PATIENT DAILY TO DO LIST (DOCUMENT)

DAY 0 – TREATMENT DAY
*PLEASE SEE ADDITIONAL INFORMATION IN THE MISCELLANEOUS SECTION*
*LESS THAN OPTIMAL RESULTS WILL OCCUR IF YOU DO NOT FOLLOW INSTRUCTIONS*

1. PHARMACY SHOPPING LIST: PICK UP MEDICATIONS AND SUPPLIES TODAY.

PLEASE SEE YOUR PHARMACY SHOPPING LIST FOR ADDITIONAL INFORMATION.

2. MASSAGING & SHAPING PROTOCOL

PLEASE REFER TO THE VIDEOS LOCATED IN THE WEBSITE FOR ADDITIONAL INFORMATION. THE VIDEOS ARE LOCATED ON www.loriamedical.com GO TO THE VIDEO TAB. USERNAME: Patient; PASSWORD: loriamedicalwrap (ALL LOWER CASE, ONE WORD). ALL EXERCISES MUST BE DONE WITH THE BARRIERS ON.
PLEASE NOTE: MASSAGING, SHAPING, & GLANS PUMPING EXERCISES ARE NOT THE SAME
- MASSAGING IS A TWO MINUTE LIGHT RANDOM FINGER TIP MASSAGE OF THE PENILE SHAFT. THE PURPOSE OF MASSAGING IS TO HELP MIX THE FILLER MATERIAL UNDER THE SKIN WHICH WILL PROMOTE VERY SMOOTH COLLAGEN PRODUCTION.
- SHAPING INVOLVES DIRECT FINGER PRESSURE, FINGER ROLLING MOTION WITH PRESSURE, CURVE CORRECTION, AND OTHER TECHNIQUES. THE PURPOSE OF SHAPING IS TO PROMOTE BALANCE AND SYMMETRY.
- GLANS PUMPING IS TO HELP INCREASE CIRCULATION AND PROMOTE HEALING
  - STEP 1: GLANS PUMPING
    - GENTLY GRAB THE GLANS (OR HEAD OF THE PENIS) AND GENTLY SQUEEZE AND HOLD FOR 15 SECONDS UNTIL ALL THE ‘BLOOD’ IS SQUEEZED OUT, THEN RELEASE AND WAIT 15 SECONDS.
    - REPEAT PROCESS 5-10 TIMES 3 TIMES A DAY (MORNING, AFTERNOON AND EVENING).
  - STEP 2: GLANS SHAPING (DO THIS IF YOU HAD THE GLANS TREATED)
    - GENTLY MASSAGE/RUB THE GLANS FOR 1- MINUTE WITH FINGER TIPS.
    - GENTLY PULL AND RUB THE SKIN OF THE GLANS TO SMOOTH OUT THE SURFACE.
  - STEP 3: FINGER PRESSURE BELOW GLANS BULGE AREA
    - PLACE DIRECT FINGER PRESSURE ON THIS AREA. WHILE HOLDING THE PENILE SHAFT IN ONE HAND FOR SUPPORT, PLACE DIRECT MODERATE FINGER PRESSURE FOR 10-15 SECONDS ON THE AREA ON THE UNDERSIDE OF THE PENILE SHAFT JUST BELOW THE HEAD OF THE PENIS. THIS HELPS PREVENT A BULGE FROM DEVELOPING IN THAT AREA.
  - STEP 4: BARRIER BREAK HO15 MINUTES
    - REMOVE YOUR LOOPED RUBBER BAND EVERY 4-6 HOURS FOR 15 MINUTES, BUT NO LONGER THAN 15 MINUTES.
    - IF YOU LEAVE THE LOOPED RUBBER BAND OFF FOR LONGER THAN 15 MINUTES YOU RISK LOSING FILLER MATERIAL.
  - STEP 5: MASSAGE SKIN AREA UNDER LOOPED RUBBER BAND FOR 1-MINUTE
    - DO NOT PERFORM FINGER ROLLING OR FINGER PRESSURE MOTIONS, WHICH IS USED FOR SHAPING ONLY.
    - REMEMBER TO PLACE THE BARRIER BACK ON AFTER YOUR 10-15 MINUTE BREAK.
  - STEP 6: PLACE THE BARRIER BACK ON
    - NOTE: DURING THE FIRST 7 DAYS YOUR PRIMARY BARRIER WILL BE THE TIGHT LOOPED RUBBER BAND AND TIGHT HALF-FOLD. WHEN YOU ARE ABOUT TO PLACE THE LOOPED RUBBER BAND BACK ON AFTER THE 10-15 MINUTE BREAK, PLACE THE LOOPED RUBBER BAND BACK ON IN A SLIGHTLY DIFFERENT LOCATION ON THE HALF FOLD.
  - STEP 7: ALTERNATE PENIS POSITION
    - PENIS POSITION IS ALWAYS PLACED EITHER UPWARDS OR DOWNWARDS, IF POSSIBLE.

3. WRAP PROTOCOL

NO RE-WRAP TODAY. DO NOT REMOVE YOUR WRAP UNLESS INSTRUCTED TO DO SO.

4. BARRIER PROTOCOL

A BARRIER SUCH AS A YOUR LOOPED RUBBER BAND & TIGHT HALF-FOLD AT THE BASE OF THE PENILE SHAFT PLAY A KEY ROLE IN PREVENTING THE LOSS OF FILLER MATERIAL INTO THE PUBIC OR SCROTAL AREA. BARRIERS ARE TO BE WORN 24/7

WITH THE EXCEPTIONS OF THE MANDATORY BREAKS. MANDATORY BREAKS ARE CRITICAL TO PREVENT THE DEVELOPMENT OF SKIN SORES/CUTS OR ULCERS.

LOOPED RUBBER BAND BREAK
- REMOVE THE LOOPED RUBBER BAND AFTER COMPLETING YOUR MASSAGING & SHAPING EXERCISES.
- REMOVE LOOPED RUBBER BAND FOR 15 MINUTES AND DO THIS EVERY 4-6 HOURS.
- YOU CAN MASSAGE THE AREA DIRECTLY UNDER THE LOOPED RUBBER BAND AREA FOR 1-2 MINUTES.
- AFTER THE 10-15 MINUTE BREAK, PLACE THE LOOPED RUBBER BAND BACK ON.

KEEP YOUR BARRIERS ON
- THE LOOPED RUBBER BAND, MUST BE WORN AT ALL TIMES, UNLESS INSTRUCTED OTHERWISE, EXCEPT DURING YOUR 15 MINUTE BARRIER BREAKS EVERY 4-6 HOURS. NOTE: PAD UNDER THE PLASTIC RING WITH GAUZE/COTTON BALLS & PLACE TRIAMCINOLONE OINTMENT ON AS WELL TO HELP PREVENT SKIN SORES, AND, ALTERNATE LOOPED RUBBER BAND POSITION.

NOTE: IF YOU HAD THE SCROTUM TREATED, YOU WILL NEED TO WEAR THE STRETCHY RINGS (TWO SCROTAL RINGS OR THE FIGURE 8 SCROTAL RING) FOR THE FIRST 7 DAYS ALSO. THE SCROTAL RINGS WILL BE WORN UNTIL DAY 21.
- FIGURE 8 SCROTAL RING
  - WILL BE PLACED WITH THE BIG LOOP AROUND THE SHAFT & SCROTUM AT THE SAME TIME, AND THE SMALL LOOP POSITIONED BEHIND THE SCROTAL SACK, WILL FLIP UPWARDS TO ISOLATE THE SCROTUM ALONE.
- TWO SCROTAL RINGS WILL BE PLACED IN TOTAL.
  - THE SILICONE SCROTAL RING (OR THE SMALLEST SCROTAL RING IN DIAMETER POSSIBLE), WILL BE PLACED AROUND THE SCROTAL SACK, ISOLATING THE SCROTUM.
  - THE NEXT SCROTAL RING (BIG RUBBER BANDS) IN SIZE WILL BE PLACED AROUND THE SHAFT AND SCROTUM.
MASSAGING & SHAPING IS ALWAYS WITH YOUR BARRIERS ON
ALTERNATE SHAFT POSITION IF POSSIBLE, UPWARDS & DOWNWARDS EVERY 4-6 HOURS WHILE AWAKE

5 MEDICATIONS & DIET PROTOCOL

PLEASE REFER TO YOUR MEDICATIONS & DIET PROTOCOL FOR ADDITIONAL INFORMATION
WHAT YOU WILL TAKE TODAY
- TRIAMCINOLONE & BACITRACIN OINTMENTS – PLACE ON GLANS (HEAD OF THE PENIS) AT BEDTIME
- NITRO-BID – PLACE A VERY TINY QUANTITY (LIKE A GRAIN OF RICE) ON GLANS AFTER PLACING THE TRIAMCINOLONE & BACITRACIN AT BEDTIME ONLY. IF YOU DO NOT YET HAVE THE NITRO-BID YET, PLACE ON WHEN PRESCRIPTION IS RECEIVED.
- LIDOCAINE OINTMENT: PAIN CREAM – APPLY EVERY 3-4 HOURS IF YOU EXPERIENCE PAIN.

WHAT YOU WILL NOT TAKE TODAY
- CEPHALEXIN: ANTIBIOTIC – TAKE NONE TODAY. THIS WAS GIVEN TO YOU IN THE OFFICE.
  - (IF ALLERGIC THEN TAKE BACTRIM)
- METRONIDAZOLE: ANTIBIOTIC – TAKE NONE TODAY. THIS WAS GIVEN TO YOU IN THE OFFICE.
  - (IF ALLERGIC THEN TAKE CLINDAMYCIN)
- PREDNISONE: STEROID ANTI-INFLAMMATORY – TAKE NONE TODAY. THIS WAS GIVEN TO YOU IN THE OFFICE.

6. PAIN & DISCOMFORT PROTOCOL

PAIN & DISCOMFORT MAY OCCUR AFTER ANY TREATMENT INCLUDING A CIRCUMCISION, GLANS FILLER TREATMENT, SHAFT FILLER TREATMENT, SCROTAL FILLER TREATMENT, OR ANY OTHER TREATMENTS OFFERED AT LORIA MEDICAL
- FOR GENERAL PAIN & DISCOMFORT:
  - FOR MILD & MODERATE PAIN & DISCOMFORT
    - USE ICE PACKS FIRST FOR PAIN AND DISCOMFORT. ICE PACKS CAN BE PLACED 30-MINUTES ON AND THEN 30-MINUTES OFF UNTIL YOU HAVE RELIEF FROM THE DISCOMFORT.
    - ALEVE OR ADVIL. USE AS PRESCRIBED ON BOTTLE.
  - FOR SEVERE PAIN USE TYLENOL #4
    - FOR ADDITIONAL COMFORT, APPLY ADDITIONAL TRIAMCINOLONE AND LIDOCAINE OINTMENTS ON SENSITIVE SKIN AREAS 2 X A DAY.
    - • TAKE ONE TYLENOL #4 PAIN MEDICATION ONLY IF NEEDED TO HELP WITH NOCTURNAL ERECTION DISCOMFORT, WHICH OCCURS DURING SLEEP. THIS MEDICATION MAY CAUSE NAUSEA AND LIGHTHEADEDNESS… IF THIS OCCURS LIE DOWN UNTIL SYMPTOMS SUBSIDE AND NOTIFY THE LORIA MEDICAL STAFF.

7. BEDTIME PROTOCOL

TRIAMCINOLONE & BACITRACIN OINTMENTS
- PLACE LIBERALLY ON GLANS AT BEDTIME.
NITRO-BID OINTMENT
- PLACE ON GLANS AFTER PLACING THE TRIAMCINOLONE & BACITRACIN AT BEDTIME ONLY.
- USE A TINY AMOUNT OF THIS MEDICATION… A TINY AMOUNT ONLY (LIKE A GRAIN OF RICE).
- PLACE TRIAMCINOLONE & BACITRACIN OINTMENTS ON GLANS FIRST, THEN PLACE A VERY TINY AMOUNT OF NITRO-BID USING A Q-TIP APPLICATOR. NOTE: NITRO-BID MAY CAUSE NAUSEA, SWEATING AND LIGHTHEADEDNESS… IF THIS OCCURS LIE DOWN UNTIL SYMPTOMS SUBSIDE AND NOTIFY THE LORIA MEDICAL STAFF. ALSO, IF YOU HAVE NOT YET RECEIVED THIS MEDICATIONS & DIET PROTOCOL, DO NOT WORRY, AND START PLACING IT ON WHEN YOU ARE ABLE.

