Changes in the mean penile girth of both groups were not significantly different during the study period. Our multicenter, patient-blinded/evaluator-blinded, randomized comparative trial was performed for 18 months after the single injection of fillers. This study aimed to compare the long-term clinical outcomes of hyaluronic acid (HA) and polylactic acid (PLA) filler injections for PA. Although several types of penile augmentation (PA) fillers have been recently introduced, no long-term follow-up studies have compared them. At Cleveland Clinic, we’ll work to create a treatment plan that’s right for you. If you have a condition that’s affecting your urinary system, you want expert advice. It’s not wise to put lotions, creams or devices on your penis without the approval of or recommendation from your healthcare provider. Infection is a rare outcome after HA injection for PGE purposes, but can lead to detrimental outcomes. The penile circumference rose by 2.66 ± 1.24 cm, 2.28 ± 1.02 cm, and 1.80 ± 0.83 cm, respectively, during the 1-month, 3-month, and 6-month postoperative follow-ups. Ahn et al. recruited 64 participants in a prospective, randomised, controlled multicentre trial, comparing a HA filler to a PLA filler. Many patients notice improved appearance and confidence right away. XWZ participated in the surgeries, guided the study, and made the managements of all the complications. We aimed to provide some effective treatment ideas for the complications of HA injection. This article mainly discussed the complications and management of PA with HA injection. When performed correctly, ligament release surgery is a safe and effective component of penis enlargement surgery.Men experience mild and transient effects from these dermal fillers, ensuring the process remains comfortable.HA fillers were found to potentially cause adverse events early after the procedure or even years later.This is why choosing the right clinic matters more than the technique itself.This was considered to be due to the difference in the properties of the HA filler used in this study and in previous studies.During the evaluator-blind portion of the study, all post-injection assessments at each institution were performed by one trained independent physician who was not involved in screening or filler injection.Patients report mild and transient side effects that usually resolve rapidly.In a Z plasty, triangles made at 60-degree angles when transposed can lead to a 1.75× increase in length . The procedure usually takes under an hour and is performed in a clinic setting by qualified Urologists who are experts in genital medicine and surgery Unlike surgery, fillers do not involve incisions or downtime. The gel-like filler increases thickness (girth) and can subtly improve symmetry. In this guide, we’ll cover everything you need to know about penis fillers in the UK, from cost and safety to results and alternatives. Length and girth surgery- So far so good, Two days post surgery and everything is settling really well.. You’ll need to be realistic in your expectations and should realize that serious complications are possible. If you’re not satisfied with how your penis looks and you’re considering penis enlargement, make sure you spend enough time talking with your surgeon about the outcomes. First, an operator-blinded trial was impossible because of the unique characteristics of each filler material. Two cases of injection site inflammation and three cases of injection site pain were reported in our study. After injection, the penis cannot be completely restored to its pre-injection state. It also supports the idea that men who want to enlarge their penis have psychological distress that could require counseling or psychotherapy . Therefore, our study might help physicians choose the most appropriate type of filler. There are a variety of skin-related reconstruction procedures that help to increase penile length, such as V-Y and Z plasty, ventral phalloplasty, and scrotoplasty 9,42. The following review aims to compare surgical outcomes, quality of life, and complications of non-invasive and invasive approaches to penile augmentation surgery. In recent years, the popularity of penile augmentation surgery has increased significantly . The primary outcomes were changes in penile dimensions, specifically in terms of length and girth, as well as the incidence of surgical complications and the impact on quality of life. Introduction When considering penis enlargement surgery, one of the most common questions patients ask is, “Is it safe? Penis enlargement surgery is considered permanent and is still the “gold standard” way to increase your penis size. At the same time, we can also increase the flaccid and erect girth of your penis, also by one to two inches. We can increase the flaccid length of your penis between one and two inches with our ligamentolysis procedure. We then purify the fat and use the pure fat cells to increase girth to the maximum. The Urologists reveals hidden penis length by cutting the ligaments that are holding your extra penis length back. Permanent increase in flaccid and erect girth using your own purified fat cells Professional consultants who guide you through the process of having genital surgery sympathetically and with care. An overview of the studies dealing with the adoption of HA injections to treat PE is available in Table 3. The maximal glandular circumference significantly increased, and the rate of patient satisfaction was 64.9%, 70.3% and 78.4% at the 1st, 3rd and 6th month of follow-up, respectively. The same authors reported the results of a 5-year follow-up in 38 patients, documenting a decrease in the IELT compared with the 6-month assessment, but this was still longer compared to baseline (e.g., 4.2 folds). This method uses injectable hyaluronic acid gel for penile augmentation. The Technique offers a straightforward approach to penile enhancement. Expert practitioners will administer the filler injections with care. Couldn’t of made my surgery any better to be honest, fantastic services and helped me with a lot. He answered all my questions and so far it seems he has done a great job. Four main people to point out that made the journey easier and almost enjoyable ( if you could say that). Everything was explained well to me pre and post surgery. We have refined injection techniques to improve results, we have tried different fillers and