had a protocol where there's a decent amount of aftercare molding for several days to keep it in position and wrapping to help it not migrate. However, we found no matter what some people did, it would still migrate and we'd have to spot dissolve or try to fill in areas. Kind of went back to the drawing board and put in a different plane. And now we have. There's no migration pretty much stays exactly where we put it. There's no aftercare involved at all. So much better.

So you found the right spot?

We found the right spot. The P spot, I suppose.

I see. Okay. So what, is there a big trend in then seeking these procedures? Like, is there big ways?

I think it's certainly, you know, for lack of a better term, growing. It's really just an awareness problem. So, you know, over the last couple years, I've seen more articles on it, both positive and negative. Recently on the. On Stephen Colbert show, he. He mentioned it in one of his, you know, comedy segments. So there is growing awareness, but there's still, you know, when I go to a function and talk to people, wedding or conference, depending on the subject matter, and we mention what we do, nobody's heard of it. So I. I know that the vast majority of people don't know it's a thing, like I said. So you're overcoming this. The same stigma of, you know, people think it's gimmicky or not realizing, you know, that you can do something to treat that area that's not surgery and not a gimmick, like a supplement.

And you think the stigma around it, of course, is a sensitive subject, you know, sex senses, subject Anyhow, especially in a society that's a little bit more conservative for the US Compared to Europe. Right. For example, around subject to sex. So why do you think the stigma has changed in recent years?

I don't know so much that the stigma has changed. I hope it's changing. But I think, again, like you said, fairly conservative society compared to Europe or some of the other populations. And, you know, it takes a lot for men to kind of shirk off the, you know, men are tough. We don't cry, we don't wear makeup and do any of that stuff. And hair or, you know, putting filler in the face, you know, is still dominated by women, but more and more men are coming in for that. But something like this, I think when I tell people, you know, you know, whether or not they knew about it, they're very intrigued that this is a thing. So I think would there be stigma for something like this? Sure. It's not like something that, you know, guys are going to run out and tell their friends about.

So.

So that's also one of the reasons that it's not very well known. A lot of the guys that find us and come to our clinics are specifically looking for this kind of treatment. You know, it's not like, you know, we're on TV or it's hard one, it's hard to advertise for something like this because, you know, of censorship and the stigma. So generating awareness is kind of difficult. So that's part of it. And again, I think mostly it's just men are slow on the uptake of things like, you know, cosmetic enhancement. It just hasn't been something if it's been done in the past, it's been, you know, more on the hush hush side. When you think about when breast augmentations came out, you know, it was very hush hush. No women would want to say that they've had anything done. And now, you know, it's, you know, like going to the office, you know, it's very common. People aren't shy about it. And I think ultimately if you have the ability to improve your confidence and feel better about yourself, why you're a man or I think that's, you know, I think that's turning. Obviously it's not a problem for women, but I think it's, it's certainly improving the male population.

It's definitely, I think, you know, dog design is putting men, you know, in a little bit of a disadvantage as far as whatever your design is that it's shown out in the open. Right. You have a male female interaction and females, you know, the structure can be different, they could be experiencing different things, but everything's hidden. Like it's not, is not a, you know, flag people showing the world. So when a man, you know, even just in locker room women, you know, they can be a locker room. So no one is going to see who has what. But for men it's just become such a. Yeah. Such a subject. So I can see how they, that could really affect the confidence level. Yeah, yeah. And their mental health. So how do you see these treatments that, you know, what you see as affecting their confidence and mental health?

Well, again, just, you know, it's an immediate result. They can look down at the end of the procedure and see that they're, you know, noticeably bigger. And again, because we are out there, as you said, and so being out there and feeling better about yourself in that situation makes all the difference. And, and I, I can't tell you, you know, I see the inquiries come in from all our clinics across the country. So, you know, people will text, email or leave messages and, you know, you see some of these sad stories like, please help, my girlfriend laughs at me or my wife laughs at me or says I'm inadequate. And I mean, one, I, I just think that's incredibly cruel. But, you know, I see it again and again. So clearly, if you're a guy on the receiving end of something like that, it's absolutely going to be devastating. And so, you know, being able to improve that, you know, it literally changes a person's life, even though, you know, you can't see it 99% of the time when they know that they're, they're, you know, if they have to get undressed or if they have to go to a locker room or be it a urinal, you know, a lot of men say, you know, I, I can't go in a public bathroom or at the gym, I can't take a shower. No, it's just whether or not it's true, if you feel that way, you know, it's going to affect a lot of aspects of your life that you wouldn't necessarily consider, but it's always there at the back of their mind. It does affect. Approximately half of all men at some point feel inadequate. So again, I think, you know, apart from, you know, the confidence, it really does impact people's health and mental health as, you know, counts, you know, counts in your physical health and being able to improve that will hopefully improve all aspects of your life. Even though, again, it's hidden most of the time, but just, you know, puts a spring in your step, as they say.

