Healthy Living by Willow Creek Springs
A podcast about practices to promote healthy lives featuring experts, businesses, and clients: we gather to share our stories about success, failure, exploration, and so much more. Our subscription episodes feature some personal and vulnerable, real-life stories that are sensitive to some of the general public.
Healthy Living by Willow Creek Springs
The Penis Enlargement Revolution with Dr Joel Pash
The conversation around men's health is evolving rapidly, and Dr. Joel Pash stands at the forefront of this transformation. As medical director of the Upsize Clinic in San Francisco, Dr. Pash brings his extensive background in anesthesiology and complex injectable procedures to the growing field of penile enhancement.
From the moment our discussion begins, Dr. Pash dismantles misconceptions about penile enhancement with refreshing honesty and medical precision. He explains why hyaluronic acid fillers—the same substance used in facial cosmetic procedures—have become the gold standard for safe, effective penile enlargement. Unlike permanent alternatives such as surgical implants or silicone injections, these reversible fillers offer patients both peace of mind and impressive results with minimal recovery time and risk.
What makes this conversation particularly valuable is Dr. Pash's transparent approach to discussing both benefits and potential complications. He walks us through the entire process from consultation to procedure (which typically takes just 45-60 minutes) to recovery (minimal restrictions for about a week). His ethical stance on patient screening and setting realistic expectations provides a stark contrast to what he describes as "charlatans" in the field making unrealistic promises.
Perhaps most powerful are the stories of transformation. Dr. Pash shares how these procedures have revitalized relationships, boosted confidence, and genuinely improved patients' quality of life. Having performed approximately 1,500 procedures since beginning this practice in 2022, his expertise offers valuable guidance for anyone considering this increasingly popular option.
Whether you're curious about men's health innovations, considering penile enhancement yourself, or a medical professional interested in training opportunities, this episode delivers straightforward information that's rarely discussed with such clinical expertise and candor. Visit upsizematters.com to learn more about these procedures or urosculpt.com for professional training opportunities.
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Well, hello and welcome back to the Healthy Living Podcast. I'm your host, Joe Grumbine, and today we have a very special guest. His name is Dr Joel Pasch, and I am excited because this is a topic that we've never discussed before and I think that it's going to be pretty interesting. So Dr Pasch is a co-founder of the Upsize Clinic and the medical director of its San Francisco location. He completed medical school at Midwestern University and went on to a residency in anesthesiology at the University of Calgary. Since that time, he's performed thousands of complex injectable procedures, including nerve blocks, epidural and spinal injections, intravenous and arterial catheters and penile injections. He's published academic papers on subjects such as operating room management and pain management, and he's on staff at several hospitals in Northern California, at two upsized locations, and, if you haven't figured it out by now, he is an expert on penile enlargement. And Dr Pash, welcome. It's a pleasure to have you here.
Speaker 2:Thanks for having me. I appreciate it. This will be fun.
Speaker 1:This is a very interesting topic and recently we had a sexologist here on the show and we talked about you know the importance of libido and performance in a relationship and for health in general, and you know there's so much information and ED is such a big deal, and people's self-esteem and confidence are factors in all this. So I'd certainly like to hear your perspective. Why don't you tell us a little bit about your work?
Speaker 2:Yeah, so I'll start by saying that just the men's health space in general is kind of a growing thing in general is kind of a growing thing. Men's sexual health in general is growing even more, and cosmetic procedures in men are growing, so a lot of these things that used to be things that women did traditionally, now men are getting into also. Like, for example, 20 years ago you might have not seen a lot of guys getting filler put in their face or botox, for example, and now that's becoming commonplace, um and uh. So what we do is penile injections of filler which makes the penis thicker, and there's some overlap with, as you mentioned, ed, in the sense that a lot of people, as they get into their 50s and 60s, have erectile dysfunction, and obviously that's age is 35 to 55. And some of those people have ED and they may want ED treatment, but they may also want their penis to be bigger, and so actually we can help with both of those things.