modified aftercare too. In a randomized controlled trial by Abdallah et al.23 where all the patients were circumcised prior to HA gel injection, no penile edema was reported. Our results have shown that the patients who had penile edema after the operation had redundant prepuce. In summary, the procedure was performed via local anesthesia by injecting lidocaine (Lidocaine HCL Hydrate Injection 2%; Huons, Co., Ltd., Sungnam, Korea) or applying EMLA cream (Emla 5% cream; AstraZeneca Korea, Co., Ltd., Korea). The PLA filler (PowerFill®; REGEN Biotech, Inc., Seoul, Korea), which has been recently developed for PA, is a powder consisting of 10 g of 50 μm PLA microparticles suspended in 3 mL of methylcellulose and carboxymethylcellulose. The HA filler (Hyafilia Impact®; CHA Meditech, Co., Ltd., Daejeon, Korea), which has been newly developed for PA, is a transparent gel consisting of 20 mg of cross-linked bi-phasic HA and 3 mg of lidocaine in 1 mL of saline. Laboratory examinations were performed at baseline, 6 months, and 18 months after injection. Satisfaction with penile appearance and sexual performance was assessed using a 5-point visual analog scale (VAS). PGE with HA and PLA fillers resulted in significant enhancement of girth without serious AEs with no significant differences. There was no statistically significant difference between the groups in terms of increase in penile girth or change in satisfaction level. The use of PMMA injections for penis enlargement is a controversial practice that comes with significant risks and dangers. Although this can happen with a fat transfer or hyaluronic acid injections, PMMA lumps may require surgery to remove them. At Moorgate Andrology, we perform more penis filler procedures than almost any clinic in the UK. Moreover, a report on complications after injection of various polymethyl methacrylate-based dermal fillers had already been published by Salles et al.,8 such as tissue necrosis, granulomas, chronic inflammatory reaction and infection. Although several options are available for penile girth augmentation, none of them is free from complications. However, only few studies and follow-ups have investigated the various complications of hyaluronic acid injection and their corresponding management. Hyaluronic acid injection is becoming a popular way for penile augmentation. Over several years, repeat treatments may cost more than one-time penis enlargement surgery. However, further studies are recommended regarding the efficacy and safety of PGE using fillers in patients with severe PE. Patients are also advised on activity restriction and recovery timelines to reduce complications. This is why choosing the right clinic matters more than the technique itself. At Moorgate Andrology, patient safety and realistic expectations are prioritised at every stage. Understanding the potential complications and how they are managed is essential before making a decision. A low rate (11.2–14.4%) of mild, temporary adverse events and poor-to-moderate patient satisfaction were found. What happens before penis enlargement procedures? In our case, methacrylate injection was used for penile enhancement. The best option and outcome for penile girth augmentation remain unclear. However, the “experimental” nature of this kind of approach is almost never completely explained to these patients, who believe that they are undergoing a modern and safe procedure. If you have excess fat in the pubic area it can be a source of embarrassment and discomfort. Do you have excess skin in the scrotum that makes the scrotum look unattractive?. At Moorgate Andrology and Gynaecology we can replace the lost testicle with an implant that will closely resemble the “ real” testicle. This indicates that although HA injection is safe for most of the patients, diabetics and immunocompromised patients have a higher risk for infection. However, a disadvantage is that in some of the patients, the injection sites do not heal spontaneously, which may be sites for infection from the pubic hair flora in the absence of skin preparation. It usually takes about 3 days to take effect, and patients would not have to undergo another surgery. All patients have been informed of the study and have approved the collection of patient data. This is a retrospective study involving patients who underwent PA with HA injection in Beijing Eden Hospital (Beijing, China) and Chengdu Kowloon Hospital (Chengdu, China) between January 2018 and December 2019. Table 2. Changes in the satisfaction of subjects with penile appearance and sexual life during the study period. No, penis filler does not affect sexual performance. Will penis filler affect sexual function? Although penis fillers are minimally invasive its important to follow the post treatment regime carefully. If you would like to take the loan over longer, say up to five years, and perhaps not pay a deposit, then we can arrange for you to pay for the procedure monthly. All surgical procedure carry some element of risk. Sutures from the base of the penis after lengthening are falling out naturally, penis shape continues to improve. Some bruising still on belly and inner thighs, penis starts to take shape as the new fat cells organise The pure fat cells are injected into the shaft through a single entry point at the base of the penis On further questioning, the patient admitted to supplemental testosterone use. A 56-year old male presented to the emergency department (ED) for concerns of penile pain and swelling over a period of two weeks. If you are considering surgery, a consultation with a regulated provider is essential. They were asked to sign the informed consent after a detailed explanation of possible adverse events (AEs) related to the filler and filler injection procedure. Subsequently, using a 22-gauge or 20-gauge cannula, HA or PLA filler was injected in the respective group of patients, between the Buck's fascia and the dartos fascia, by combining the back-and-forth and fanning techniques. The PLA filler (PowerFill; REGEN Biotech, Inc., Seoul, Korea) is a currently commercially available powder consisting of 10 g of 50-μm PLA microparticles suspended in 3 mL of methylcellulose and carboxy-methylcellulose that is reconstituted with 8 mL of saline immediately before injection. These layers and anatomy are important to keep in mind when considering complications. He was followed by Urology 1 week later in clinic with