Yeah. So how many times does, how many different types of procedures do you, do you use or are there out there? I know in our clinic we actually inject stem cells right into the penis into corpus cavernosum, and we can use combination of shockwave ultrasound or penile pump, et cetera, to help enhance the in engorgement and erectile tissue health and vasculature. So I have definitely seen people's scars growing. So do you also incorporate those in your practice?

We've not done stem cells yet. We are going to be bringing in shockwave for ED treatment, and we're looking at some systems now. How have your results been with stem cells? I know that kind of a. I know you're big in stem cells and it's seen as a panacea for a lot of different conditions. But down there specifically.

Yeah, that will be not there, you know, for stem cell field to think of as a panacea. Although a lot of the public, a lot of people may think that way and some doctors also may say things to that effect. But so it's very much based on what the cells can do in different locations. So specifically for the penis, one, it can reduce inflammation. Right. Inflammatory conditions, vascular deficiencies, has a lot to do with poor erectile function. So that's why when we treat diabetes, when we treat hypertension, the erectile function can improve. So some of the benefits is probably as a result of reducing inflammation, balancing immune system, and helping cardiovascular health. Because there's research showing that stem cell therapy can reduce plaques in the vasculature. You know, some are dramatic results showing aortic root reduction of plaques. So it can help with cardiovascular health and then it can help promote new blood vessels to form, just those things. And then it can break down scar tissue. Because I've treated multiple people with Peyronie's. The abnormal curvature, inflammatory plaque formation is very, very easy to treat. Just injects in stem cells right into the location and it releases very easily. Yeah, it is a very embarrassing condition for men, but very, you know, I've seen just one for itself. So breaking down scar tissue, enhancing vascular formation, helping, reducing formation, cleaning out, you know, forming better arterial linings and all those can be very helpful. And then, of course, it triggers local cells to replenish, so it can make new cells in the matrix. So, yeah, I think it would be a wonderful addition to, you know, to what you're doing.

It's certainly worth looking into. How many treatments do you typically use for something like Peyronie's, for example? How many?

Like, I only did one. Yeah, just beautiful results. Yeah, yeah, it's pretty. It's very satisfying as a doctor, you know, to see that kind of improvement. Yeah, the penile function improvement. You know, people can notice benefit within one treatment, but we generally recommend three sessions, probably about one to two months apart. And I just think whatever people do, adding stem cells for eds that's that's the thing. And what do you think of the penile implants?

Well, I don't want to get too onto that subject. However, I've had patients, several patients that have had different kinds of implants from the ones that they have the pump to something like the penuma. I assume you're familiar with that's basically a silicone sheet that's placed subdermal and it also is to enhance girth and basically increase size. It's surgery, so comes with the attendant risks. I have seen some patients that have had complications from various surgical procedures and they've suffered the consequences such as loss of sensation, loss of length from scarring. So my feeling is if you have, you know, you know, uncorrectable ed where you need a pump, that's one thing. If you're looking to enhance your size, to me a, the, the minimally invasive route is favored. The, it's a double edged sword. You know, it's, the service isn't cheap. However, it's very safe and it's as you know, the dermal fillers, depending on which one you use, are fully reversible. So if you're going to get a surgery, if you don't like it, you're stuck with it. If you have complications or you know, such as, and I've seen this, such as erosion through the skin with resulting infection, necrosis and requiring chronic wound care, you're obviously going to be wishing you did something that was less invasive. But again, a lot of people don't necessarily know that there's a less invasive option. But, but I think for me surgery should be a last result for something like that.

Where do they put the implant exactly?

As far as physicians for the penuma, I know it's subdermal. The other pumps go into the corpora. For somebody who has, let's say they have diabetic complications from diabetes and have essentially lost erectile function completely, then those, those pumps go into the corpora and they're literally, you know, a pump where they have to actually squeeze and fill the area to have sex and then they can release the fluid. So it pumps in, you know, saline into the corpora or where there are some rigid pumps that are just, they're terminally hard basically. So those are, you know, but as far as just augmenting size, the only one I'm really aware of that's, that's popular is the, probably the penuma pump. That's just, it's not for function and it's not, I'm sorry The penuma implant, which is more for, you know, it's an aesthetic procedure as opposed to something for erectile function. But in my mind, if you given the options of something that's, you know, reversible and essentially non invasive compared to a surgery, I would choose eight.

Yeah, right. And as far as non surgical approaches, what do you think are the most significant advancements in the field?

Well, I think what we do basically is now there are, there's multiple fillers, there are some people who are putting in permanent fillers that I'm aware of, which sounds great, but the same potential complications exist, such as, you know, if you have migration or, you know, things get misshapen and you're using a permanent product, then the only way to address that will be surgery, which. Which can have some devastating consequences. So again, the downside is that this doesn't last forever and that it's fairly expensive. But the upside is, you know, if you don't like it, you can go back to exactly where with a simple injection of hyaline X and you don't have to undergo surgery. So it really is a balance. As you say, there's no free lunch. So there are things that can make you permanently bigger, and if they turn out great, you're going to be happy for the rest of your life. If they don't, there's some real downsides.