Speaker 1:All right. Well, that's exciting and interesting. I've got a lot of questions bubbling up, as I don't know anything about this, and I'm curious. First of all, though, you went through training for anesthesiology and then you jumped over to this field. I'm curious how did that all come about?
Speaker 2:It's a good question. A lot of doctors are trying to move into non-traditional medicine for many reasons, I would say, the most common being they feel that they're overworked in the hospital or in their regular medical clinics. In my case, I was looking I still like doing anesthesia and I do practice anesthesia two days a week but I was looking for kind of a change in career. I had a friend from Canada, where I'm from, who had a brother, who has a brother in Sacramento who's a cosmetic surgeon. I was introduced to him and we kind of got together and tried to find some cosmetic procedures that we could do. And it's something I stumbled across after meeting a few people and kind of looking into this. I'd never heard of penis injections but I came across it, looked into it further and sure enough it was a legitimate thing and I had an office to do it in. So I started doing it.
Speaker 1:Interesting, I started doing it. Interesting, and the training and certification or whatever that's required was that substantial or minimal, well, at the time.
Speaker 2:so, backing up a bit, this isn't something you learn in medical school or residency there's. In fact, at the time that I was trying to learn how to do it, there was really no way to learn how to do it, so I watched a few people do it and, as you alluded to at the beginning, I had done thousands of procedures with, you know, putting needles in people's spines and nerves and arteries and stuff like that. So the you know the move over to doing penises is actually quite easy. You know it's a lot more difficult to stick a needle in someone's spine than, or a lot more dangerous and difficult, or at stake, that's for sure yeah yeah
Speaker 2:so you know when you're paralyzed near the penis, you know exactly where it is got it and it's fine, you don't. So anyways, I was kind of uniquely set um, set up to be able to learn how to do this on my own. It was, to be honest, quite like I, like I said, it was a lot easier than what I was regularly doing. At least technically it was easier. Now I am the person that trains and the certification. I've probably trained 40, or between me and my business partner, we probably trained 40 doctors, nurse practitioners, physician assistants, etc. And we do the certification to the extent that it's necessary.
Speaker 1:Well, that's exciting, that's so. You're truly a pioneer in the field.
Speaker 2:I think. I mean, I think so there's. I'm not the only one, but I'm certainly one of the the only one, but I'm certainly one of the first few and I probably do more procedures than most people in the country and if you combine all of the upsized clinic doctors, we certainly do more than most people in the country. There may be a few that do more, but we're pretty busy.
Speaker 1:So my curiosity is piqued as far as you know how, the mechanics of this and the substance of it all. When you talk about fillers and injectable fillers, you know thinking about cosmetic surgery. I don't know a whole lot about it, I've never had a procedure done but what I know is you know they use everything from your own fat cells to silicone compounds and and probably various other things saline and all different things to um to use as a filler for things lips to butts, to cheeks, to whatever breasts, whatever. You know, we've been enhancing body parts for a while and there's a pretty wide spectrum of compounds that are used with varying degrees of safety and risks, and all that I'm curious to know about. What is it that you're injecting?
Speaker 2:Good question. So you can obviously inject all kinds of things, as you alluded to. Some are safe, some are not safe, some are, you know, accepted medical procedures, some are fringe weird things. Some are FDA approved, some are not. So we try to do what we think is the safest way to make the penis bigger. The filler that we use is a hyaluronic acid filler, which is commonly known by most people as a filler that goes in the lips, and it's fairly common for women to get that, you know, to get that procedure done. Also, it can be put other places in the face. So the nice thing about that filler is it's reversible in the event that there were to be any complications or that you would you know, for life circumstances want to change or want to go back to how you were before. That's not to say that that's very common. In fact, I've never had a serious complication where it needed to be reversed. But that option is there. But that option is there. That's, I think. In the cosmetic medical community, hyaluronic acid are pretty much universally accepted to be the safest fillers because of that. There's other ways, though, that you can make the penis bigger, which we do not do because we don't feel that it's safe, or either that it's not safe or it's not effective.