complaints of continued penile tenderness and erythema despite daily use of the topical hydrocortisone, amoxicillin and/or clavulanate, and mupirocin. Herpes simplex virus (HSV) and Varicella zoster virus (VZV) polymerase chain reaction (PCR) swabs were obtained as well as bacterial cultures which were all negative. We explained that this diagnostic work-up could provide more specific information about a diagnosis to better treat the pathology. At this point, the patient was offered skin biopsy versus skin scrapings to determine a histologic diagnosis. What results are realistic and achievable after having penis enlargement surgery ? Complications can be minor with hematoma and penile oedema which most commonly resolve with conservative treatment. These flaps can be harvested from several body areas including the scapula, radial forearm, buttock, and latissimus dorsi, but the most commonly used for good cosmetic results is the radial forearm flap. In general, two flaps are created from a body area and are used to form a neophallus around a neourethra that is formed (“tube within a tube” technique). Patients who have a diseased shaft skin or retracted penis due to previous circumcisions may require further reconstruction in the form of a penile shaft skin (±foreskin) excision and a split-skin graft taken from the inner thigh 17,41. Lipoplasty is usually performed alone or in combination with another procedure to manage a buried penis secondary to obesity. The characteristics of studies on the techniques for increased penile length are summarized in Table 1. Until now a combination of multiple surgical approaches seemed to be the most suitable solution for surgeons and patients. These patients should first undergo lipoplasty, and only in case of inadequate penis size should a further intervention be considered . Gentle hygiene helps support safe penis enlargement recovery. Yes, you can shower after your penis filler treatment. Learn more about our penis filler treatments or book a discreet consultation today. Injections increase penile circumference by around 3cm , however large volumes are required to change girth ( ml) . Thus, penile injectable filler may be viewed as the only reasonable option to many surgeons due to being minimally invasive and promising initial improvements in penile girth. Non-invasive techniques revealed no change in penile girth at three months. Multiple techniques exist for penile girth augmentation. The flaccid penis length has increased by 5cm though a ligamentosis procedure, moving from a pre-operative measurement of 8cm, to a post operative measurement of 13cm. In addition, penile shortening was reported in 4.7% of patients who had a release of the penoscrotal web vs. 83.8% who did not have the release .There may be medical reasons for seeking an enlargement surgery if you have micropenis or a buried penis.A 36-year-old male sought medical care with a complaint of penile deformity and sexual dysfunction after methacrylate injection.It’s a great erection booster and we have many patients who swear by its natural healing properties.Many fillers are available for tissue augmentation,2,3,4,5 but the ideal filling substance remains unknown.In our case, methacrylate injection was used for penile enhancement.Reviews show that men who had realistic expectations and proper support reported the highest satisfaction rates. This ensures safe recovery and maintains the best results from your hyaluronic acid based filler. Following your male enhancement aftercare instructions can help speed up recovery. Yes, minor swelling, redness, or bruising is common after penis filler. In a modern study of 25,594 men, 45% indicated that they desired a larger penis . Immediately after injections, penile swelling or bruising was observed, but disappeared within a week. Any irregularity, retraction, lump, or deformity of penis, and migration of fillers were not observed. HA, hyaluronic acid; PLA, polylactic acid; n, number of patients; SD, standard deviation. The baseline demographic and clinical characteristics of patients were similar between groups (Table 1). Girth Enlargement Surgery The fat suctioned with a liposuction apparatus is divided into syringes after being filtered and is then injected into the penile tissue with the assistance of a cannula, thus ensuring equal distribution. Each technique is evaluated based on its clinical outcomes, durability of results, and complications. Several modifications of this technique have been described regarding either the site/shape and size of tunica albuginea incisions or the closure of defects with Buck’s fascia instead of graft material 34,54,55 (techniques described in detail in Table 1). The penile length gain occurs in both flaccid and erect status and is mainly dependent on the flexibility of the NVB and urethra. Post-procedural complications after penile girth injections seem to be under-reported and unfortunately can result in severe deformity and dysfunction of the penis. We describe a case of post-procedural dermatitis after receiving penile girth enhancement injections in an adult male and discuss management of penile girth injection side effects. The majority of studies conducted in the past decade examining penile enhancement procedures in both healthy men and those with concurrent penile disorders have reported successful increases in penile dimensions or corrections of deformities, with only a few significant complications . Standardization of the surgery protocol and elucidation of the effects of other injection parameters are still lacking. Preoperative redundant prepuce may increase the incidence of penile edema or postoperative gel migration. There were no systemic or local allergic reactions among all the patients. During the entire 6-month follow-up, 4.3% had complications such as subcutaneous bleeding, subcutaneous nodules, and infection. Many patients report both a physical transformation and improved self-confidence in relationships. However, as with any medical intervention, PMMA injections carry risks and potential side effects that individuals should be aware of before considering this to enlarge the penis.The HA filler used in this study had a higher degree of cross-linking and HA concentration than the HA fillers used in previous studies, thus increasing the viscosity and cohesivity of the filler, which in turn increases the longevity and tissue volume of the injection site .Moreover, a report on complications after injection of various polymethyl methacrylate-based dermal fillers had already been published by Salles et al.,8 such as tissue necrosis, granulomas, chronic inflammatory reaction and infection.Fertility is not affected by penis enlargement surgery.Interestingly, the increase in mean penile girth by 22.7 mm in this study exceeded the results of previous studies that reported changes from 19.1.