8. WHAT NOT TO DO TODAY

DO NOT REMOVE THE WRAP
DO NOT LEAVE YOUR BARRIERS OFF MORE THAN THE SPECIFIED BARRIER BREAK TIMES, WHICH ARE 15 MINUTES EVERY 4-6 HOURS WHILE AWAKE.
DO NOT START SHAFT MASSAGING OR SHAPING (THIS STARTS ON DAY-3) EXCEPT FOR GLANS PUMPING.
DO NOT TAKE CEPHALEXIN, METRONIDAZOLE OR PREDNISONE TODAY. YOUR MEDICATIONS & DIET PROTOCOL FOR TODAY WERE ALREADY GIVEN TO YOU IN THE OFFICE
DO NOT SLEEP ON YOUR STOMACH/BELLY, TRY TO SLEEP ON YOUR BACK OR SIDE, AND PILLOW BETWEEN LEGS IF NECESSARY
DO NOT EXERCISE
DO NOT CONSUME/DRINK ALCOHOL

DAY 1, 2, & 3

MORNING

1. TAKE PHOTOS

SEND PHOTOS WITH COMMENTS EACH MORNING (BEFORE NOON) AND SEND ON A DAILY BASIS TO THE GROUP MESSAGE, NO EXCEPTIONS. THIS IS CRITICAL FOR FOLLOW-UP, EVALUATION AND OPTIMAL RESULTS.

2. MASSAGING & SHAPING PROTOCOL

MASSAGING & SHAPING PROTOCOL SEQUENCE IN ORDER “FROM TOP TO BOTTOM”.
- STEP 1: GLANS PUMPING.
- STEP 2: GLANS SHAPING (DO THIS IF YOU HAD THE GLANS TREATED).
- STEP 3: FINGER PRESSURE BEHIND GLANS BULGE AREA.
- STEP 4: PENILE CURVE CORRECTION IF NEEDED (AFTER DAY 3).
  - YOU CAN APPLY CONTRALATERAL PRESSURE AGAINST ANY ANOMALOUS CURVATURE DEVELOPED, HOLD THE POSITION FOR 15-20 SECONDS, REPEAT THREE TIMES A DAY IF NEEDED.
- STEP 5: SCROTAL MASSAGE & SHAPING (IF YOU HAD A SCROTAL ENLARGEMENT TREATMENT) (AFTER DAY 3).
  - MASSAGING IS A TWO MINUTE LIGHT RANDOM FINGER TIP MASSAGE OF THE SCROTAL SKIN. THE PURPOSE OF MASSAGING IS TO HELP MIX THE FILLER MATERIAL UNDER THE SKIN WHICH WILL PROMOTE VERY SMOOTH COLLAGEN PRODUCTION.
- STEP 6: BARRIER BREAK 15 MINUTES.
- STEP 7: MASSAGE SKIN AREA UNDER LOOPED RUBBER BAND FOR 1-MINUTE.
- STEP 8: PLACE THE BARRIER BACK ON.
- STEP 9: ALTERNATE PENIS POSITION.

3. WRAP PROTOCOL

NO RE-WRAP TODAY. DO NOT REMOVE YOUR WRAP UNLESS INSTRUCTED TO DO SO.

4. BARRIER PROTOCOL

LOOPED RUBBER BAND BARRIER BREAK
- REMOVE THE LOOPED RUBBER BAND AFTER ALL MASSAGING & SHAPING PROTOCOL HAVE BEEN COMPLETED.
- REMOVE LOOPED RUBBER BAND FOR 15 MINUTES AND DO THIS EVERY 4-6 HOURS.

NOTE: IF YOU HAD THE SCROTUM TREATED, YOU WILL NEED TO WEAR THE STRETCHY RINGS (TWO SCROTAL RINGS OR THE FIGURE 8 SCROTAL RING) FOR THE FIRST 7 DAYS ALSO. THE SCROTAL RINGS WILL BE WORN UNTIL DAY 21.
- FIGURE 8 SCROTAL RING
  - WILL BE PLACED WITH THE BIG LOOP AROUND THE SHAFT & SCROTUM AT THE SAME TIME, AND THE SMALL LOOP POSITIONED BEHIND THE SCROTAL SACK, WILL FLIP UPWARDS TO ISOLATE THE SCROTUM ALONE.
- TWO SCROTAL RINGS (TWO SEPARATE PIECES).
  - THE SILICONE SCROTAL RING (OR THE SMALLEST SCROTAL RING IN DIAMETER POSSIBLE), WILL BE PLACED AROUND THE SCROTAL SACK, ISOLATING THE SCROTUM.
  - THE NEXT SCROTAL RING (BIG RUBBER BANDS) IN SIZE WILL BE PLACED AROUND THE SHAFT AND SCROTUM.

TRY TO ALTERNATE SHAFT POSITION, IF POSSIBLE, THROUGHOUT THE DAY, PLACING UPWARDS AND DOWNWARDS (NOT RIGHT OR LEFT).

5. MEDICATIONS & DIET PROTOCOL

PLEASE REFER TO YOUR MEDICATIONS & DIET PROTOCOL FOR ADDITIONAL INFORMATION
WHAT YOU WILL TAKE THIS MORNING

CEPHALEXIN – TAKE TWO CAPSULES 2 X A DAY FOR 10 DAYS.
METRONIDAZOLE – TAKE TWO TABLETS 2 X A DAY FOR 5 DAYS.
PREDNISONE – TAKE TWO TABLETS 2 X A DAY FOR 3 DAYS.
TRIAMCINOLONE & BACITRACIN – PLACE ON GLANS.

WHAT YOU WILL NOT TAKE THIS MORNING

NITRO-BID OINTMENT

6. PAIN & DISCOMFORT PROTOCOL

FOR GENERAL PAIN & DISCOMFORT:

FOR MILD TO MODERATE PAIN & DISCOMFORT

USE ICE PACKS FIRST FOR PAIN AND DISCOMFORT. ICE PACKS CAN BE PLACED 30-MINUTES ON AND THEN 30-MINUTES OFF UNTIL YOU HAVE RELIEF FROM THE DISCOMFORT.
ALEVE OR ADVIL. USE AS PRESCRIBED ON BOTTLE.
LIDOCAINE CREAM: THIS IS A PRESCRIPTION THAT YOU MAY NOT HAVE YET. APPLY A THIN COAT OVER ANY SENSITIVE AREAS EVERY 3-4 HOURS IF NEEDED.

FOR SEVERE PAIN USE TYLENOL #4

FOR ADDITIONAL COMFORT, APPLY ADDITIONAL TRIAMCINOLONE AND LIDOCAINE OINTMENTS ON SENSITIVE SKIN AREAS 2 X A DAY.

PENILE SHAFT DISCOMFORT & PAIN
- THE PENILE SHAFT FILLER TREATMENT AS WELL AS THE SCROTAL TREATMENT WILL NOT, IN MOST CASES CAUSE ANY IMMEDIATE DISCOMFORT AND/OR PAIN. EVEN IF YOU WERE TO HAVE DISCOMFORT ON THE SAME DAY, OR SHORTLY AFTER YOUR PROCEDURE, THE REMEDY WILL BE THE SAME. (THE INSTRUCTIONS BELOW APPLY TO PAIN AND DISCOMFORT AFTER SCROTAL TREATMENTS AS WELL).

LIDOCAINE CREAM AND TRIAMCINOLONE OINTMENT: THESE MEDICATIONS ARE TYPICALLY USED IF THE SKIN UNDER THE HALF-FOLD AND RUBBER BAND AREA BEGINS TO BECOME IRRITATED. YOU CAN PLACE BOTH MEDICATIONS ON WITH A Q-TIP APPLICATORS, AND SLIDE IT UNDER THE WRAP (TEMPORARILY REMOVE THE RUBBER BAND SO THE Q-TIP APPLICATOR CAN GET UNDER EASILY), OR IF YOU ARE AT THE POINT TO DO A RE-WRAP, THEN PLACE IT ON AFTER THE WRAP IS OFF.
TYLENOL #4: IT IS RECOMMENDED TO GO TO THE PHARMACY AS SOON AS POSSIBLE AND PICK UP YOUR PRESCRIPTION MEDICATIONS, INCLUDING THIS PAIN KILLER, AND HAVE READILY AVAILABLE. TAKE 1-2 TABLETS EVERY 3-4 HOURS. DO NOT EXCEED 6 TABLETS IN A 24-HOURS, DO NOT DRIVE WHILE ON THIS MEDICATION.
HOW TO TREAT MINOR SKIN CUTS/SORES: MINOR, RELATIVELY SMALL SKIN CUTS OR SORES MAY OCCUR AT THE BASE OF THE PENILE SHAFT AFTER PROLONGED USE OF THE TIGHT HALF-FOLD AND RUBBER BAND, OR PROLONGED USE OF THE PLASTIC RING WHEN IT IS ON WITH HIGH TENSION. IT IS REMEDIED BY TAKING A HOT SHOWER WITH SOAP AND WATER, PAT DRY, TAKE PHOTOS, AND PLACING BACITRACIN OINTMENT WITH A SMALL AMOUNT OF LIDOCAINE CREAM DIRECTLY ON THE SKIN CUT OR SORE. LASTLY, PLACE A BAND-AID TO COVER. YOU WILL NEED TO DO THIS EVERY 24-48 HOURS AFTER DAY 7, SO YOUR RE-WRAPS WILL BE DONE MORE FREQUENTLY. IN ADDITION, YOU WILL NEED TO DECREASE THE AMOUNT OF TENSION ON THE HALF-FOLD. IF YOU HAVE A SKIN CUT FROM THE PLASTIC RING (THE CUT IS TYPICALLY FOUND VERY LOW ON THE SHAFT AND SCROTAL SKIN, AND IS DIRECTLY UNDER THE PLASTIC RING), THE SAME PROTOCOL APPLIES, BUT IN ADDITION, YOU CAN ADD SOME GAUZE OR COTTON PADDING UNDER THE PLASTIC RING FOR ADDITIONAL COMFORT.
SKIN ULCER ON PENILE SHAFT: A SKIN ULCER IS A LARGER AND DEEPER SKIN CUT. SKIN ULCERS ON THE PENILE SHAFT ARE RARE, AND ARE CAUSED BY TOO MUCH INFLAMMATION CAUSED BY AN AGGRESSIVE REACTION TO THE FILLER MATERIAL. IT IS VERY IMPORTANT TO TAKE CARE OF THIS SKIN ULCER IN A VERY SPECIFIC WAY. YOU ARE TO TAKE A HOT SHOWER WITH SOAP AND WATER, PAT DRY, TAKE PHOTOS, THEN PLACE PLENTY OF BACITRACIN OINTMENT (MUPIROCIN IF PRESCRIBED) ONLY ON THE SKIN ULCER, THEN PLACE BAND-AID TO COVER IT. YOU WILL NEED TO DO THIS EVERY 24-48 HOURS, SO YOUR RE-WRAPS WILL BE DONE MORE FREQUENTLY AFTER DAY 7. IT IS IMPERATIVE FOR THE SKIN ULCER TO BE MOIST WITH LOTS OF BACITRACIN OINTMENT (OR MUPIROCIN IF PRESCRIBED) ON IT AT ALL TIMES. IF THE SKIN ULCER IS NOT MOIST, AND IS IN CONTACT WITH THE AIR, IT WILL HEAL TOO RAPIDLY AND NOT HEAL WELL.

SCROTAL SKIN DISCOMFORT & PAIN
- SAME INSTRUCTIONS AS ABOVE.