So for the kind of procedures that you do, what could be some of the potential risks or downsides?

The biggest risk with any kind of procedure, especially, you know, using a dermal filler, would be, you know, concern for infection or possibility of skin necrosis. However, we've seen none of those. We do use prophylactic antibiotics before treatment. Just a single pre opdose and a single post opdose. That's really it. As far as the other complication is just not having it turn out cosmetically good. And that's all that we've seen is on occasion, especially in the previous technique, we'd have to do some corrections for migration. So. So currently we don't deal with that anymore. And I would say 95 plus percent turn out great. Now, one thing that can happen is when we put in filler, people actually do typically gain length, flaccid length, and so sometimes the base gets a little thinned from the weight of the filler. And so when they come back, they have to put a little more in. I guess that's not necessarily a complication, but a consequence of the increased weight. But it's very safe. Um, there's Very few complications. Like I said, the only ones that we typically worry about would be infection, which we just don't see. Knock wood, but that's the biggest concern. Skin necrosis, obviously, would be a terrible complication there as well. With the technique we use. We have not seen that either.

Do you guys also look at all the other aspects of health and to, you know, for example, nutrition for. For people coming to the clinic or. Or anything that. That may. Or hormone aspects. Do you do any of those?

I do in my general practice. And that does kind of, you know, bleed over into the male enhancement side of my crack. So, you know, given that I do liposuction primarily, I do counsel people significantly on nutrition, exercise, this, you know, I explained that the procedure is not a substitute for taking good care of yourself. And if you don't, you know, the area where we took fat away will stay slim, but the other area, parts of your body will not. Same with men. Like smokers, I really, really try to get them to quit because that, as, you know, increases complication rates for anything you do. It also affects erectile function, which in another reason to quit smoking. And fortunately, I see very few smokers. One thing that is fairly common is a large pubic fat pad, which I do liposuction for. So some men come in feeling that they're small, but a lot of it has to, you know, a lot of their length is taken up in a fat pad. So a lot of times I will do just liposuction on that focal area. And then sometimes they don't need a procedure, and sometimes they want it after that. Or actually they usually want it after that. But I do talk about general health, nutrition. I'm a big proponent of nutrition and exercise, and I try to take good care of myself and I really try to help patients out. Even though I'm a surgeon and classically trained in Western medicine, I'm a big believer in complementary and alternative medicine approaches. And I know some. There are a lot of quackery, but I know a lot of it is very beneficial. Things like, you know, know, this new suite of peptides coming out. We don't currently do testosterone therapy in our clinic, so if they do have an issue with that, I refer them out to get their levels checked. If they're, you know, if their primary complaint is erectile dysfunction, then I typically will refer them to endocrinology or their primary care doctor to get further testing. Primarily a cosmetic practice.

Okay, so you want to address, before the erection issue is in place, that there were Already concerns that's apart from the erection part. So you're saying that that's where you really come in and basically it enhanced the aesthetic portion of that.

Yeah. So sometimes, you know, in my conversations with men before I do the procedure, a lot of them will complain about, you know, certain aspects of erectile function. So, you know, on questioning a lot of it, you can narrow down to it's really not a biological problem, it's more of a psychological problem. And so if I don't think, you know, they have any erectile function, I'm going to say you can have this procedure, but it's not going to change anything. And you may need, you know, other kinds of treatments. You may need further testing to see what the cause of the erectile dysfunction is. If they're, you know, an older man who's a diabetic smoker, clearly those are the problems. But for guys in their 30s, 40s, they should generally not be having issues with erectile function, assuming they're otherwise healthy. And so we kind of go, we go into that a bit and I do, you know, kind of try to fet out what their problems are and whether they're reasonable candidates for the procedure and whether this will help them with their erectile function. So I would never say, you know, putting filler in is going to help your, you know, ed. However, if they, if it's primarily psychological, it really does make a difference and it does seem to solve the problem.

Yeah, fantastic. I'm glad that you're looking at the different, different causes of concern and sending people in the right direction and sounds like you're providing a very valuable service for men. That's, and you know, I can't imagine as, as a woman, but you know, as a man, you know, if, if indeed that has been a part of my life that's bringing me dissatisfaction and low self esteem, definitely what you are doing can be a huge help for them. So where can people find you to, you know, to, to maybe get a consultation with you?

Sure. Our website is upsizematters.com we're also on Instagram at Upsize Matters. And my own practice is norcal lipo.com if people are interested in that kind of service. I do mail in emails. I do from head to toe. As far as special kinds of liposuction, I treat a lot of lipedema as well. For our male enhancement services, upsizematters.com is probably the best place to go.

Wonderful. Thank you so much, Dr. Freelander. My interesting subject and I'm glad that you are providing these treatments that has been effective and safe for many men.

Thank you. Great talking.

Nice talking with you.

Bye Bye.