–21.0 mm.This non-invasive option makes it an appealing alternative to surgery. Hyaluronic acid fillers provide a safe alternative to surgical options, with studies showing their efficacy and safety. Penis filler treatments offer several benefits for those seeking non-surgical enhancement. A careful patient selection is of paramount importance to increase postoperative satisfaction after HA injections in andrology, and mastering the injection technique by adequate training is necessary in order to achieve an optimal outcome. Even though the application of HA injections in the everyday clinical practice of the andrologist is increasing, more high-quality scientific studies are still needed to confirm the efficacy and safety of these procedures. Penile girth enlargement (PGE) using HA proved to be safe and effective in enhancing the diameter of the penis, with durable and satisfactory outcomes in long-term follow-up. For men considering penis enlargement surgery, safety is always the number-one concern. In our case, the patient had an injection approximately 2 weeks prior; although, the patient did have his original injection about a decade earlier. Short-term complications include infection, edema, hypersensitivity, erythema, and penile disfigurement.1 These short-term complications are noted to occur within days or weeks of the injection. It is hypothesised that the filler injected between Buck’s fascia and dartos fascia acts as a barrier between tactile inputs and the dorsal-nerve ending receptors in the penile shaft, hence lowering the sensitivity threshold. Similarly, the degree of satisfaction with penile appearance as measured by a VAS score increased after the procedure, an effect which was maintained without significant differences between the two groups at the conclusion of the follow-up period. One year after the injection, 95% of Group 1 and 100% of Group 2 maintained more than 50% of the injected volume, based on the subjective patient’s visual estimation. One year later, the net increase in maximal glandular circumference was 14.93 ± 0.80 mm in the subset of 100 naive patients and of 14.78 ± 0.89 mm in 87 patients who received a previous unsatisfactory dermo-fat graft. Whilst some may well have the skills to inject the penis safely, it should be obvious that injecting the penis is not the same as injecting the face. Numbers over 20ml start to look very fake , whatever the length of the penis. If too much filler is added it can look obvious that something has been done. If your penis is shorter than the average then it will be best to focus on more modest amounts, perhaps 10 to 15ml, but not much more. The mean penile girth at 4, 12, and 24 weeks increased significantly in both groups compared to that at baseline (pFig. 3). Between-group comparisons, including differences in the change in mean penile girth, satisfaction level, PEP score, and self-estimated IELT, were analyzed by analysis of covariance using the injected volume of filler as a covariate. During the study period, assessments before and after the procedure were performed by a single physician, independent of the filler injection at each institution (evaluator-blinded). Care at Cleveland Clinic Data on flaccid, stretched, and/or erect penile length, as well as patient satisfaction and quality of life, were extracted when available. The stretched penile length (SPL) represents the most overlapping measurement of the erect penis, corresponding to the distance between the pubic symphysis and the apex of the glans . Moreover, the condition can be classified as a body dysmorphic disorder if the patient experiences obsessive behaviors, significant psychological distress, and SPA present at least 1 h per day . Will penile enhancement surgery affect erections ? Differences among patients (e.g., redundant prepuce before injection) must be standardized in the succeeding studies. The patient developed penile edema on the 35th day postoperation following sexual intercourses. The two patients that had infection during the follow-up underwent incision and drainage (I&D). In our study, we found that injecting the root of the penis using an 18G cannula provides ease for the even distribution of HA. Meanwhile, the demand for surgical treatment to enlarge genital circumference has steadily increased, and various procedures are available, including PGE using dermal acellular graft , autologous fat injection , and other scaffolds . A multidisciplinary approach is essential for men requesting penile augmentation, and further research is needed to successfully manage patients seeking these procedures. Penis fillers have become one of the most in-demand non-surgical procedures for men. Three to six sessions were performed and, after a mean follow-up of 20 months (range 1-36 months), these investigators reported that an increase in penile girth of 27% had been achieved. Girth enhancement techniques, including soft tissue fillers, grafting procedures, biodegradable scaffolds, and subcutaneous penile implants, have gained traction. Whatever the reason and/or the medical condition driving patients to seek penile augmentation surgeries, the decision to undergo penile enhancement surgery necessitates careful consideration. They are a faster recovery than surgical procedures to increase penis girth but still require some aftercare Using advanced hyaluronic acid (HA) injections, this non-surgical procedure offers an immediate increase in girth with minimal downtime. Despite some concerns about PGE using injectable filler in terms of patient satisfaction, a high satisfaction level with penile appearance and sexual life through a careful approach to men looking for penile enhancement was achieved in the current study. Thickening of the penis depends on the volume inserted filler and averages + 2–4 cm in circumference.In 2003, Moon et al. for the first time proposed a method of enlarging the penis head with hyaluronic acid. When performed correctly with approved products, fillers