7. WHAT NOT TO DO TODAY

DO NOT REMOVE THE WRAP
DO NOT LEAVE YOUR BARRIERS OFF MORE THAN THE SPECIFIED BARRIER BREAK TIMES, WHICH ARE 15 MINUTES EVERY 4-6 HOURS WHILE AWAKE.
DO NOT START SHAFT MASSAGING OR SHAPING (THIS STARTS ON DAY-3)…EXCEPT FOR GLANS PUMPING.
DO NOT EXERCISE
DO NOT CONSUME/DRINK ALCOHOL

DAY 1, 2, & 3 AFTERNOON

1. MASSAGING & SHAPING PROTOCOL

STEP 1: GLANS PUMPING.
STEP 2: GLANS SHAPING (DO THIS IF YOU HAD THE GLANS TREATED).
STEP 3: FINGER PRESSURE BEHIND GLANS BULGE AREA.
STEP 4: PENILE CURVE CORRECTION.
STEP 5: SCROTAL MASSAGE & SHAPING (IF YOU HAD A SCROTAL ENLARGEMENT TREATMENT).
STEP 6: BARRIER BREAK 15 MINUTES.
STEP 7: MASSAGE SKIN AREA UNDER LOOPED RUBBER BAND FOR 1-MINUTE.
STEP 8: PLACE THE BARRIER BACK ON.
STEP 9: ALTERNATE PENIS POSITION.

2. BARRIER PROTOCOL

LOOPED RUBBER BAND BARRIER BREAK
- REMOVE THE LOOPED RUBBER BAND AFTER ALL MASSAGING & SHAPING PROTOCOL HAVE BEEN COMPLETED.
- REMOVE LOOPED RUBBER BAND FOR 15 MINUTES AND DO THIS EVERY 4-6 HOURS.

NOTE: IF YOU HAD THE SCROTUM TREATED, YOU WILL NEED TO WEAR THE STRETCHY RINGS (TWO SCROTAL RINGS OR THE FIGURE 8 SCROTAL RING) FOR THE FIRST 7 DAYS ALSO. THE SCROTAL RINGS WILL BE WORN UNTIL DAY 21.
- FIGURE 8 SCROTAL RING
  - WILL BE PLACED WITH THE BIG LOOP AROUND THE SHAFT & SCROTUM AT THE SAME TIME, AND THE SMALL LOOP POSITIONED BEHIND THE SCROTAL SACK, WILL FLIP UPWARDS TO ISOLATE THE SCROTUM ALONE.
- TWO SCROTAL RINGS WILL BE PLACED IN TOTAL.
  - THE SILICONE SCROTAL RING (OR THE SMALLEST SCROTAL RING IN DIAMETER POSSIBLE), WILL BE PLACED AROUND THE SCROTAL SACK, ISOLATING THE SCROTUM.
  - THE NEXT SCROTAL RING (BIG RUBBER BANDS) IN SIZE WILL BE PLACED AROUND THE SHAFT AND SCROTUM.

TRY TO ALTERNATE SHAFT POSITION, IF POSSIBLE, THROUGHOUT THE DAY, PLACING UPWARDS AND DOWNWARDS (NOT RIGHT OR LEFT).

3. WRAP PROTOCOL

NO RE-WRAP TODAY. DO NOT REMOVE YOUR WRAP UNLESS INSTRUCTED TO DO SO.

4. MEDICATIONS & DIET PROTOCOL

PLEASE REFER TO YOUR MEDICATIONS & DIET PROTOCOL FOR ADDITIONAL INFORMATION

WHAT YOU WILL NOT TAKE THIS AFTERNOON

NO PLACEMENT OF NITRO-BID OINTMENT.

5. PAIN & DISCOMFORT PROTOCOL

FOR GENERAL PAIN & DISCOMFORT:

FOR MILD & MODERATE PAIN & DISCOMFORT

USE ICE PACKS FIRST FOR PAIN AND DISCOMFORT. ICE PACKS CAN BE PLACED 30-MINUTES ON AND THEN 30-MINUTES OFF UNTIL YOU HAVE RELIEF FROM THE DISCOMFORT.
ALEVE OR ADVIL. USE AS PRESCRIBED ON BOTTLE.

FOR SEVERE PAIN USE TYLENOL #4

FOR ADDITIONAL COMFORT, APPLY ADDITIONAL TRIAMCINOLONE AND LIDOCAINE OINTMENTS ON SENSITIVE SKIN AREAS 2 X A DAY.

6. WHAT NOT TO DO TODAY

DO NOT REMOVE THE WRAP
DO NOT LEAVE YOUR BARRIERS OFF MORE THAN THE SPECIFIED BARRIER BREAK TIMES, WHICH ARE 15 MINUTES EVERY 4-6 HOURS WHILE AWAKE.
DO NOT START SHAFT MASSAGING OR SHAPING (THIS STARTS ON DAY-3)…EXCEPT FOR GLANS PUMPING.
DO NOT EXERCISE
DO NOT CONSUME/DRINK ALCOHOL

DAY 1, 2, & 3 EVENING

1. MASSAGING & SHAPING PROTOCOL

STEP 1: GLANS PUMPING.
STEP 2: GLANS SHAPING (DO THIS IF YOU HAD THE GLANS TREATED).
STEP 3: FINGER PRESSURE BEHIND GLANS BULGE AREA.
STEP 4: PENILE CURVE CORRECTION.
STEP 5: SCROTAL MASSAGE & SHAPING (IF YOU HAD A SCROTAL ENLARGEMENT TREATMENT).
STEP 6: BARRIER BREAK 15 MINUTES.
STEP 7: MASSAGE SKIN AREA UNDER LOOPED RUBBER BAND FOR 1-MINUTE.
STEP 8: PLACE THE BARRIER BACK ON.
STEP 9: ALTERNATE PENIS POSITION.

2. RE-WRAP PROTOCOL

RE-WRAP WILL BE PERFORMED EITHER ON THE EVENING OF DAY-3 OR THE MORNING OF DAY-4. THIS RE-WRAP WILL BE THE VERY SAME WRAP RECEIVED ON THE TREATMENT DAY (UNLESS INSTRUCTED OTHERWISE).

WHEN IT IS TIME FOR YOUR RE-WRAP, PLEASE PREPARE FIRST: YOU WILL LAY OUT ALL OF YOUR WRAP MATERIALS FIRST, THEN TAKE A SHOWER, AND DURING THE SHOWER YOU CAN REMOVE THE CURRENT WRAP, THEN PAT ALL DRY, THEN TAKE PHOTOS WHILE THE WRAP IS OFF, THEN PLACE COMPLETE WRAP BACK ON, THEN TAKE PHOTOS AGAIN.
PLEASE NOTE: THAT YOUR LOOPED RUBBER BAND AND TIGHT HALF FOLD AT THE PENILE BASE IS YOUR PRIMARY PENILE SHAFT BARRIER UNTIL DAY-8.
- STEP 1 – REMOVE YOUR WRAP (EXCEPT GLUED DOWN SPOT BAND-AID) DURING YOUR 10-15 MINUTE HOT SHOWER, THEN PAT DRY, THEN TAKE PHOTOS.
- STEP 2 – INSPECT THE SPOT BAND-AID AREA TO MAKE SURE ALL IS SECURE. IF LEAKING IS VISIBLE, REPLACE SPOT BAND-AID AND RE-GLUE.
- STEP 3 – PLACE 2 TOE PADS OVERLAPPING EACH OTHER ON THE UNDERSIDE OF THE SHAFT, JUST UNDER THE GLANS.
- STEP 4 – THEN PLACE YOUR WINGED BAND-AIDS ON AT THE VERY BASE OF THE PENILE SHAFT, ONE ON THE UPPER SIDE (PENILE SHAFT AND PUBIC AREA) AND ANOTHER ONE ON THE BOTTOM (PENILE SHAFT AND SCROTUM) (USE TAPE TO SECURE IF NEEDED).
- STEP 5 – PLACE A THIN COAT OF TRIAMCINOLONE 0.5% OINTMENT SPREADING OUT EVENLY THROUGHOUT ON THE ENTIRE PENILE SHAFT, GLANS, PUBIC, AND SCROTAL AREAS (ESPECIALLY WHERE THE LOOPED RUBBER BAND AND THE PLASTIC RING PLACES PRESSURE ON THE PUBIC AND SCROTAL AREAS).
- STEP 6 – PLACE BROWN STRETCH GAUZE WRAP ON ENTIRE SHAFT WITH MILD TENSION, STARTING FROM THE BASE, AS LOW AS POSSIBLE, AND OVERLAPPING 80-90%, UNTIL YOU REACH THE GLANS (HEAD OF PENIS), COVERING THE TOE PAD BUT NOT ABOVE. PLACE PAPER TAPE TO SECURE.
- STEP 7 – PLACE 8-10 TURNS OF BLUE PRE-WRAP WITH VERY MILD TENSION AS LOW AS POSSIBLE ON THE PENILE SHAFT (ON TOP OF WINGED BAND-AID), JUST BELOW THE EDGE OF THE BROWN STRETCH GAUZE. PLACE PAPER TAPE TO SECURE. THIS PROVIDES SKIN CUSHION FOR WHEN THE TIGHT HALF-FOLD AND LOOPED RUBBER BAND ARE PLACED AFTERWARDS.
- STEP 8 – PLACE BROWN STRETCH GAUZE WRAP DIRECTLY ON THE BLUE PRE-WRAP, AND WORK UP THE SHAFT TO ⅓-½ THE WAY, NO MORE, AND WITH MILD TENSION ONLY. LEAVE A SMALL VISIBLE EDGE OF THE BLUE PRE-WRAP.
- STEP 9 – PLACE THE TIGHT HALF-FOLD ON AS LOW AS POSSIBLE ON THE PENILE SHAFT BASE AREA AND WITH TWO FULL TURNS AROUND THE PENILE SHAFT (DIRECTLY ON TOP OF THE BLUE PRE-WRAP & LARGE BAND-AID), AND WITH MODERATE (NOT HIGH) TENSION, LEAVE A VISIBLE BLUE PRE-WRAP EDGE THEN PLACE PAPER TAPE TO SECURE.
- STEP 10 – PLACE LOOPED RUBBER BAND DIRECTLY ON THE TIGHT HALF-FOLD LOCATED AT THE PENILE BASE AREA. THIS IS YOUR PRIMARY PENILE SHAFT BARRIER. NOTE: ALTERNATE LOOPED RUBBER BAND PLACEMENT EACH TIME YOU TAKE A BARRIER BREAK.
- STEP 11 – PLACE HALF-FOLD ON THE UPPER SHAFT AREA JUST UNDER THE GLANS. THERE ARE TWO WAYS TO DO THIS:
  - THE ‘SWOOP’ HALF-FOLD IS THE METHOD OF CHOICE IMMEDIATELY AFTER YOUR TREATMENT. IS DONE BY PLACING THE HALF-FOLD DIRECTLY ON THE FRONT OR TOP SIDE OF THE GLANS, AND THEN SWOOP DOWN ON THE UNDERSIDE OF THE GLANS. CONTINUE THIS, BUT ON EACH TURN THE HALF-FOLD SHOULD REMAIN ON THE FRONT OR TOP SIDE OF THE GLANS, AND ON THE UNDERSIDE THE HALF-FOLD SHOULD BE PLACED IN A MORE BROAD WIDE FASHION. PLACE ON WITH MILD TENSION.
  - THE SECOND METHOD: PLACE THE HALF-FOLD DIRECTLY UNDER THE GLANS, LEAVING NO VISIBLE SHAFT SKIN. GO AROUND TWO TIMES AND WITH MILD TENSION. IF YOU ARE UNCIRCUMCISED, OR YOU ARE DEVELOPING A SHAFT SKIN BULGE THAT IS HANGING OVER THE GLANS, THEN YOU NEED TO PLACE THE HALF-FOLD ON IN THIS FASHION, BUT WITH MODERATE (NOT MILD) TENSION.
- STEP 12 – PLACE YOUR STRETCHY RING ON – (THIS IS ONLY PLACED ON IF YOU HAD A SCROTAL TREATMENT).
  - FIGURE 8 SCROTAL RING.
    - THE BIG LOOP GOES AROUND THE SHAFT AND SCROTUM AT THE SAME TIME.
    - THE SMALL LOOP FLIPS UPWARDS TO ISOLATE THE SCROTUM ALONE.
  - TWO SCROTAL RINGS TECHNIQUE.
    - THE SILICONE SCROTAL RING (OR THE SMALLEST SCROTAL RING IN DIAMETER POSSIBLE), WILL BE PLACED AROUND THE SCROTAL SACK, ISOLATING THE SCROTUM.
    - THE NEXT SCROTAL RING (BIG RUBBER BANDS) IN SIZE WILL BE PLACED AROUND THE SHAFT AND SCROTUM.
- STEP 13 – INSPECT EVERYTHING TO MAKE SURE ALL IS IN ON PROPERLY, THEN SEND PHOTOS FOR EVALUATION.