Speaker 2:You'll see people doing surgery by implanting devices in the penis. I always recommend to not have surgery on anything unless you need it. Those devices that they put in can get infections and they can get scar tissue and cause erectile dysfunction and need to be removed. So there's all kinds of and cosmetically not look good and need to be removed. So there's all kinds of issues with that. Um, there are doctors that are injecting silicone in the penis. Silicone, again, is not. It is actually, I think, fda approved for other uses. For example, they put it in the eyeball for retinal detachments, but it's not a dermal filler, so it's not really meant to go on the skin and you can have issues with that. Mainly, it can cause lumpiness and it can be very difficult, if not impossible, to remove.
Speaker 2:So it's pretty common that we hear people that got these things like silicone or implants injected in their penis and they don't like it because it doesn't look good and there's nothing we can do for them. In fact, I just got a message from someone yesterday that had gone to some fairly well-known doctor in the United States gotten silicone injected. He got it done two weeks ago. He, to quote him, said it looks horrendous and was wondering if.
Speaker 2:I could help him, wow. So I actually have to call him today to see what we can do. But unfortunately, when you get these things that are permanent injected in there, they're kind of permanent and a lot of times you need surgery to remove them or you, you know, if you're lucky, maybe we can put some temporary filler around it at least to hide whatever imperfections are there. So you know, in this particular guy's case that would be the thing we're looking at, doing it if I can help him at all. But you know, now he's going to be in it for twice as much money and it's not permanent anyways, because you know.
Speaker 1:I'm somewhat familiar with hyaluronic acid. I'm a formulator of natural cosmetics and I use that in a number of my anti-aging serums and things like that and I guess my, my question would be is the body prone to absorb this or is it just? It just stays put?
Speaker 2:well, yeah, you definitely do break it down it, so it is not a permanent filler, which is that. That's the downside, if they're. It's an upside and a downside. Right, it's a downside in the sense that a lot of people want to spend the least amount of money possible and have something that lasts forever, which is like the guy I just told you the story about, right, but but um, no, it is. It is. Hyaluronic acid is a natural substance in your body, so your body is constantly, you know, breaking things down and rebuilding things and whatever, and that's what keeps you kind of looking young. Right is that your body can regenerate tissue and cells and collagen and, uh, hyaluronic acid is one of those things. So we inject it, your body kind of breaks it down over two years or so and then you need to get injected again, you know, to keep that size.
Speaker 2:But again that's an advantage, I would say, even more so than a disadvantage.
Speaker 1:Sounds like it and it seems like it's. You know, for a somewhat invasive procedure. It seems like it's pretty minimal and probably happens a somewhat invasive procedure. It seems like it's pretty minimal and probably happens pretty quick and there's not a lot of recovery time. You know, if you get a surgery you're going to be out of commission for a minute and all these potential you know infections and complications, rejections, whatever else might come of it, whereas it seems to me I guess you're going to share a little bit about how it all works. So a patient comes in, you do a consultation, you figure out, you know, tell me, walk us through that process a little bit.
Speaker 2:Sure. So the patient comes in, we do a medical consultation as you just said. We're all doctors that do this procedure go over their medical history if they've had any procedures before, and then we do a physical exam, which essentially consists of looking at their current penis or situation and coming up with a plan with the patient as to what they're looking for. Of course, what people are looking for varies from wanting to be just a little bit bigger to want to be a monster, to don't really know why they're here and maybe they don't want anything.