are generally safe. This structured approach gives patients the best chance of safe, successful outcomes. These advantages make fillers appealing to men who want to “test the waters” before committing to a permanent solution like surgery. We have spent years perfecting our techniques and updating the fillers that we use today. This scarring, known as fibrosis, can lead to a lumpy, hardened appearance of the penis and may interfere with normal erectile function. The genital area is particularly susceptible to infections, which can be challenging to treat and may require surgical intervention. PMMA injected into the penis can migrate from the injection site over time. The filler may not distribute evenly, leading to visible or palpable bumps and nodules along the shaft. The idea is to provide a permanent increase in circumference, improving the appearance of the penis during both flaccid and erect states. The flaccid length measured 7.5 cm and the post-surgery length measures 14cm. Below are examples of before and after undergoing surgery. We also offer other diagnostic services such as Ultrasound scans of the penis and genitals, and general laboratory investigations as required. However, studies to date have only described short-term complications, and no long-term implications are known. The main complication is irregularities from nodule formation which were noted in 48% of patients . PMMA is a non-absorbable soft-tissue filler that has previously been commonly used for prosthodontics due to its low density, ease of manipulation and cost-effectiveness. It is used in both penile shaft and glans. A natural polysaccharide macromolecule typically found in the extracellular matrix of connective tissue, hyaluronic acid is biocompatible, bioactive, non-immunogenic and non-thrombogenic. Finally, 34 patients were included per group considering a dropout rate of 20% during the study period. Patients were instructed to massage the penile shaft gently and to abstain from sexual intercourse for 1 month. At each institution, an experienced physician performed the injection procedure. HA can also be used to obtain enhancement of the dimensions of the glans (Figure 1), which may have both an aesthetic and a functional usefulness, as a small glans with a thicker shaft may lead to penetrative issues. A multidisciplinary evaluation, including a psychiatric and/or psychological assessment, may help in discerning those patients who would benefit the most from counselling from those who would benefit from interventional management instead . Penile size has gained importance over time, with adequate dimensions corresponding to a perception of an advantage from both an aesthetic and a sexual standpoint. Although injective HA treatment in andrology is increasing, current criticism of its andrological applications is secondary to the lack of established procedures, poorly defined indications, and concerns with the reliability of the existent scientific literature in this field. Injection of HA in the glans seems to represent an alternative treatment option for those patients with premature ejaculation (PE) who fail to respond to conventional medications. If complications are diagnosed, prognosis is satisfactory after treatment. Furthermore, most of the complications can resolve spontaneously without further side effects. Second, the low number of cases and short follow-up period hindered the detection of rare and late-onset complications. Access is via penile inversion either through an infrapubic incision or by a “concealed” lateral scrotal incision near the penoscrotal junction.27 This implant is distinct from implants that treat erectile disfunction as it is anchored distally at the coronal sulcus between Buck’s and dartos fascia and provides no erectile function. A single center reviewed 355 cases of cosmetic elongation, enlargement, and combined elongation/enlargement phalloplasty with autologous fat obtained from liposuction. The most common of these complications is development of a subcutaneous nodule, with a reported incidence of 2.2%. In our case, the primary urologist had injected no deeper than deep fascia based on exam and imaging findings. Laboratory examinations were performed at baseline, 6 months, and 18 months after injection.Cai et al. published a prospective, randomised phase III study with 81 PD patients enrolled at two centres and randomised to oral HA administration combined with intralesional HA vs. intralesional treatment only.A major advantage of HA filler over temporary fillers such as fat and collagen is its low complication rate .Much of the negative information comes from non-surgical filler clinics, not surgeons.If your problem is excess fat and overhanging skin, then a pubic lift would be the way forward.Filler injections often result in minimal downtime, allowing individuals to return to normal activities quickly.The penile length gain occurs in both flaccid and erect status and is mainly dependent on the flexibility of the NVB and urethra.It was wrapped around the penis short of the corpus spongiosum and insinuated under the glans. Penis fillers are one of the fastest-growing treatments for men looking to improve their confidence and sexual wellbeing. Furthermore, it was demonstrated that PGE using fillers improved clinical symptoms related to ejaculation. In particular, the current study showed safety using HA filler with a higher HA concentration and cross-linking degree than the HA filler in previous studies. Despite these limitations, the present study showed the efficacy and safety of PGE using HA fillers with properties different from those of previous studies. As the present study was not specifically designed to evaluate PGE using injectable fillers for the treatment of PE, further studies are needed to demonstrate the therapeutic effect of PGE on PE. Additionally, among the subjects who completed the ejaculation assessment, less than half showed clinical PE. The PEP questionnaire has yet to be validated as a sensitive tool for evaluating PE. Therefore, the current study used active treatment in the control group, as in previous studies. All work together to assess patients suitability for surgery and your safety sat the top of their agenda Performed under anaesthesia in CQC-approved facilities, the procedures are highly controlled.Specialist Urologists ensure precision, minimise complications, and they deliver natural results. A