3. BARRIER PROTOCOL

LOOPED RUBBER BAND BARRIER BREAK

REMOVE THE LOOPED RUBBER BAND AFTER ALL MASSAGING & SHAPING PROTOCOL HAVE BEEN COMPLETED.
REMOVE LOOPED RUBBER BAND FOR 15 MINUTES AND DO THIS EVERY 4-6 HOURS.

IF YOU HAD THE SCROTUM TREATED, YOU WILL NEED TO WEAR THE STRETCHY RINGS (TWO SCROTAL RINGS OR THE FIGURE 8 SCROTAL RING) FOR THE FIRST 7 DAYS ALSO. THE SCROTAL RINGS WILL BE WORN UNTIL DAY 21.
- FIGURE 8 SCROTAL RING
  - WILL BE PLACED WITH THE BIG LOOP AROUND THE SHAFT & SCROTUM AT THE SAME TIME, AND THE SMALL LOOP POSITIONED BEHIND THE SCROTAL SACK, WILL FLIP UPWARDS TO ISOLATE THE SCROTUM ALONE.
- TWO SCROTAL RINGS WILL BE PLACED IN TOTAL.
  - THE SILICONE SCROTAL RING (OR THE SMALLEST SCROTAL RING IN DIAMETER POSSIBLE), WILL BE PLACED AROUND THE SCROTAL SACK, ISOLATING THE SCROTUM. THE NEXT SCROTAL RING (BIG RUBBER BANDS) IN SIZE WILL BE PLACED AROUND THE SHAFT AND SCROTUM.

TRY TO ALTERNATE SHAFT POSITION, IF POSSIBLE, THROUGHOUT THE DAY, PLACING UPWARDS AND DOWNWARDS (NOT RIGHT OR LEFT).

4. MEDICATIONS & DIET PROTOCOL

PLEASE REFER TO YOUR MEDICATIONS & DIET PROTOCOL FOR ADDITIONAL INFORMATION
WHAT YOU WILL TAKE THIS EVENING.

CEPHALEXIN – TAKE TWO CAPSULES 2 X A DAY FOR 10 DAYS.
METRONIDAZOLE – TAKE TWO TABLETS 2 X A DAY FOR 5 DAYS.
PREDNISONE – TAKE TWO TABLETS 2 X A DAY FOR 3 DAYS.
PLACE TRIAMCINOLONE AND BACITRACIN OINTMENTS ON THE GLANS, THEN PLACE A VERY SMALL QUANTITY OF NITRO-BID (LIKE A GRAIN OF RICE) ON THE GLANS AND SPREAD OUT EVENLY. .

5. PAIN & DISCOMFORT PROTOCOL

FOR GENERAL PAIN & DISCOMFORT:

FOR MILD & MODERATE PAIN & DISCOMFORT

USE ICE PACKS FIRST FOR PAIN AND DISCOMFORT. ICE PACKS CAN BE PLACED 30-MINUTES ON AND THEN 30-MINUTES OFF UNTIL YOU HAVE RELIEF FROM THE DISCOMFORT.
ALEVE OR ADVIL. USE AS PRESCRIBED ON BOTTLE.

FOR SEVERE PAIN USE TYLENOL #4

FOR ADDITIONAL COMFORT, APPLY ADDITIONAL TRIAMCINOLONE AND LIDOCAINE OINTMENTS ON SENSITIVE SKIN AREAS 2 X A DAY.

6. WHAT NOT TO DO TODAY

DO NOT LEAVE YOUR BARRIERS OFF MORE THAN THE SPECIFIED BARRIER BREAK TIMES, WHICH ARE 15 MINUTES EVERY 4-6 HOURS WHILE AWAKE.
DO NOT START SHAFT MASSAGING OR SHAPING (THIS STARTS ON DAY-4)…EXCEPT FOR GLANS PUMPING.
DO NOT EXERCISE
DO NOT CONSUME/DRINK ALCOHOL

DAY-4 TO DAY-7

MORNING

1. TAKE PHOTOS

SEND PHOTOS WITH COMMENTS EACH MORNING AND SEND ON A DAILY BASIS TO THE GROUP MESSAGE, NO EXCEPTIONS. THIS IS CRITICAL FOR EVALUATION AND OPTIMAL RESULTS.
DURING WRAP CHANGE DAYS, TAKE PHOTOS IMMEDIATELY AFTER YOU PAT DRY POST SHOWER SO SKIN CAN BE EVALUATED, THEN TAKE PHOTOS AFTER THE COMPLETE WRAP IS ON, INCLUDING THE PENILE WRAP, AND RING & STRAPS, SO ALL CAN BE EVALUATED.

2. RE-WRAP PROTOCOL

RE-WRAP WILL BE PERFORMED EITHER ON THE EVENING OF DAY-3 OR THE MORNING OF DAY-4.
AFTER YOU HAVE COMPLETED THE DAY-3/4 WRAP, NO MORE RE-WRAPS ARE NEEDED UNTIL THE EVENING OF DAY-7 OR MORNING OF DAY-8. DO NOT REMOVE YOUR WRAP UNLESS DIRECTED TO DO SO.

3. MASSAGING & SHAPING PROTOCOL

STEP 1: GLANS PUMPING.
STEP 2: GLANS SHAPING (DO THIS IF YOU HAD THE GLANS TREATED).
STEP 3: FINGER PRESSURE BEHIND GLANS BULGE AREA.
STEP 4: PENILE SHAFT MASSAGING & SHAPING.
STEP 5: PENILE CURVE CORRECTION.
STEP 6: SCROTAL MASSAGE & SHAPING (IF YOU HAD A SCROTAL ENLARGEMENT TREATMENT).
STEP 7: BARRIER BREAK 15 MINUTES.
STEP 8: MASSAGE SKIN AREA UNDER LOOPED RUBBER BAND FOR 1-MINUTE.
STEP 9: PLACE THE BARRIER BACK ON.
STEP 10: ALTERNATE PENIS POSITION.

4. BARRIER PROTOCOL

LOOPED RUBBER BAND BARRIER BREAK

REMOVE THE LOOPED RUBBER BAND AFTER ALL MASSAGING & SHAPING PROTOCOL HAVE BEEN COMPLETED.
REMOVE LOOPED RUBBER BAND FOR 15 MINUTES AND DO THIS EVERY 4-6 HOURS.

IF YOU HAD THE SCROTUM TREATED, YOU WILL NEED TO WEAR THE STRETCHY RINGS (TWO SCROTAL RINGS OR THE FIGURE 8 SCROTAL RING) FOR THE FIRST 7 DAYS ALSO. THE SCROTAL RINGS WILL BE WORN UNTIL DAY 21.
- FIGURE 8 SCROTAL RING
  - WILL BE PLACED WITH THE BIG LOOP AROUND THE SHAFT & SCROTUM AT THE SAME TIME, AND THE SMALL LOOP POSITIONED BEHIND THE SCROTAL SACK, WILL FLIP UPWARDS TO ISOLATE THE SCROTUM ALONE.
- TWO SCROTAL RINGS WILL BE PLACED IN TOTAL.
  - THE SILICONE SCROTAL RING (OR THE SMALLEST SCROTAL RING IN DIAMETER POSSIBLE), WILL BE PLACED AROUND THE SCROTAL SACK, ISOLATING THE SCROTUM. THE NEXT SCROTAL RING (BIG RUBBER BANDS) IN SIZE WILL BE PLACED AROUND THE SHAFT AND SCROTUM.

TRY TO ALTERNATE SHAFT POSITION, IF POSSIBLE, THROUGHOUT THE DAY, PLACING UPWARDS AND DOWNWARDS (NOT RIGHT OR LEFT).

5. MEDICATIONS & DIET PROTOCOL

PLEASE REFER TO YOUR MEDICATIONS & DIET PROTOCOL FOR ADDITIONAL INFORMATION

WHAT YOU WILL TAKE/DO THIS MORNING

CEPHALEXIN – TAKE TWO CAPSULES 2 X A DAY FOR 10 DAYS.
METRONIDAZOLE – TAKE TWO TABLETS 2 X A DAY FOR 5 DAYS.
PLACE TRIAMCINOLONE AND BACITRACIN OINTMENTS ON THE GLANS.

WHAT YOU WILL NOT TAKE/DO THIS MORNING

NITRO-BID OINTMENT

6. PAIN & DISCOMFORT

FOR GENERAL PAIN & DISCOMFORT:

FOR MILD & MODERATE PAIN & DISCOMFORT

USE ICE PACKS FIRST FOR PAIN AND DISCOMFORT. ICE PACKS CAN BE PLACED 30-MINUTES ON AND THEN 30-MINUTES OFF UNTIL YOU HAVE RELIEF FROM THE DISCOMFORT.
ALEVE OR ADVIL. USE AS PRESCRIBED ON BOTTLE.

FOR SEVERE PAIN USE TYLENOL #4

FOR ADDITIONAL COMFORT, APPLY ADDITIONAL TRIAMCINOLONE AND LIDOCAINE OINTMENTS ON SENSITIVE SKIN AREAS 2 X A DAY.

7. WHAT NOT TO DO TODAY

DO NOT REMOVE THE WRAP
DO NOT LEAVE YOUR BARRIERS OFF MORE THAN THE SPECIFIED BARRIER BREAK TIMES, WHICH ARE 15 MINUTES EVERY 4-6 HOURS WHILE AWAKE.
DO NOT EXERCISE.
DO NOT CONSUME/DRINK ALCOHOL

DAY-4 TO DAY-7 AFTERNOON

1. MASSAGING & SHAPING PROTOCOL

STEP 1: GLANS PUMPING.
STEP 2: GLANS SHAPING (DO THIS IF YOU HAD THE GLANS TREATED).
STEP 3: FINGER PRESSURE BEHIND GLANS BULGE AREA.
STEP 4: PENILE SHAFT MASSAGING & SHAPING.
STEP 5: PENILE CURVE CORRECTION.
STEP 6: SCROTAL MASSAGE & SHAPING (IF YOU HAD A SCROTAL ENLARGEMENT TREATMENT).
STEP 7: BARRIER BREAK 15 MINUTES.
STEP 8: MASSAGE SKIN AREA UNDER LOOPED RUBBER BAND FOR 1-MINUTE.
STEP 9: PLACE THE BARRIER BACK ON.
STEP 10: ALTERNATE PENIS POSITION.

2. RE-WRAP PROTOCOL

RE-WRAP WAS ALREADY COMPLETED. THIS WAS PERFORMED EITHER ON THE EVENING OF DAY-3 OR THE MORNING OF DAY-4.

AFTER YOU HAVE COMPLETED THE DAY-3/4 WRAP, NO MORE RE-WRAPS ARE NEEDED UNTIL THE EVENING OF DAY-7 OR MORNING OF DAY-8. DO NOT REMOVE YOUR WRAP UNLESS DIRECTED TO DO SO.

3. BARRIER PROTOCOL

LOOPED RUBBER BAND BARRIER BREAK

REMOVE THE LOOPED RUBBER BAND AFTER ALL MASSAGING & SHAPING PROTOCOL HAVE BEEN COMPLETED.
REMOVE LOOPED RUBBER BAND FOR 15 MINUTES AND DO THIS EVERY 4-6 HOURS.

