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Lip Fillers for Penis Enlargement Are the Newest Trend

Men are turning to hyaluronic acid fillers to increase the girth and length of the penis. But is this procedure safe?

Only 55% of men are satisfied with their penis size, according to a 2015 survey. However, concerns about the penis being too small might be unfounded in reality.

For example, "small penis syndrome," or excessive concern over the size of a penis, is much more common in men with normal-sized penises than those with small micropenis.

Unsurprisingly, there is an increasing interest in non-surgical penoplasty — penis enlargement treatment with hyaluronic acid (HA), which is widely used and approved by the Food and Drug Administration (FDA) for increasing the volume of lips.

In a recent position statement, the Sexual Medicine Society of North America recognized that it is no longer in the niche areas of sexual medicine, reflecting the increasing demand for the procedure.

What are penis fillers?

Non-surgical penoplasty involves injecting hyaluronic acid to increase the girth and length of the penis. The 30-minute procedure involves an administration of a local anesthetic and injection of the filler into the penis shaft with a cannula. Penis is then massaged to distribute the gel into the tissues evenly.

Providers say the effect — a 20-30% increase in the size of the penis — is seen immediately. The penis will be noticeably bigger both in the flaccid and erect condition.

Patients are promised to get back to their normal sexual activities within a few days without any effect on sexual performance and complications like clogging blood vessels or surrounding nerves.

What are the pros of penis fillers?

Amy Pearlman, M.D., a board-certified urologist performing injections at Prime Institute, says commercially available hyaluronic acid, when followed up by a post-injection protocol, has multiple benefits.

She says the in-office procedure is well-tolerated, meaning no operating room is required, and provides completely personalized results—the amount of filler injected can be customized to each patient's desired girth increase.

Dr. Amy Pearlman
Dr. Amy Pearlman

Moreover, the downtime is minimal. For the most part, patients can go back to normal activities following each injection session other than limiting sexual activity.

Hyaluronic acid fillers are also reversible, as they can be easily dissolved in the office if necessary to smooth out filler or if, in rare circumstances, a patient no longer desires to have filler, according to Pearlman.

Is hyaluronic acid better than other fillers?

Laurence Levine, M.D., a board-certified urologist in Chicago, says he has seen penile enhancement injections with other products like polymethyl methacrylate (PMMA), silicone, and fat, causing side effects that may be difficult to counteract.

For example, fat is reabsorbed in an irregular fashion and frequently becomes lumpy and bumpy, resulting in a very unnatural appearance.

Meanwhile, silicone and PMMA would frequently develop into very firm nodules. Because of an exuberant inflammatory response, particularly with silicone, very severe deformities of the penis can develop.

These deformities are difficult to correct without the removal of the entire skin of the shaft of the penis with the underlying inflammatory mass.

Levine says one advantage of hyaluronic acid is that if irregularities develop, they can be dissolved by injecting the enzyme that breaks down HA.

"There are several different approaches being used, but unfortunately, there is very little peer-reviewed literature to support its use, which provides useful outcome data on complications, patient satisfaction, and long-term outcomes," Levine tells Healthnews.

Are penis injections risky?

As with any other medical procedure, hyaluronic acid injections carry some health risks, including subcutaneous bleeding, penile edema, infection, and penile subcutaneous nodules, which is the most common complication observed in 2.2% of cases.

A 2021 report published in Sexual Medicine describes the case of a 56-year-old man who presented to the emergency department with penile pain and swelling that persisted over a two-week period after receiving HA injection at an outside clinic.

The patient's penis was swollen, and the skin was red, with yellow liquid noted at the tip of the penis. He was diagnosed with dermatitis and penile edema.

Pearlman says the risks of penis enlargement injections with HA are fairly minimal when performed by a skilled healthcare provider.

In a study including 471 men who underwent penile girth enhancement with HA filler, none of them reported erectile function or loss of penile sensation. Superficial infections were also rare and occurred in patients who engaged in sexual activity sooner than instructed.

Three patients developed granulomas (lumps), which were completely resolved with a single treatment of hyaluronidase, an enzyme that breaks down hyaluronic acid.

Pearlman tells Healthnews, "The key concepts for great outcomes rely on using quality hyaluronic acid, having a healthcare provider performing the injections with expert knowledge in penile anatomy, following a standardized post-injection protocol, and having an informed discussion with each patient to understand and manage expectations."

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