procedure that was intended to improve self-esteem and confidence can have the opposite effect if complications arise. It's important to consider the psychological impact of unsatisfactory results or complications from PMMA injections. Excessive or improperly administered PMMA injections can cause scarring of the penile tissues. The key to safety lies in regulation, surgical expertise, and proper aftercare. A specialist consultation ensures patient safety and appropriate decision-making. Some men assume non-surgical options are automatically safer. Ligament release surgery is often misunderstood online. Penis enlargement surgery is strictly regulated in the UK. If you have a bend in your penis, with or without pain, get in touch today and we will arrange an assessment with Dr. Nenad Djakovic, Urologist. When all else has failed to get your erections back on track, a penile implant can be a great option. Please note that we do not use unregulated filler, or worse, a filler that is contraindicated for the genitals, as some other providers do. To cover the defect in the ventral shaft skin, local flaps are created by making a ventral midline scrotal incision with horizontal relaxing incisions. Other described skin flaps used to lengthen the penis include the lower abdominal Z plasty and the W-flap reconstruction . In a Z plasty, triangles made at 60-degree angles when transposed can lead to a 1.75× increase in length . A urethral catheter is left in situ and the penile skin graft is dressed and/or vacuum-assisted for 10–14 days . The effects of augmentation appear to be lifelong. The microspheres become encapsulated with granulation tissue following injection and develop ingrowth of blood vessels, thus eventually creating ‘living tissue’. The main notable complication is diminished tactile sense of the penile body. The large volumes of injected fat have led to reports of reduced erectile rigidity due to corporal bodies being overlayed by fat . All complications were treated accordingly, and no further deterioration or severe sequelae were observed. At Moorgate, patient safety and satisfaction always come first. We have done the research over the years since we started to perfect the technique and ensure safe and predictable treatments The data required to reproduce these findings cannot be shared at this time due to legal and ethical reasons. Because fillers do not increase length — only girth — men who expect more may be disappointed. This review seeks to describe the available materials, techniques, and risk profiles of the various types of fillers used for penile augmentation. As fillers are more commonly used in cosmetic procedures to augment facial features, most genitourinary surgeons are unfamiliar with these therapies. The growing demand for penile augmentation surgeries is driven by various factors such as increasing awareness about the availability of these procedures in combination with the availability of different techniques. The history of penile augmentation surgery dates to ancient civilizations, where the practice of enlarging the penis through various methods, such as stretching or tying weights to the penis, was reported. This systematic review aims to summarize the available evidence on outcomes, complications, and quality of life after penile augmentation surgery, examining both minimally invasive and more radical techniques. You should wait one week after hyaluronic acid injections, or until any tenderness or swelling has completely settled. There is a growing trend now of penis fillers being performed by cosmetic practitioners. At Moorgate Andrology, procedures are carried out by surgeons with extensive experience in genital surgery. Penis enlargement surgery is a recognised urological procedure when performed by a GMC-registered Specialist Urologist. This article explains the real risks, how safety is managed, and what patients should understand before proceeding. You can opt for just length or girth surgery and that costs £ 6995. † Injected filler volume and baseline penile girth-adjusted analysis of covariance test from baseline. The mean penile girth was defined as the mean of the circumference measures on distal, mid-, and proximal shafts. The trends in results measured at the distal, mid-shaft, and proximal shaft were similar to those of the mean penile girth (Figure 3b–d). Who is a Good Candidate for Penis Filler Treatments? Micheels et al. reintroduced the “Mushroom technique” proposed by Sito, which aimed to boost sexual feeling in both the treated individuals and their partners. The isovolemic degradation constantly maintains the gel in balance with the water, thus maintaining the effect even in low concentrations of the filler . Biochemical reticulation (e.g., cross-linking) stabilizes the HA molecule such that it resists degradation by hyaluronidases, thus improving its longevity without a decrease in biocompatibility . There is no standard approach to the management and follow-up of patients seeking penile enlargement procedures described in the literature, and the surgical penile enlargement methods are controversial.However, only few studies and follow-ups have investigated the various complications of hyaluronic acid injection and their corresponding management.Finally, penile girth enhancement may be performed using soft tissue fillers, grafting procedures, biodegradable scaffolds, and Penuma®.For men considering penis enlargement surgery, safety is always the number-one concern.A careful patient selection is of paramount importance to increase postoperative satisfaction after HA injections in andrology, and mastering the injection technique by adequate training is necessary in order to achieve an optimal outcome.Second, the low number of cases and short follow-up period hindered the detection of rare and late-onset complications.An overview of the studies dealing with the adoption of HA injections to treat PD is available in Table 2. To our knowledge, though the adverse effects of the HA injection are usually mild, if any, at the least, these may cause negative psychological effects on the patients. At 1-month, 3-month, and 6-month postoperative follow-ups, the penile circumference had increased by 2.66 ± 1.24 cm, 2.28 ± 1.02 cm, and 1.80 ± 0.83 cm, respectively. If you’d like to explore whether fillers or surgery are right for you, book a private consultation with Moorgate Andrology today. This will depend on