IF YOU HAD THE SCROTUM TREATED, YOU WILL NEED TO WEAR THE STRETCHY RINGS (TWO SCROTAL RINGS OR THE FIGURE 8 SCROTAL RING) FOR THE FIRST 7 DAYS ALSO. THE SCROTAL RINGS WILL BE WORN UNTIL DAY 21.
- FIGURE 8 SCROTAL RING
  - WILL BE PLACED WITH THE BIG LOOP AROUND THE SHAFT & SCROTUM AT THE SAME TIME, AND THE SMALL LOOP POSITIONED BEHIND THE SCROTAL SACK, WILL FLIP UPWARDS TO ISOLATE THE SCROTUM ALONE.
- TWO SCROTAL RINGS WILL BE PLACED IN TOTAL.
  - THE SILICONE SCROTAL RING (OR THE SMALLEST SCROTAL RING IN DIAMETER POSSIBLE), WILL BE PLACED AROUND THE SCROTAL SACK, ISOLATING THE SCROTUM. THE NEXT SCROTAL RING (BIG RUBBER BANDS) IN SIZE WILL BE PLACED AROUND THE SHAFT AND SCROTUM.

TRY TO ALTERNATE SHAFT POSITION, IF POSSIBLE, THROUGHOUT THE DAY, PLACING UPWARDS AND DOWNWARDS (NOT RIGHT OR LEFT).

4. PAIN & DISCOMFORT

FOR GENERAL PAIN & DISCOMFORT:

FOR MILD & MODERATE PAIN & DISCOMFORT
- USE ICE PACKS FIRST FOR PAIN AND DISCOMFORT. ICE PACKS CAN BE PLACED 30-MINUTES ON AND THEN 30-MINUTES OFF UNTIL YOU HAVE RELIEF FROM THE DISCOMFORT.
- ALEVE OR ADVIL. USE AS PRESCRIBED ON BOTTLE.

FOR SEVERE PAIN USE TYLENOL #4
- FOR ADDITIONAL COMFORT, APPLY ADDITIONAL TRIAMCINOLONE AND LIDOCAINE OINTMENTS ON SENSITIVE SKIN AREAS 2 X A DAY.

5. WHAT NOT TO DO THIS AFTERNOON

DO NOT LEAVE YOUR BARRIERS OFF MORE THAN THE SPECIFIED BARRIER BREAK TIMES, WHICH ARE 15 MINUTES EVERY 4-6 HOURS WHILE AWAKE.
DO NOT EXERCISE
DO NOT CONSUME/DRINK ALCOHOL

DAY-4 TO DAY-7 EVENING

RE-WRAP WILL BE PERFORMED EITHER ON THE EVENING OF DAY-7 OR THE MORNING OF DAY-8.

1. MASSAGING & SHAPING PROTOCOL

STEP 1: GLANS PUMPING.
STEP 2: GLANS SHAPING (DO THIS IF YOU HAD THE GLANS TREATED).
STEP 3: FINGER PRESSURE BEHIND GLANS BULGE AREA.
STEP 4: PENILE SHAFT MASSAGING & SHAPING.
STEP 5: PENILE CURVE CORRECTION.
STEP 6: SCROTAL MASSAGE & SHAPING (IF YOU HAD A SCROTAL ENLARGEMENT TREATMENT).
STEP 7: BARRIER BREAK 15 MINUTES.
STEP 8: MASSAGE SKIN AREA UNDER LOOPED RUBBER BAND FOR 1-MINUTE.
STEP 9: PLACE THE BARRIER BACK ON.
STEP 10: ALTERNATE PENIS POSITION.

2. RE-WRAP PROTOCOL

WHEN THE EVENING OF DAY-7 APPROACHES, YOUR NEXT RE-WRAP SHOULD BE DONE. EITHER IN THE EVENING OF DAY-7 OR MORNING OF DAY-8.
PREPARATION FOR RE-WRAP: YOU WILL PREPARE ALL OF YOUR WRAP MATERIALS FIRST.

STEP 1 – REMOVE YOUR WRAP (EXCEPT GLUED DOWN SPOT BAND-AID) DURING YOUR 10-15 MINUTE HOT SHOWER (EASIER TO REMOVE WHEN WET), THEN PAT DRY, THEN TAKE PHOTOS.
STEP 2 – INSPECT THE SPOT BAND-AID AREA: THERE IS NO NEED TO RE-SEAL THIS HOLE AREA. IF THIS IS STILL LEAKING TAKE PHOTOS OF IT AND SENT TO THE GROUP MESSAGING FOR EVALUATION.
STEP 3 – PLACE 2 TOE PADS ON THE UNDERSIDE OF THE SHAFT, JUST UNDER THE GLANS
STEP 4 – PLACE YOUR WINGED BAND-AIDS ON AT THE VERY BASE OF THE PENILE SHAFT OR WHERE IT’S NEEDED (SHAFT/PUBIC AREA, SHAFT/SCROTAL AREA, BEHIND THE SCROTAL SACK).
STEP 5 – PLACE A THIN COAT OF TRIAMCINOLONE 0.5% OINTMENT SPREADING OUT EVENLY THROUGHOUT ON THE SHAFT, GLANS, PUBIC, AND SCROTAL AREAS (ESPECIALLY WHERE THE STRETCHY RINGS AND THE PLASTIC RING PLACE PRESSURE ON THE PUBIC AND SCROTAL AREAS).
STEP 6 – PLACE BROWN STRETCH GAUZE WRAP ON ENTIRE SHAFT WITH MILD TENSION, STARTING FROM THE BASE, AS LOW AS POSSIBLE, AND OVERLAPPING 80-90% UNTIL YOU REACH THE GLANS (HEAD OF PENIS), COVERING THE TOE PAD BUT NOT ABOVE. PLACE PAPER TAPE TO SECURE
STEP 7 – PLACE HALF-FOLD ON THE UPPER SHAFT AREA JUST UNDER THE GLANS. THERE ARE TWO WAYS TO DO THIS:
- THE ‘SWOOP’ HALF-FOLD AS EXPLAINED BEFORE.
- THE SECOND METHOD: PLACE THE HALF-FOLD DIRECTLY UNDER THE GLANS, LEAVING NO VISIBLE SHAFT SKIN. GO AROUND TWO TIMES AND WITH MILD TENSION. IF YOU ARE UNCIRCUMCISED, OR YOU ARE DEVELOPING A SHAFT SKIN BULGE THAT IS HANGING OVER THE GLANS, THEN YOU NEED TO PLACE THE HALF-FOLD ON IN THIS FASHION, BUT WITH MODERATE (NOT MILD) TENSION.
STEP 8 – PLACE THE “COMFORT PAD” OVER THE PUBIC AREA AROUND THE BASE OF THE SHAFT
STEP 9 – PLACE STRETCHY RINGS DURING THE DAY AND PLASTIC RING & STRAPS DURING THE NIGHT (WITH HIGH TENSION). THIS ARE NOW THE PRIMARY PENILE SHAFT BARRIERS.
STEP 10 – PLACE YOUR STRETCHY RINGS ON- ALTERNATING WITH THE PLASTIC RING AND STRAPS.
- FIGURE 8 SCROTAL RING (DURING THE DAY).
  - THE BIG LOOP WILL GO AROUND THE SHAFT AND SCROTUM AT THE SAME TIME.
  - THE SMALL LOOP WIL BE UNDER THE SCROTAL SACK, THEN IT FLIPS UPWARDS TO ISOLATE THE SCROTUM ALONE.
- TWO SCROTAL RINGS TECHNIQUE (TWO SCROTAL RINGS WILL BE PLACED IN TOTAL).
  - THE SILICONE SCROTAL RING (OR THE SMALLEST SCROTAL RING IN DIAMETER POSSIBLE), WILL BE PLACED AROUND THE SCROTAL SACK, ISOLATING THE SCROTUM ALONE. THE NEXT SCROTAL RING (BIG RUBBER BANDS) IN SIZE
STEP 11 – INSPECT EVERYTHING TO MAKE SURE ALL IS ON PROPERLY, THEN SEND PHOTOS FOR EVALUATION.
PLEASE NOTE: THAT YOU WILL NO LONGER WEAR THE LOOPED RUBBER BAND AND TIGHT HALF-FOLD AT THE PENILE BASE FROM DAY-8 FORWARD.

3. BARRIER PROTOCOL

THE DAY 7/8 WRAP CHANGE WILL OCCUR, EITHER ON DAY-7 EVENING OR DAY-8 EARLY MORNING.
THE PRIMARY BARRIER WILL CHANGE FROM THE LOOPED RUBBER BAND & TIGHT HALF-FOLD (WHICH WILL BE TOTALLY REMOVED) TO THE PLASTIC RING & STRAPS WITH HIGH TENSION ALTERNATING WITH THE STRETCHY RINGS.
AFTER THE CHANGE HAS BEEN MADE, YOU WILL NOTICE THAT THE VERY BASE OF THE PENILE SHAFT WILL BE MORE NARROW OR THINNER THAN THE REST OF THE PENILE SHAFT. THIS NARROWING IS CAUSED BY THE LOOPED RUBBER BAND & TIGHT HALF-FOLD.
THE REASON WHY WE MUST BEGIN WITH A LOOPED RUBBER BAND & TIGHT HALF-FOLD BARRIER, INSTEAD OF THE PLASTIC RING & STRAPS FROM DAY-0 IS BECAUSE THE FILLER, WITH THE INFLAMMATION AND EDEMA, MAKES THE FLUID VERY WATERY (LOW VISCOSITY). THIS LOW VISCOSITY FLUID CANNOT BE HELD BACK WITH THE PLASTIC RING (NOT GOOD TO HOLD BACK LOW VISCOSITY FLUIDS). HOWEVER, THE LOOPED RUBBER BAND AND TIGHT HALF-FOLD WILL DO THE JOB. BY DAY 7/8, WHEN THE EDEMA IS LESS AND THE FLUID UNDER THE SKIN BECOME THICKER (HIGHER VISCOSITY) THE PLASTIC RING CAN NOW BE AN EFFECTIVE BARRIER. SO, WHEN YOU TRANSITION TO THE PLASTIC RING FROM THE LOOPED RUBBER BAND & TIGHT HALF-FOLD, THE NARROW PENILE BASE NEEDS TO BE CORRECTED BY PUSHING FILLER DOWN TO THIS AREA.

STRETCHY RINGS (DAY TIME)
- THOSE WHO HAVE HAD A SCROTAL TREATMENT WILL NOW PLACE THE PLASTIC RING & STRAPS ON, AND CONTINUE WEARING THE SCROTAL RING. THE SILICONE SCROTAL RING WILL NOW BE PLACED DIRECTLY AROUND THE SCROTUM.
- PLEASE KEEP IN MIND THAT THE STRETCHY RINGS MAY LEAVE AN INDENTATION IN THE SKIN AT THE PENILE BASE AREA.
- FIGURE 8 SCROTAL RING. THE BIG LOOP WILL GO AROUND THE SHAFT AND SCROTUM AT THE SAME TIME, AND THE SMALL LOOP WIL FLIPS UPWARDS TO ISOLATE THE SCROTUM ALONE.
- TWO SCROTAL RINGS TECHNIQUE. WITH THIS ALTERNATIVE YOU WILL PLACE THE SILICONE RUBBER SCROTAL RING AROUND THE SCROTAL AREA ALONE, ISOLATING THE SCROTUM, AND THE OTHER SCROTAL RING (ONE OF THE BIG RUBBER BAND OR ANOTHER SILICONE RUBBER SCROTAL RING) WILL BE PLACED AROUND BOTH THE PENILE SHAFT AND SCROTUM.

PLASTIC RING & STRAPS (NIGHT TIME)
- KEEP ON WITH MILD TENSION: BARRIER BREAKS ARE MANDATORY AND NECESSARY.
- NOTE: PAD UNDER THE PLASTIC RING WITH GAUZE/COTTON BALLS & PLACE TRIAMCINOLONE OINTMENT ON AS WELL TO HELP PREVENT SKIN SORES.

TRY TO ALTERNATE SHAFT POSITION, IF POSSIBLE, THROUGHOUT THE DAY, PLACING UPWARDS AND DOWNWARDS (NOT RIGHT OR LEFT).

4. MEDICATIONS & DIET PROTOCOL

PLEASE REFER TO YOUR MEDICATIONS & DIET PROTOCOL FOR ADDITIONAL INFORMATION.