Speaker 2:So we kind of that's something we go through and then if they decide that they want to have a procedure done and it's the right thing for what they're looking for, then we usually do it right away. It takes anywhere from 45 minutes to an hour. They'll have some bruising and some swelling and stuff for maybe a week, but there's no real restrictions in terms of not being able to do exercise or not being able to go to work or anything like that. The only restriction they do have is we ask them not to have sex for one week. That's just an abundance of caution, just to prevent infection or anything like that. With surgeries, as you said, you could be out for a month or two months.
Speaker 2:Oh, yeah, assuming everything heals up nice. 99% of the time it heals nicely and there's no further work necessary and everyone's happy. Sometimes there's some kind of cosmetic imperfections and those are easily addressed because it's a reversible filler and we can always either and like say you had a lump, for example, sometimes people don't care because it's not really noticeable. Sometimes people do care and we just put a little dissolving in it or say you have like a little notch that you need. Then we just fill in a little bit more filler to fix it.
Speaker 2:So it's like a 0% chance that you're. There's not something we can fix one way or another.
Speaker 1:It sounds. That sounds a lot, a lot more comforting than maybe you're going to have a problem we can't do anything about.
Speaker 2:Right, and with the permanent things whether it's surgery or silicone or other kinds of, there's another filler called PMMA which is permanent. With all those things, like I said, usually you're just kind of screwed. If you don't like what you got, you might have to go to a urologist and get your penis cut open and get all this stuff removed and if you're lucky, maybe we can fix it a little bit.
Speaker 1:Wow, that doesn't sound like any fun. Is there anybody that you would say, well, we really can't or shouldn't help you?
Speaker 2:Yeah, it's not common and it's mostly not common because I think at least in our case, within Upsize, we screen people pretty well before they get to our office. So we have two guys that answer the phones and talk to everyone and answer questions and stuff. So if it's something clearly that they're not the patient is not looking for, it's not appropriate to them, we try not to even book them an appointment, just to not waste anyone's time. But sure, there's cases like, say, for example, it's clearly you have maybe some body dysmorphia and there's your expectations are unreasonable and what we can do is not going to make you happy.
Speaker 2:Then I wouldn't inject them with anything. Have an infection there right now, maybe you have some, you know, a urinary tract infection, or maybe you're on antibiotics for a skin infection, for example, then we wouldn't inject around that. The other things would be like I've had guys that you know. I can think of one guy, for example, example, and he was having every single problem in his life and he he was sure that if he got this it was going to fix everything and I you know I felt really cautious about giving this guy a bigger penis and just because I want people to be happy right, right, right.
Speaker 1:Well, that makes sense when we're dealing with medical issues. I've recently been dealing with my own medical issues around cancer and I've done a lot of exploring Western and allopathic medicine, as well as alternative things, and the one thing that I've discovered is there's so much information out there and there's good information and bad information. Some of it comes from experts and physicians, others comes from quacks and charlatans and really, you know, it's patient beware and it's the patient's responsibility to get this information. But with this patient's responsibility to get this information, but with this it seems like it's a pretty completely elective sort of a process. It isn't something that somebody would do to save their life. It might be to save their psyche or, to, you know, enhance their life in many ways, but what would you say, if any would be the inherent risks, if somebody would be to make all the wrong choices, aside from, you know, having a procedure that might not be reversible?
Speaker 2:So I'll just I'll start with the first comment you made, which is there's charlatans out there and there's honest doctors, and it's up to the patient to decide. I think there's some truth to that. I'll say that, at least with myself. I pride myself on not being one of those charlatans and there's. I see so many patients that have kind of shopped this around and they've gone and seen this doctor, that doctor, and I know that what they've been told is complete BS, and so a lot of times I'm the guy that has to say look like that's not true, what you're looking for doesn't exist, or this is what it's really going to be like it's, you know those kinds of things. Like no, you're not going to gain six inches and it's going to last for a whole life, and look perfect. Like that's just not a thing, right? So so there's that. Um. Now to your question about bad I think you said about bad decisions. Do you mean, like, what are the risks of the product?