the penis enlargement filler you choose On average, penis fillers last 12–24 months before gradually dissolving. Satisfaction level regarding penile appearance and sexual life significantly increased in both groups. Moorgate Andrology recommends surgery first for permanent enhancement. It is a minor surgical procedure that takes just one hour in most cases. These studies should also be conducted following standardized reporting criteria for surgical outcomes and complications, using uniform data collection and analysis, facilitating better comparisons. Lastly, it examines interventions aimed at enhancing both the length and circumference of the penis. The papers analyzed in this review demonstrated inconsistent approaches in evaluating changes in penile dimensions, highlighting the absence of a consensus in assessing and reporting efficacy outcomes. However, complications such as infection, hematoma, and dissatisfaction have been reported across different techniques, highlighting the need for cautious consideration. Conversely, more invasive methods including penile disassembly and total phalloplasty offer substantive length gains . Healthy men between ages 20 and 66 years who wanted to enlarge their penis due to concerns that it was smaller than normal for an adult male were recruited for our study. Our study aimed to compare the clinical outcomes of HA and PLA fillers for temporary PA in a randomized non-inferiority trial. HA fillers have direct and passive effects, whereas PLA fillers have delayed and bio-stimulatory effects . For PA, both fillers have been introduced in scientific journals and approved in several countries 7,10,11,15. It should be reconstituted with 7 mL of saline immediately before injection. The patient-blinded/evaluator-blinded status was maintained until the data were finalized. Randomization was performed using SAS version 9.4 (SAS Institute Inc., Cary, NC, USA) by an independent biostatistician. Vital signs were observed and laboratory examinations, including complete blood count, liver function, metabolic function, serum electrolyte, blood clotting function, and urinalysis, were performed to assess the general health status. Another interesting aspect of this study is that PGE improved clinical symptoms related to ejaculation in several patients. Although the mechanisms of tissue expansion of the two fillers are different, there was no significant difference in the effects and stability of the two fillers in this study, consistent with the results of previous studies 13,14,15. Data including penile girth; 5-scale satisfaction regarding penile appearance and sexual life; and self-estimated IELT, PEDT, and PEP measurements at baseline and at 12 and 24 weeks for all subjects were expressed as mean±SD. While mild swelling or bruising can occur, serious complications are rare when carried out by professionals. At Moorgate Andrology, all treatments are performed in a medical setting by trained specialist Urologists. If you don't mind the top up treatments and realise that you will need to spend more to maintain the results, then go for it. In this era of growing emphasis on minimally invasive procedures, the popularity of soft tissue fillers has grown, with a renewed interest in their andrological applications. HA intra-plaque injections represent a valid option which may contribute to restore sexual activity in patients with Peyronie’s disease (PD). Potential catastrophic complications of exogenous materials such as liquid silicone, paraffin, Vaseline, oils (motor, baby, cod liver), and other materials injected into the penis for girth enhancement have been reported and their use is not medically advised.5–11 Silicone for injectable use has been fraught with complications. Such a substance would be biocompatible, non-antigenic, non-pyrogenic, non-inflammatory, nontoxic, easy to use, stable after injection, non-migratory, natural looking and not too expensive. No late complications were observed; the skin flap healed well, except for a small distal area; and, after two months, satisfactory cosmetic and functional outcomes were reached (Figure 5). The patient also left the hospital on the second postoperative day. There were no complications during the early postoperative period. Much of the negative information comes from non-surgical filler clinics, not surgeons. Ligament release surgery has been widely discussed online, often inaccurately. That said, all surgery carries risk, and proper consent and assessment are essential. At Moorgate Andrology, patient safety is the primary consideration at every stage of assessment, surgery, and recovery. The authors confirm that the data supporting the findings of this study are available within the article. Although fillers have been comprehensively studied for use in the face, the penile anatomy, function, and injection techniques are clearly different from those of the face 8,9.The defects that were created by the incisions in tunica albuginea are covered with grafts, such as porcine pericardium or Tachosil, and in most cases a penile prosthesis is inserted .Abdallah et al. examined the outcomes of HA glans injections in 60 PE patients in a randomised non-controlled trial.In a retrospective study including 83 patients, Sito et al. compared the outcomes of HA emicircumferential penile shaft injections with those obtained using a similar technique with lipofilling.All complications were treated accordingly, and no further deterioration or severe sequelae were observed.A procedure that was intended to improve self-esteem and confidence can have the opposite effect if complications arise.Candidates for penis filler treatments often seek a safe and non-invasive option for penile enhancement. Penis enlargement surgery can be an effective option... If you are unsure whether surgery is right for you, a specialist consultation is the best first step. Penis enlargement surgery is not experimental, but it must be done properly. Long-term issues are rare and usually related to poor technique or inappropriate patient selection. One of the biggest safety factors is who performs the surgery. Most patients who choose PMMA injections so o because they are enticed with the promise of longer lasting results. One of the most common issues with PMMA injections in the penis is the risk of developing an irregular shape or lumps. PMMA, or polymethylmethacrylate, is a synthetic, biocompatible substance that is