WHAT YOU WILL TAKE THIS EVENING

CEPHALEXIN – TAKE TWO CAPSULES 2 X A DAY FOR 10 DAYS.
METRONIDAZOLE – TAKE TWO TABLETS 2 X A DAY FOR 5 DAYS.
PLACE TRIAMCINOLONE AND BACITRACIN OINTMENTS ON THE GLANS, THEN PLACE A VERY SMALL QUANTITY OF NITRO-BID (LIKE A GRAIN OF RICE) ON THE GLANS AND SPREAD OUT EVENLY.
TAKE A TYLENOL #4 PAIN MEDICATION TO HELP WITH NIGHTTIME ERECTIONS.

5. PAIN & DISCOMFORT

FOR GENERAL PAIN & DISCOMFORT:

FOR MILD & MODERATE PAIN & DISCOMFORT

USE ICE PACKS FIRST FOR PAIN AND DISCOMFORT. ICE PACKS CAN BE PLACED 30-MINUTES ON AND THEN 30-MINUTES OFF UNTIL YOU HAVE RELIEF FROM THE DISCOMFORT.
ALEVE OR ADVIL. USE AS PRESCRIBED ON BOTTLE.

FOR SEVERE PAIN USE TYLENOL #4

FOR ADDITIONAL COMFORT, APPLY ADDITIONAL TRIAMCINOLONE AND LIDOCAINE OINTMENTS ON SENSITIVE SKIN AREAS 2 X A DAY.

6. WHAT NOT TO DO THIS EVENING

DO NOT LEAVE YOUR BARRIERS OFF MORE THAN THE SPECIFIED BARRIER BREAK TIMES, WHICH ARE 15 MINUTES EVERY 4-6 HOURS WHILE AWAKE.
DO NOT EXERCISE.
DO NOT CONSUME/DRINK ALCOHOL.

DAY-8 TO DAY-21

MORNING

START YOUR PREDNISONE REFILL TODAY (DAY 8).

1. TAKE PHOTOS

SEND PHOTOS WITH COMMENTS EACH MORNING AND SEND ON A DAILY BASIS TO THE GROUP MESSAGE, NO EXCEPTIONS. THIS IS CRITICAL FOR EVALUATION AND OPTIMAL RESULTS.
DURING WRAP CHANGE DAYS, TAKE PHOTOS IMMEDIATELY AFTER YOU PAT DRY POST SHOWER SO SKIN CAN BE EVALUATED, THEN TAKE PHOTOS AFTER THE COMPLETE WRAP IS ON, INCLUDING THE PENILE WRAP, AND RING & STRAPS, SO ALL CAN BE EVALUATED.

2. IF A SKIN SORE OR CUT DEVELOPED (LOOK AT ALL OF THE SKIN CAREFULLY)

DURING YOUR RE-WRAP TODAY, AND WHILE THE WRAP IS OFF, OBSERVE FOR ANY SKIN SORES OR SKIN CUTS. IF YOU SEE A SKIN SORE OR SKIN CUT TAKE ADDITIONAL PHOTOS OF THIS. THEN, DURING YOUR SHOWER AND WRAP CHANGE, WASH ALL WITH SOAP AND WATER, THEN PAT DRY WITH A CLEAN TOWEL, AND THEN PLACE BACITRACIN OINTMENT ON THE SKIN SORE. THEN PLACE A SMALL BAND-AID ON. THEN CONTINUE PLACING YOUR WRAP, AS WELL AS THE CORRESPONDING BARRIERS ON, AND THEN SEND PHOTOS OF THE COMPLETED WRAP.
THE CLEANING OF THE SKIN SORE OR SKIN CUT WILL NEED TO BE DONE EVERY 1-2 DAYS. THIS MEANS THAT THE ENTIRE WRAP WILL NEED TO BE CHANGED AS WELL.

3. MASSAGING & SHAPING PROTOCOL

STEP 1: GLANS PUMPING.
STEP 2: GLANS SHAPING (DO THIS IF YOU HAD THE GLANS TREATED).
STEP 3: FINGER PRESSURE BEHIND GLANS BULGE AREA.
STEP 4: FINGER ROLLING FILLER DOWN TO PENILE BASE AREA.
STEP 5: PENILE SHAFT MASSAGING & SHAPING.
STEP 6: PENILE CURVE CORRECTION.
STEP 7: SCROTAL MASSAGE & SHAPING (IF YOU HAD A SCROTAL ENLARGEMENT TREATMENT).
STEP 8: BARRIER BREAK 15 MINUTES.
STEP 9: PLACE THE BARRIER BACK ON.
STEP 10: ALTERNATE PENIS POSITION

4. RE-WRAP PROTOCOL

RE-WRAP WILL BE PERFORMED EITHER ON THE EVENING OF DAY-7 OR THE MORNING OF DAY-8.
AFTER YOU HAVE COMPLETED THE DAY-7/8 WRAP, RE-WRAPS WILL BE PERFORMED EVERY 2-3 DAYS UNLESS DIRECTED OTHERWISE UNTIL DAY-21.
IF THERE IS A SKIN SORE OR ULCER, YOU WILL NEED TO CHANGE THE WRAP EVERY 1-2 DAYS. THIS EXTRA CLEANING OF THE SKIN WILL HELP THE SKIN ULCER HEAL.
PLEASE NOTE: THAT YOUR LOOPED RUBBER BAND AND TIGHT HALF-FOLD ARE NO LONGER USED AT THE PENILE BASE. NOW THE PLASTIC RING & STRAPS DURING THE NIGHT, WITH THE STRETCHY RINGS DURING THE DAY WILL BE YOUR PRIMARY PENILE SHAFT BARRIER UNTIL DAY-21.

5. BARRIER PROTOCOL

STRETCHY RINGS STAYS ON
- FIGURE 8 SCROTAL RING
  - WILL BE PLACED AROUND THE SHAFT AND SCROTUM AT THE SAME TIME, AND THEN THE SMALL LOOP FLIPS UPWARD TO ISOLATE THE SCROTUM ALONE.
- TWO SCROTAL RINGS WILL BE PLACED IN TOTAL.
  - THE SILICONE SCROTAL RING (OR THE SMALLEST SCROTAL RING IN DIAMETER POSSIBLE), WILL BE PLACED AROUND THE SCROTAL SACK, ISOLATING THE SCROTUM.
  - THE NEXT SCROTAL RING (BIG RUBBER BANDS) IN SIZE WILL BE PLACED AROUND THE SHAFT AND SCROTUM.

6. MEDICATIONS & DIET PROTOCOL

PLEASE REFER TO YOUR MEDICATIONS & DIET PROTOCOL FOR ADDITIONAL INFORMATION

WHAT YOU WILL TAKE THIS MORNING

START PREDNISONE REFILL (2 TABLETS 2 TIMES A DAY FOR 3 DAYS)
CEPHALEXIN TAKE 2 TABLETS 2 TIMES A DAY UNTIL DAY 10.

WHAT YOU WILL NOT TAKE THIS MORNING

NITRO-BID OINTMENT

7. PAIN & DISCOMFORT

FOR GENERAL PAIN & DISCOMFORT:

FOR MILD & MODERATE PAIN & DISCOMFORT

USE ICE PACKS FIRST FOR PAIN AND DISCOMFORT. ICE PACKS CAN BE PLACED 30-MINUTES ON AND THEN 30-MINUTES OFF UNTIL YOU HAVE RELIEF FROM THE DISCOMFORT.
ALEVE OR ADVIL. USE AS PRESCRIBED ON BOTTLE.

FOR SEVERE PAIN USE TYLENOL #4

FOR ADDITIONAL COMFORT, APPLY ADDITIONAL TRIAMCINOLONE AND LIDOCAINE OINTMENTS ON SENSITIVE SKIN AREAS 2 X A DAY.

8. YOU MAY BEGIN EXERCISING, UPPER BODY AT 50% INTENSITY. STILL NO DEEP SQUAT OR ABDOMINAL CRUNCH MOTIONS UNTIL DAY 28.

9. WHAT NOT TO DO TODAY

DO NOT REMOVE THE WRAP.
DO NOT LEAVE YOUR BARRIERS OFF MORE THAN THE SPECIFIED BARRIER BREAK TIMES, WHICH ARE 15 MINUTES EVERY 4-6 HOURS WHILE AWAKE.
DO NOT CONSUME/DRINK ALCOHOL.

DAY-8 TO DAY-21 AFTERNOON

1. MASSAGING & SHAPING PROTOCOL

STEP 1: GLANS PUMPING.
STEP 2: GLANS SHAPING (DO THIS IF YOU HAD THE GLANS TREATED).
STEP 3: FINGER PRESSURE BEHIND GLANS BULGE AREA.
STEP 4: FINGER ROLLING FILLER DOWN TO PENILE BASE AREA.
STEP 5: PENILE SHAFT MASSAGING & SHAPING.
STEP 6: PENILE CURVE CORRECTION.
STEP 7: SCROTAL MASSAGE & SHAPING (IF YOU HAD A SCROTAL ENLARGEMENT TREATMENT).
STEP 8: BARRIER BREAK 15 MINUTES.
STEP 9: PLACE THE BARRIER BACK ON.
STEP 10: ALTERNATE PENIS POSITION.

2. RE-WRAP PROTOCOL

DAY 7/8 RE-WRAP PROTOCOL TO BE FOLLOWED EVERY 2-3 DAYS UNLESS INSTRUCTED OTHERWISE.

3. BARRIER PROTOCOL

STRETCHY RINGS STAYS ON
- FIGURE 8 SCROTAL RING
  - WILL BE PLACED DURING THE DAY, THE BIG LOOP IS PLACED AROUND THE SHAFT AND SCROTUM AT THE SAME TIME, AND THEN THE SMALL LOOP FLIPS UPWARD TO ISOLATE THE SCROTUM.

TWO SCROTAL RINGS.
- THE SILICONE SCROTAL RING (OR THE SMALLEST SCROTAL RING IN DIAMETER POSSIBLE), WILL BE PLACED AROUND THE SCROTAL SACK, ISOLATING THE SCROTUM.
- THE NEXT SCROTAL RING (BIG RUBBER BANDS) IN SIZE WILL BE PLACED AROUND THE SHAFT AND SCROTUM.

4. MEDICATIONS & DIET PROTOCOL

PLEASE REFER TO YOUR MEDICATIONS & DIET PROTOCOL FOR ADDITIONAL INFORMATION

WHAT YOU WILL NOT TAKE THIS AFTERNOON

NITRO-BID OINTMENT

5. PAIN & DISCOMFORT

FOR GENERAL PAIN & DISCOMFORT:

FOR MILD & MODERATE PAIN & DISCOMFORT

USE ICE PACKS FIRST FOR PAIN AND DISCOMFORT. ICE PACKS CAN BE PLACED 30-MINUTES ON AND THEN 30-MINUTES OFF UNTIL YOU HAVE RELIEF FROM THE DISCOMFORT.

ALEVE OR ADVIL. USE AS PRESCRIBED ON BOTTLE.

FOR SEVERE PAIN USE TYLENOL #4

FOR ADDITIONAL COMFORT, APPLY ADDITIONAL TRIAMCINOLONE AND LIDOCAINE OINTMENTS ON SENSITIVE SKIN AREAS 2 X A DAY.

6. WHAT NOT TO DO THIS AFTERNOON

DO NOT LEAVE YOUR BARRIERS OFF MORE THAN THE SPECIFIED BARRIER BREAK TIMES, WHICH ARE 15 MINUTES EVERY 4-6 HOURS WHILE AWAKE.
DO NOT CONSUME/DRINK ALCOHOL

DAY-8 TO DAY-21 EVENING

1. MASSAGING & SHAPING PROTOCOL

STEP 1: GLANS PUMPING.
STEP 2: GLANS SHAPING (DO THIS IF YOU HAD THE GLANS TREATED).
STEP 3: FINGER PRESSURE BEHIND GLANS BULGE AREA.
STEP 4: FINGER ROLLING FILLER DOWN TO PENILE BASE AREA.
STEP 5: PENILE SHAFT MASSAGING & SHAPING.
STEP 6: PENILE CURVE CORRECTION.
STEP 7: SCROTAL MASSAGE & SHAPING (IF YOU HAD A SCROTAL ENLARGEMENT TREATMENT).
STEP 8: BARRIER BREAK 15 MINUTES.
STEP 9: PLACE THE BARRIER BACK ON.
STEP 10: ALTERNATE PENIS POSITION.