Speaker 1:yeah, let's just say that I do yeah, let's say they made all the wrong choices and, aside from what we've already discussed having potentially to have a surgery to reverse this is there any other risks that somebody might be taking? Like, for example, you know, with my cancer, if I made the wrong choice I could be dealing with lifetime of complications that I couldn't go back and fix. But I don't believe that this is that kind of a risk. I'm just curious from your point of view, like, if somebody made all the wrong choices, what do they have at stake?
Speaker 2:So do you mean with my procedure that I do, or with other penis procedures?
Speaker 1:With your procedure, with mine, okay so then they're not making the wrong decision.
Speaker 2:In my opinion, they're like, hopefully you're saying if they made the right decision and they came to me, what are the bad things that could still happen? Yeah, what's okay yeah yeah.
Speaker 2:So of course, any medical procedure does have risks, right? I can't say that the thing that I do is 100% risk-free, because that's just not true, and that goes back to my point that a lot of doctors will lie to you about that. I like to break things into kind of common risks, so in other words, words risks that are that, while not likely to happen, are like reasonable things to worry about. Um, risks that. And then there's risks that are like one in a million, right, where, like I have to tell you about it and it's theoretically possible, but I've never seen it and I'll probably never see it. Um, so and that's's, by the way, the same as like in like I'm an anesthesiologist, so if someone comes in and says you know what are the risks, it's like okay, well, you could have a stroke and die having your appendix out, but that's one in a million, but you could also be nauseous and have a sore throat, and that's one in 10, right.
Speaker 2:So it's like the same kind of thing with with this procedure, like the thing that I've seen happen is you can get an infection. So I would say that's maybe one in a hundred or so. In most cases, you give antibiotics and it gets better. Theoretically, you could need to dissolve the filler, which is doable because it's dissolvable filler. So you know, that's kind of I would say that's the most riskiest thing that might actually happen, okay, so that's like the nausea equivalent of a penis procedure. Right, got it. Now, things that other could happen is you can get a thing called a granuloma, which is essentially like a lump under the skin. That's an immune reaction that can happen. I'm not sure what the frequency is. It's also reversible just by dissolving the filler. So not like a huge deal.
Speaker 2:Um, you now moving on to like kind of more rare things, but still possible, would be like a skin necrosis, where, if you inject too much filler or you inject into, like into a mini blood vessel, you can actually have some necrosis of the skin, meaning the skin doesn't get blood flow to it and the skin in that area dies Usually if that, I'm not sure I've ever seen that before, but it is a known thing with dermal fillers. Usually if that happens it's something that just kind of heals up on its own, unless it's a huge area. But being a big area would be very rare, because usually you you'd see that before they leave your office. So that's kind of like a risk. It's not common but not impossible.
Speaker 2:And then then, like going down the list, there's things like actual damage to the penis itself, damage to structures in the penis nerves, arteries, veins, the corpus cavernosum, which is the structural part of the penis, the urethra. So while those are theoretically possible because you're putting a needle in the penis, it's extremely, extremely unlikely for that to happen. If you have any idea what you're doing, it's like basically like, if I can give an analogy, it would be like Damaging. You know you're having like a surgery on your toe and the surgeon mistakenly like injures your arm while they're doing that right, like it's like, as long as you know, that's the toe and don't go near the arm, that's why they use the big sharpie and right yeah incision here yeah, so so it's possible, right?
Speaker 2:I mean, it's possible that the scalpel could slip and he could fall and the thing could cut your arm instead of your toe, but it's pretty unlikely, unlikely well, that sounds like a very relatively safe procedure, considering you know all the the risks that people are willing to take.
Speaker 1:When did you begin this practice?
Speaker 2:the first injection I did was in mid 2022, so that would be three years ago and about approximately.
Speaker 1:You know how many patients have you seen?