sometimes used as a permanent filler in cosmetic procedures. We brought penis fillers to the United Kingdom about 12 years ago now. In this blog, we separate the myths from reality when it comes to penis fillers. Although standardization of surgical protocols and elucidation of the effects of several HA parameters are still lacking, it is sufficient to conclude that HA injection is an effective and safe method for PA. Although there is no study explaining the role of redundant prepuce on the incidence of complications, we hypothesized that the distal migration of the injected HA contributes to its pathogenesis. Studies have reported increases in penile girth of 2-4cm post-injection, with relatively high satisfaction 1,6. Although believed to be chemically inert, there have been multiple reports of adverse inflammatory reactions in penile injections when compared to other plastic procedures. Fixation of the penile skin is a procedure often performed at Moorgate Andrology for cases of buried penis, usually alongside e penis enlargement surgery. We have a small range of tried and tested penis fillers to increase your flaccid and erect penis girth. Penoplasty is the medical term for surgical procedures that enhance the size, length, or girth of the penis. It is cross-linked ex vivo in a lab in order to prevent or delay resorption by the body.16 However, highly cross-linked HA increases the risk of local responses, inflammation, edema, and granulomas.16 HA filler can be reversed by administering hyaluronidase in absence of local infection or allergy to bee stings and/or hyaluronidase. Unfortunately, penile and even scrotal deformity can occur in men who previously had normal anatomy leading to lifelong anatomic and even physiologic dysfunction. Development of a subcutaneous nodule typically occurs 2 weeks following HA injection, and can be managed with either surgery or hyaluronidase therapy.6 Injection of HA in the glans seems to represent an alternative treatment option for those patients with premature ejaculation (PE) who fail to respond to conventional medications.In cosmetic procedures, PMMA is primarily utilized as a dermal filler in the face, aimed at plumping up the skin and smoothing out wrinkles and lines.At the time of writing we have three patients referred to us who need surgery to remove calcified lumps in the penis after such injections.That said, all surgery carries risk, and proper consent and assessment are essential.Ahn et al. recruited 64 participants in a prospective, randomised, controlled multicentre trial, comparing a HA filler to a PLA filler.A multidisciplinary evaluation, including a psychiatric and/or psychological assessment, may help in discerning those patients who would benefit the most from counselling from those who would benefit from interventional management instead .Additionally, it does not exclusively focus on a specific group of interventions (surgical or non-invasive) or a particular condition or disease (e.g., PD), providing a comprehensive picture of the current landscape.Penis Enlargement Surgery Risks – What You Need to Know Correction of curvature was observed in all patients, no erectile dysfunction was reported, and satisfaction of patients ranged between 90 and 100% 30,31,32,33,34,54,55. The technique is utilized in most studies for patients with severe erectile dysfunction, Peyronie’s disease, and short length either due to curvature or after treating prostate cancer (radical prostatectomy or combination of hormonal therapy and radiotherapy) 30,31,32,33. The defects that were created by the incisions in tunica albuginea are covered with grafts, such as porcine pericardium or Tachosil, and in most cases a penile prosthesis is inserted . A neo glans can be formed usually some months after the formation of neophallus/neourethra, and the final third stage is usually the insertion of a penile prosthesis. There is no standard approach to the management and follow-up of patients seeking penile enlargement procedures described in the literature, and the surgical penile enlargement methods are controversial. Our study suggests that filler injections can be cautiously used to treat men who want a larger penis. As almost all filler injections for PA are performed due to the desires of men reporting a small penis, it is very important to understand the different clinical courses of various fillers after injection. However, these girth increases lasted up to 18 months after injections of both HA and PLA fillers. The use of hyaluronic acid filler allows for a quick procedure with little interruption to daily life. As they explore these enhancements, understanding the procedure details is essential for informed decisions about their health and satisfaction. Men appreciate the non-invasive nature of these procedures compared to surgical alternatives. It enhances girth effectively, leading to increased confidence during intimate encounters. Non-surgical male enhancement options provide a safe alternative that many find appealing. Surgical treatment (e.g., dorsal penile neurectomy) can represent an alternative treatment option , but its adoption is typically discouraged due to the non-negligible risk of permanent loss of penile sensitivity. To date, a number of treatment modalities have been implemented for PE, including topical anaesthetic agents, selective serotonin reuptake inhibitors (SSRIs), and opiates . PE is defined as an ejaculation that nearly always occurs before or within about 1 min of vaginal penetration. In conclusion, HA is emerging as a valid choice for the treatment of acute-phase PD, may contribute to the stabilisation of the disease and to improvement in the clinical picture, and should be regarded as a viable early option before considering any other possibilities. The majority of the above-mentioned trials were relatively large, had a prospective randomised design, and all of them consistently showed a reduction in the volume of plaque, along with a clinically modest but statistically significant decrease in the severity of the curvature. This efficiency makes nonsurgical penile augmentation an appealing choice for those seeking safe alternatives to surgery. Unlike surgical options, which typically involve longer recovery times, injectable treatments for penile enhancement require only a brief rest period. These injectable gels can increase penile girth, helping many men achieve improved aesthetics.