2. RE-WRAP PROTOCOL

DAY 7/8 RE-WRAP PROTOCOL TO BE FOLLOWED EVERY 2-3 DAYS UNLESS INSTRUCTED OTHERWISE.

3. BARRIER PROTOCOL

PLASTIC RING & STRAPS (NIGHT TIME)

KEEP ON WITH MODERATE TO HIGH TENSION.
NOTE: WHEN THE WRAP IS CHANGED TODAY, YOU WILL PLACE THE PLASTIC RING & STRAPS ON WITH MODERATE TO HIGH TENSION AND NO LONGER USE THE LOOPED RUBBER BAND AND TIGHT HALF FOLD. THE PLASTIC RING & STRAPS WILL NOW BECOME YOUR PRIMARY BARRIER.
NOTE: PAD UNDER THE PLASTIC RING WITH GAUZE/COTTON BALLS & PLACE TRIAMCINOLONE OINTMENT ON AS WELL TO HELP PREVENT SKIN SORES.

4. MEDICATIONS & DIET PROTOCOL

PLEASE REFER TO YOUR MEDICATIONS & DIET PROTOCOL FOR ADDITIONAL INFORMATION

WHAT YOU WILL TAKE THIS EVENING

CEPHALEXIN – TAKE TWO CAPSULES 2 X A DAY UNTIL DAY 10.
PLACE TRIAMCINOLONE AND BACITRACIN OINTMENTS ON THE GLANS, THEN PLACE A VERY SMALL QUANTITY OF NITRO-BID (LIKE A GRAIN OF RICE) ON THE GLANS AND SPREAD OUT EVENLY.
TAKE A TYLENOL #4 PAIN MEDICATION TO HELP WITH NIGHT-TIME ERECTIONS.

5. PAIN & DISCOMFORT

FOR GENERAL PAIN & DISCOMFORT:

FOR MILD & MODERATE PAIN & DISCOMFORT

USE ICE PACKS FIRST FOR PAIN AND DISCOMFORT. ICE PACKS CAN BE PLACED 30-MINUTES ON AND THEN 30-MINUTES OFF UNTIL YOU HAVE RELIEF FROM THE DISCOMFORT.
ALEVE OR ADVIL. USE AS PRESCRIBED ON BOTTLE.

FOR SEVERE PAIN USE TYLENOL #4

FOR ADDITIONAL COMFORT, APPLY ADDITIONAL TRIAMCINOLONE OINTMENT ON SENSITIVE SKIN AREAS 2 X A DAY.
FOR ADDITIONAL COMFORT, APPLY LIDOCAINE CREAM EVERY 3-4 HOURS IF YOU ARE EXPERIENCING PAIN.

6. WHAT NOT TO DO THIS EVENING

DO NOT LEAVE YOUR BARRIERS OFF MORE THAN THE SPECIFIED BARRIER BREAK TIMES, WHICH ARE 15 MINUTES EVERY 4-6 HOURS WHILE AWAKE.
DO NOT CONSUME/DRINK ALCOHOL
AFTER CHANGING YOUR WRAP

YOU ARE NOT TO PLACE THE TIGHT HALF-FOLD AND LOOPED RUBBER BAND AT BASE
NO MORE BLUE PRE-WRAP AND ADDITIONAL BROWN STRETCH GAUZE IS PLACED ON THE PENILE SHAFT.

DO NOT REFILL YOUR MEDICATION (EXCEPT YOUR TOPICAL OINTMENTS AND CREAMS) UNLESS INSTRUCTED TO DO SO.

DAY-22-90 RETAINER WRAP

WHAT YOU ARE TO-DO TODAY:

1. PHOTOS AND COMMENTS

PHOTOS ARE TO BE DONE WEEKLY (NOT DAILY) AND SENT TO THE GROUP MESSAGE.
THIS IS CRITICAL FOR EVALUATION AND OPTIMAL RESULTS.
YOU WILL ALSO CONTINUE TO TAKE PHOTO MEASUREMENTS OF THE PENILE SHAFT GIRTH OR THICKNESS WITH THE PAPER-TAPE MEASURE PROVIDED TO YOU IN YOUR BLUE TO-GO BAG. SEND PHOTOS WITH AND WITHOUT THE TAPE MEASURE ON, IN THE FLACCID (SOFT) AND ERECT STATES, WEEKLY, SO WE CAN QUANTIFY YOUR RESULTS.

2. MASSAGING & SHAPING PROTOCOL

STEP 1: FINGER PRESSURE BEHIND GLANS BULGE AREA.
STEP 2: FINGER ROLLING FILLER DOWN TO PENILE BASE AREA.
STEP 3: PENILE SHAFT SHAPING.
STEP 4: PENILE CURVE CORRECTION.
STEP 5: SCROTAL SHAPING (IF YOU HAD A SCROTAL ENLARGEMENT TREATMENT).
NO MORE BARRIERS ARE ON AT THIS TIME
NO MORE ALTERNATION OF THE PENILE SHAFT POSITION IS NEEDED

3. RETAINER WRAP PROTOCOL: FROM DAY 22 TO DAY-90

THIS IS A SIMPLE LOW TENSION BROWN STRETCH GAUZE WRAP OF THE PENILE SHAFT TO BE WORN 12-18 HOURS A DAY
IF THE BROWN STRETCH GAUZE IRRITATES THE SKIN, PLACE EITHER BACITRACIN OINTMENT ON OR WHITE GAUZE OR BLUE PRE-WRAP ON FIRST FOR COMFORT.
THE PURPOSE OF THIS WRAP IS TO HELP MAINTAIN SHAPE, AND PREVENT ANY UNCONVERTED FILLER FROM SHIFTING AND CAUSING ANY ASYMMETRIC AREAS (BUMPS AND LUMPS) UNTIL DAY 90.

4. BARRIER PROTOCOL

THERE ARE NO MORE BARRIERS TO BE PLACED ON.

5. MEDICATIONS & DIET PROTOCOL

IF THERE IS A SKIN SORE OR ULCER THAT IS STILL HEALING, CONTINUE STRICT PROTOCOL WITH WASHING AT LEAST ONCE DAILY WITH SOAP AND WATER, THEN PAT DRY, THEN PLACE BACITRACIN OINTMENT ON, THEN A BAND-AID. FOLLOW THIS PROTOCOL UNTIL ALL HAS HEALED.
THERE IS NOT NEED TO REFILL MEDICATION UNLESS DIRECTED TO DO SO.

6. PAIN & DISCOMFORT

THERE SHOULD BE NO DISCOMFORT AT THIS TIME UNLESS THERE IS A SKIN SORE.

7. WHAT YOU ARE NOT TO DO TODAY:

YOU ARE NOT TO WEAR THE RING & STRAPS NOR THE SCROTAL RING ANY LONGER

YOU MAY CONSUME ALCOHOLIC BEVERAGES AND RESUME FULL EXERCISE ACTIVITIES.

MISCELLANEOUS INFORMATION / REVIEW

THIS PATIENT TO DO LIST APPLIES TO ALL PATIENTS WHO HAVE HAD A PENILE SHAFT FILLER TREATMENT. IF YOU HAD ONLY A SCROTAL TREATMENT, ONLY A GLANS TREATMENT, OR ONLY A CIRCUMCISION TREATMENT, MOST OF THIS INFORMATION DOES NOT APPLY. PLEASE READ THE SEPARATE SHEET PAPERWORK FOR SCROTAL, GLANS, AND CIRCUMCISION TREATMENTS.

THIS FORM, AND ADDITIONAL PAPERWORK (AND VIDEOS IF AVAILABLE), WILL PROVIDE GENERAL INFORMATION ON WHAT YOU NEED TO DO ON A DAILY BASIS AFTER YOUR PROCEDURE.

PLEASE REVIEW ANY ADDITIONAL VIDEOS AVAILABLE ON THE www.loriamedical.com WEBSITE, AND IN ADDITION, WRITTEN DETAILED INFORMATION ON CERTAIN SUBJECTS THAT ARE TOUCHED UPON IN THIS PATIENT DAILY TO-DO LIST PAPERWORK (AND VIDEO), SUCH AS MEDICATIONS & DIET PROTOCOL, FREQUENTLY ASKED QUESTIONS, HAVE BEEN PROVIDED.

WHILE YOU ARE AT THE LOCAL PHARMACY IN YOUR CITY, REVIEW YOU PHARMACY SHOPPING LIST SO YOU CAN PICK UP ALL OF YOUR PRESCRIPTION AND NON-PRESCRIPTION ITEM.

KEEP IN MIND THAT YOU WILL BE PROVIDED WITH REFILLS ON ALL OF YOUR MEDICATIONS & DIET PROTOCOL (EXCEPT THE NARCOTIC PAIN MEDICATION), BUT DO NOT REFILL THESE MEDS UNLESS INSTRUCTED TO DO SO.

IN CASE YOU ARE UNABLE TO PICK UP NITRO-BID & TYLENOL #4, THEN YOU WILL NEED TO CALL YOUR LOCAL PHARMACY AND HAVE THEM ORDER THE NITRO-BID AND TYLENOL #4. IT USUALLY TAKES 2-3 DAYS TO ARRIVE. IF YOU DO NOT HAVE YOUR TYLENOL #4, AND IF PAIN OR DISCOMFORT WERE TO OCCUR, YOUR FIRST LINE OF PAIN TREATMENT STARTS WITH SIMPLE ICE PACKS, AND YOU CAN TAKE ALEVE OR MOTRIN IF NEEDED, AND IF ADDITIONAL SOOTHING IS NEEDED, ADD LIDOCAINE CREAM AND TRIAMCINOLONE OINTMENT ON THE TENDER SKIN AREAS. THEN EVENTUALLY, AS YOUR LAST OPTION, USE THE TYLENOL #4 IF NOTHING ELSE WORKS, WHEN IT BECOMES AVAILABLE FROM THE PHARMACY.

STARTING IMMEDIATELY, YOU WILL TAKE BARRIER BREAKS (LOOPED RUBBER BAND AND STRETCHY RING BREAKS IF IT APPLIES) EVERY 4-6 HOURS FOR 15 MINUTES ONLY AND WHILE AWAKE. ON DAY–7 YOU WILL NO LONGER BE USING THE LOOPED RUBBER BAND, YOU WILL BE USING THE STRETCHY RINGS DURING THE DAY AND PLASTIC RING & STRAPS (ON HIGH TENSION) DURING THE NIGHT AS YOUR PRIMARY PENILE SHAFT BARRIERS. BARRIER BREAKS STILL APPLY. THE PURPOSE OF THIS IS TO PROVIDE RELIEF TO THE SKIN UNDER THE LOOPED RUBBER BAND, AND TO PREVENT SKIN SORES OR ULCERS.

ALSO, STARTING IMMEDIATELY, YOU WILL PERFORM GLANS PUMPING, BUT NEVER DURING YOUR 15 MINUTE BARRIER BREAKS. THIS EXERCISE IS FOR THOSE WHO HAVE HAD A PENILE SHAFT FILLER TREATMENT. THE PURPOSE IS TO INCREASE CIRCULATION TO ASSIST IN HEALING. GLANS PUMPING SIMPLY INVOLVES SQUEEZING THE GLANS AND HOLDING IT WHILE SQUEEZING FOR 15 SECONDS, THEN RELEASE AND ALLOW THE BLOOD TO REFILL THE GLANS FOR A 15 SECOND PERIOD, THEN REPEAT THE PROCESS, DO THIS 5-10 TIMES A SESSION. PERFORM THIS EXERCISE PERIODICALLY THROUGHOUT THE DAY.