Speaker 2:I've. It's hard to say how many patients I've seen, but I'm pretty sure I've done about 1500 procedures okay. The reason I know that is because I originally I used to give. It is kind of funny, but I gave antibiotics to every patient and the bottle comes with 500 pills in it, and so I knew at a certain point how many bottles of antibiotics.
Speaker 1:I went through.
Speaker 2:That gave me an idea. Of course, course we keep charts and all that stuff. But you know, without me going through a million pages of charts, that was a pretty rough estimate sure?
Speaker 1:well, it sounds like you've got a pretty strong body of work here and I always kind of like try to get one personal story from our guests. In all those 1,500 or so patients, I'll bet you one or more cases stand out as something either remarkable or humorous or scary or whatever. What's one patient story that really stands out to you?
Speaker 2:one patient story that really stands out to you. You know we've changed, we've improved so many people's lives and sex lives and confidence and just appearance and all that stuff. There's obviously all kinds of funny things that happen that you know we try to have fun while we're doing the procedures so that people are comfortable, right, Because if you're like telling a joke or something like that while we're doing the procedures, so that people are comfortable, right, Because if you're like telling a joke or something like that while you're doing the procedure, it's a little more relaxing.
Speaker 1:Oh yeah, like a dentist, you know can be really sweet. Maybe not so much.
Speaker 2:Exactly so. I mean I have all kinds of funny stories. I mean the I'll say that there's been people where they they've come back and they've said, you know, uh, everything was, you know, my, my marriage wasn't going great and I didn't have confidence and all kinds of stuff like that. And then I got this done and you know, I got amazing results and everything's like a million times better now. The sex is better, I feel better about myself, the marriage is better.
Speaker 2:I'm not saying that to everyone, but I can think of several people where that's the case and actually, like one one thing was we, uh, one of my patients uh called me and he said he. He said he was going to this concert that was in Sacramento, which is where I live, and he asked me if I'd be going there because he knew I like music. So I said, no, I'll meet you there. So I brought my wife and he brought his wife and his wife just said to my wife like your husband's amazing. So to that point, right, it was like she was vouching for it. That is an amazing thing.
Speaker 1:I love it. I love it. Well, we're running low on time and I realized that you have two demographics that you're catering to. So you have the patients that are looking for a capable physician and a reliable and effective treatment, but you also have practitioners that are looking to get education and certification. So why don't you give us a little shout out and a plug on how people can reach you and anything else you want to share?
Speaker 2:Sure, yeah, good observation there that it's two things that I feel like a lot of people don't notice that you know I've gone on a lot of shows and to me the business is equally training people and doing procedures. So appreciate that interested in getting a procedure done or learning more, you can go to our website, which is upsizematterscom so that's U-P-S-I-Z-E-M-A-T-T-E-R-Scom. I imagine it'll be in the notes below the podcast On that. When you go to that page you can send a web form, you can call us, you can send a text and a lot of people like to text because we actually have real people on the other end that respond to text all day and they know how to answer all your questions. So that's kind of a good way to get in touch with us.
Speaker 2:If you're a doctor that wants to be trained, you can go to that same website. You can click on join upsize and it will give you some information on the. You know what we offer in terms of training and certification and all that. And we have another website called Eurosculptcom U-R-O-S-C-U-L-P-Tcom, and that site that's a business also that trains physicians. We also train nurse practitioners and physician assistants. So if you fit in one of those categories, go to that website and it's a similar thing. You'll see how to contact us and we can get you some training that way.
Speaker 1:Well, beautiful. Well, joel, it's been a pleasure. This has been a remarkably informative episode and I've certainly learned a lot, and I'm sure our listeners are going to enjoy this and I always like to welcome any guests that if you know something changes, you get some kind of a development or a reason to come back. We'd love to have you back.
Speaker 2:Great, I appreciate that. We'll stay in touch.
Speaker 1:Excellent. Well, this has been another episode of the Healthy Living Podcast. I'm your host, joe Grumbine, and I thank you for your support and we will see you next time.