PLASTIC RING AND STRAPS ARE TO BE WORN, FROM DAY-7 TO DAY-21 ONLY AT NIGHT-TIME. FROM DAY-0 TO DAY-7 THE PLASTIC RING WILL NOT BE WORN UNLESS INSTRUCTED OTHERWISE. ON DAY-7 TO DAY 21 YOU WILL WEAR THE PLASTIC RING WITH MODERATE TO HIGH TENSION. THE RING HELPS PUSH THE PUBIC FAT PAD AWAY FROM THE PENILE BASE ALLOWING LESS STRESS ON THIS AREA. DO NOT AT ANY TIME PLACE THE RING DIRECTLY ON (TOUCHING) THE SKIN, OTHERWISE YOUR SKIN WILL BECOME VERY IRRITATED OVER TIME. ALWAYS PLACE TRIAMCINOLONE OINTMENT ON THE PUBIC AND SCROTAL SKIN BEFORE PADDING THE AREA. ADD APPROPRIATE PADDING UNDER THE RING IF NEEDED, SUCH AS GAUZE OR COTTON, AND THEN PLACE YOUR UNDERWEAR ON, THEN YOUR RING AND STRAPS. PLEASE NOTE THAT THE UNDERWEAR, WHEN PLACED ON BEFORE THE PLASTIC RING & STRAPS, WILL HELP PREVENT IRRITATION FROM THE STRAPS RUBBING ON THE LEGS.

PLASTIC RING: THIS IS TO BE WORN FROM DAY 7 TO DAY-21 ONLY AT NIGHT-TIME. UNLESS INSTRUCTED TO START EARLIER. THIS IS A VERY IMPORTANT BARRIER. YOU ARE TO TAKE 10-15 MINUTE BREAKS WITH THIS RING AS WELL. SO, WHEN YOU TAKE A BARRIER BREAK, YOU CAN SIMPLY LOOSEN THE STRAPS ON THE PLASTIC RING AND THIS WILL RELIEVE THE PRESSURE FOR YOU BREAK TIME.

PLASTIC RING INTERNAL DIAMETER: THE PLASTIC RING SHOULD FIT ‘SNUG’ (OR LIGHTLY TOUCHING THE PENILE SHAFT) ON THE PENILE SHAFT BASE. IF THE INTERNAL DIAMETER (OR HOLE) OF THE PLASTIC RING IS TOO LARGE THEN ADJUST. PLACE BROWN STRETCH GAUZE AROUND THE RING TO SHRINK DOWN THE HOLE SIZE. WRAP THE GAUZE AROUND THE RING PORTION UNTIL THE DESIRED SIZE IS REACHED. THE IDEA IS TO REDUCE THE INTERNAL DIAMETER OF THE PLASTIC RING SO IT FITS SNUG ON THE BASE OF THE PENILE SHAFT.

STRETCHY RINGS: THIS ARE ONLY TO BE USED DURING DAYS 7-21 IN THE DAY TIME. UNLESS INSTRUCTED OTHERWISE, YOU MAY BE ADVISED TO WEAR IT FROM DAY 0-21. ONE OR TWO SCROTAL RINGS WILL BE PLACED IN TOTAL.

FIGURE 8 SCROTAL RING
- WILL BE PLACED DURING THE DAY, THE BIG LOOP IS PLACED AROUND THE SHAFT AND SCROTUM AT THE SAME TIME, AND THEN THE SMALL LOOP FLIPS UPWARD TO ISOLATE THE SCROTUM.

TWO SCROTAL RINGS.
- THE SILICONE SCROTAL RING (OR THE SMALLEST SCROTAL RING IN DIAMETER POSSIBLE), WILL BE PLACED AROUND THE SCROTAL SACK, ISOLATING THE SCROTUM.
- THE NEXT SCROTAL RING (BIG RUBBER BANDS) IN SIZE WILL BE PLACED AROUND THE SHAFT AND SCROTUM.

DAILY SELF EVALUATION OF PUBIC, GROIN, AND SCROTAL AREAS. LOOK FOR SIGNS OF FILLER MATERIAL MIGRATION SUCH AS SWELLING OR PUFFINESS IN THESE AREAS. SOME FILLER IS EXPECTED TO MIGRATE INTO THE PUBIC & SCROTAL AREAS AND CAUSE MILD TO MODERATE DISCOMFORT, HOWEVER, IF SWELLING IS OBSERVED, TIGHTEN THE HALF-FOLD (OR PLASTIC AND SCROTAL RINGS) JUST A SMALL AMOUNT. SEND PHOTOS OF THE SWOLLEN AREAS AND NOTIFY THE LORIA MEDICAL STAFF VIA GROUP TEXT MESSAGING.

TAKE YOUR PAIN MEDICATION WHEN YOU HAVE PAIN. PAIN MEDICATION IS SAFE TO TAKE WHEN TAKEN AS DIRECTED, BUT CAN BE DANGEROUS IF NOT TAKEN AS DIRECTED. DO NOT DRIVE WHILE TAKING YOUR PAIN MEDICATION. PLEASE USE YOUR PAIN MEDICATIONS & DIET PROTOCOL WHEN NEEDED. THEY ARE GIVEN TO PROVIDE COMFORT AND ALLOW YOU TO WEAR THE WRAP, PLASTIC RING, AND STRETCHY RING AS INSTRUCTED.

SKIN DISCOMFORT: YOU CAN MIX BOTH LIDOCAINE & TRIAMCINOLONE OINTMENT TOGETHER AND PLACE ON ANY AREAS OF DISCOMFORT OR SORENESS (EX: GLANS, PUBIC REGION, SCROTAL AREA, AND PENILE BASE). TRIAMCINOLONE IS NOT TO BE PLACED ON OPEN CUTS, JUST INTACT SKIN.

IF YOU HAD THE GLANS TREATED, IT IS POSSIBLE TO EXPERIENCE SOME BURNING PAIN IMMEDIATELY AFTER THE TREATMENT AND THIS PAIN MAY LAST A FEW HOURS. MOST PATIENTS GET SOME LEVEL OF PAIN, FROM MILD TO HIGH, SO BE PREPARED. THE BEST WAY TO TREAT THIS TYPE OF DISCOMFORT IS TO PLACE ICE ON. USE YOUR BAGGIE, SUPPLIED IN YOUR BLUE TO-GO BAG. FILL THE PLASTIC BAGGIE WITH WATER AND ICE, THEN PLACE ON AREA. THE PAIN WILL SUBSIDE IN 2-3 HOURS. IF ICE IS NOT AVAILABLE USE THE TYLENOL #4, OR ALEVE/ADVIL, WHICHEVER IS AVAILABLE. ALSO, LIDOCAINE CREAM & TRIAMCINOLONE OINTMENT WILL HELP SOME, SO PLACE THIS ON THE GLANS LIBERALLY.

IT IS MANDATORY TO TAKE DAILY PHOTOS, EVERY MORNING, AND SEND TO THE GROUP MESSAGE FOR EVALUATION. REMEMBER TO ADD COMMENTS ON HOW YOU ARE FEELING, EVEN IF IT IS ‘ALL FEELS FINE’. WHEN TAKING PHOTOS, YOU ARE TO TAKE PHOTOS AFTER YOU REMOVE THE WRAP (ON RE-WRAP DAYS), SO PHOTOS OF THE SKIN CAN BE TAKEN AND EVALUATED AS WELL. AS AN OPTION ONLY, USE THIS EMAIL ADDRESS IF TEXTING IS NOT AVAILABLE: info@loriamedical.com.

IN CASE OF AN EMERGENCY CALL AND TEXT THE LORIA MEDICAL STAFF OR ONE OF THE MEDICAL ASSISTANTS LISTED ABOVE. IF CONTACT IS NOT MADE IN A REASONABLE TIME, REMOVE YOUR WRAP, TAKE A HOT SHOWER, AND FOLLOW YOUR RE-WRAP PROTOCOL. IF THIS DOES NOT RELIEVE THE PROBLEM THEN GO TO THE EMERGENCY ROOM IMMEDIATELY.

IT IS REQUIRED TO REVIEW THE VIDEOS ON THE LORIA MEDICAL WEBSITE. GO TO www.loriamedical.com THEN SELECT THE PATIENT INFO TAB, THEN SELECT THE VIDEO SERIES TAB, THEN ENTER THE USERNAME Patient AND THE PASSWORD loriamedicalwrap. NOT ALL VIDEOS MAY BE UPDATED SO PLEASE REFER TO YOUR PAPERWORK.

PURPOSE OF WRAP: THE WRAP PROVIDES SKIN PROTECTION, HELPS PENILE SHAPING, AND PREVENTS MOVEMENT AND LOSS OF FILLER MATERIAL INTO PUBIC AND/OR SCROTAL SKIN AREAS. MUST BE WORN AS DIRECTED. DO NOT MODIFY OR CHANGE THIS PROTOCOL UNLESS THE LORIA MEDICAL STAFF DIRECTS YOU TO DO SO.

IF THE PENILE SHAFT & GLANS WERE TREATED THE PROTOCOL REMAINS THE SAME.

THIS TO-DO LIST APPLIES TO ALL PATIENTS WHO HAVE HAD A PENILE SHAFT (AND GLANS) FILLER TREATMENT.

BARRIERS: YOUR WRAP, IN ADDITION TO THE SIMPLE STRETCH GAUZE, WILL HAVE WHAT WE CALL CERTAIN ‘BARRIERS’. THESE BARRIERS, OR AREAS THAT ARE ON TO PREVENT FILLER LOSS (SUCH AS THE LOOPED RUBBER BAND & TIGHT HALF-FOLD, THE PLASTIC RING, AND YOUR STRETCHY RINGS). THE BARRIERS THAT WILL BE ON FOR THE FIRST 7-DAYS CONSIST OF A LOOPED RUBBER BAND& TIGHT HALF FOLD, WHICH WILL BE LOCATED ON THE PENILE BASE AREA. ON DAY-7 YOU WILL STOP USING THE LOOPED RUBBER BAND & TIGHT HALF FOLD. YOU WILL THEN CONTINUE TO USE THE STRETCHY RING (FIGURE 8) DURING THE DAYTIME AND THE PLASTIC RING AND STRAPS DURING THE NIGHT-TIME. THE STRETCHY RINGS AND PLASTIC RING AND STRAPS WILL CONTINUE TO REMAIN ON UNTIL DAY 21. PLEASE NOTE THAT THE STRETCHY RING OR PLASTIC RING WILL NOT BE PLACED ON (UNLESS SCROTAL TREATMENT WAS PERFORMED OR UNLESS INSTRUCTED OTHERWISE). COTTON PADDING (GAUZE OR COTTON BALLS) SHOULD BE PLACED UNDER THE STRETCHY RINGS (FIGURE 8) AND PLASTIC RING FOR COMFORT AND TO HELP PREVENT SKIN SORES/ULCERS.

PENILE ERECTION ‘SHORTENING’ ISSUES: AFTER DAY 21 THERE ARE VERY FEW PATIENTS THAT EXPERIENCE A TEMPORARY SHORTENING OF THE PENILE ERECT LENGTH. IF FILLER MATERIAL SHIFTED INTO THE PUBIC AREA, IT MAY PREVENT THE PENIS FROM ACHIEVING ITS FULL ERECT LENGTH. EVEN THOUGH THIS IS TEMPORARY, YOU CAN HELP EXPEDITE AND REMEDY THIS PROBLEM BY TAKING ONE HAND TO PULL THE PENIS AND EXTEND IT OUT FULLY WHILE ROTATING IT IN A CIRCULAR MANNER. AT THE SAME TIME (WHILE ROTATING THE PENIS IN A CIRCULAR MANNER), WITH THE OTHER HAND, PLACE A MASSAGING TYPE FINGER PRESSURE ON THE PUBIC AREA VERY CLOSE TO THE BASE OF THE PENIS. THIS WILL HELP BREAK UP ANY ADHESIONS OR STICKING OF THE NEW COLLAGEN THAT HAS FORMED AT THE BASE. DO THIS SEVERAL TIMES A DAY UNTIL ERECT LENGTH RETURNS TO NORMAL.

SHAPING ISSUES: CONTINUE AGGRESSIVE MASSAGING AND DIRECT FINGER PRESSURE TO HELP SHAPE. THE COLLAGEN WILL RESPOND BUT IT TAKES TIME AND EFFORT.

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