We aimed to evaluate the efficacy and safety of penile girth enhancement (PGE) using hyaluronic acid (HA) filler with different physical properties from previous studies. A third patient may find that the comprehensive support and aftercare provided by estethica enhance the overall value of the procedure. For instance, a patient who achieves a significant boost in self-confidence and sexual satisfaction following penile augmentation is likely to view the procedure as a valuable investment. Before the surgery, patients at estethica will undergo a comprehensive medical evaluation to assess their overall health and suitability for the procedure. Furthermore, estethica emphasizes the importance of post-operative care to ensure proper healing and long-term satisfaction. The data required to reproduce these findings cannot be shared at this time due to legal and ethical reasons. The PEP questionnaire has yet to be validated as a sensitive tool for evaluating PE. By making minimal alterations to the material, manufacturers have created HA products that are well tolerated by the immune system and exhibit favorable properties of longevity and nonreactivity . Assessing the value of penile augmentation involves careful consideration of various factors. Understanding these elements can help individuals make informed decisions about whether penis enlargement surgery is a worthwhile investment for their personal well-being. These factors include the patient's desired outcome, the surgeon's expertise, and the overall quality of care received. Additionally, estethica integrates advanced techniques, such as microblading, to improve skin texture and minimize scarring, enhancing the overall aesthetic outcome. Understanding what to expect before and after penile augmentation is essential for managing expectations and achieving optimal results. In fact, the HA concentration of the filler in this study was 23 mg/mL, which was higher than the 20 mg/mL HA concentration in previous studies, and the cross-linking degree was 12%, which was higher than the 6%–10% reported in previous studies. Although an ideal filler for PGE has not yet been established, among reversible fillers, HA has become dominant and popular . HA, calcium hydroxylapatite, polymethylmethacrylate microspheres, and PLA fillers have been examined for use in PGEs 12,17,18. Both groups showed significantly improved PEP index scores at 24 weeks post-injection; no significant differences were observed between the groups (Table 3). The mean penile girth at baseline was 81.75±9.86 mm in the HA group and 80.37±6.79 mm in the control group (no significant difference). Patients seeking a substantial increase in length or girth may perceive the value differently than those looking for more subtle enhancements. The perceived value of male enhancement surgery is influenced by a variety of factors that extend beyond the actual monetary cost. Proper preparation and adherence to post-operative guidelines are crucial for a successful penis enlargement surgery experience. After the surgery, patients can expect some swelling, bruising, and discomfort, which can be managed with pain medication. Key Considerations for Safe Penis Enlargement Surgery Thus, PLA filler was selected as a control to evaluate the effect and safety of HA filler injection for PGE in this study. Penile augmentation (PA), including penile girth enhancement (PGE), has been primarily performed in men with sexual dysfunction caused by anatomical abnormalities, such as in Peyronie's disease 1,2. PGE with HA and PLA fillers resulted in significant enhancement of girth without serious AEs with no significant differences. 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. 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. The PLA filler used for the control group in this study was also a nonpermanent filler and has been approved for PA in many countries . Vardi Y, Har-Shai Y, Gil T, et al. Zhang GX, Weng M, Wang MD, et al. Augmentative phalloplasty. Therefore, the filler injected between the Buck's fascia and the dartos fascia is speculated to act as a barrier between the tactile stimuli and the dorsal nerve ending receptor in the penile shaft, which reduces the sensation threshold. Although the reason for this has not been clearly demonstrated, it is considered to be the same mechanism as that of glans penis augmentation using HA filler for the treatment of PE . The properties of HA fillers and the results of previous studies and the current study are summarized in Table 4. Satisfaction level regarding penile appearance and sexual life significantly increased in both groups. The mean increase in girth was 22.74±12.60 mm and 20.23±8.73 mm in the HA and control groups, respectively. Patients recruited between December 2017 and March 2018 were randomly assigned to the HA filler or control group (polylactic acid PLA filler). This was a prospective, patient/evaluator-blinded, randomized, active-controlled, multicenter trial. Or, another patient who opts for fat transfer and experiences a substantial and natural-looking increase in girth. Phalloplasty, a more complex procedure, is reserved for specific cases where significant reconstruction is required. Fat transfer, on the other hand, offers a natural-looking increase in girth, but some of the injected fat may be reabsorbed by the body over time. At estethica, we are dedicated to providing evidence-based treatments and debunking common myths, ensuring patient safety and satisfaction. This dedication to patient safety and meticulous surgical practices ensures that individuals receive the highest standard of care. At estethica, we prioritize patient safety by offering evidence-based surgical options for penile augmentation. Many men considering male enhancement surgery are driven by a desire to improve their self-esteem, body image, and sexual confidence. Clinical safety and effectiveness of penile reaugmentation. Health information on this website has been obtained from health professionals specialised in their own fields. We provide detailed consultations to meticulously assess patient expectations and ensure comprehensive understanding of potential outcomes. Another individual might find that addressing perceived size inadequacies alleviates anxiety and enhances overall psychological well-being. We also integrate advanced techniques, such as microneedling, to improve skin texture and minimize scarring, enhancing the overall aesthetic outcome. This commitment to patient safety and meticulous surgical practices ensures that individuals receive the highest standard of care. A third patient might explore non surgical penis enlargement methods like lip filler, but ultimately decides on surgery for more permanent results. These procedures are performed with precision and care to ensure optimal results and patient satisfaction. Common methods include suspensory ligament release, which aims to increase the visible length of the penis, and fat transfer, which enhances girth using the patient's own tissue. Another individual might find that addressing perceived size inadequacies alleviates anxiety and enhances overall psychological well-being.At estethica, we strive to maximize the perceived value of our services by providing personalized care, utilizing advanced surgical techniques, and ensuring patient satisfaction.A major advantage of HA filler over temporary fillers such as fat and collagen is its low complication rate .The mean increase in girth was 22.74±12.60 mm and 20.23±8.73 mm in the HA and control groups, respectively.Although an ideal penile filler has not yet been established, PGE with HA and PLA filler resulted in significant PGE for 24 weeks post-injection and appears to be safe and stable.This was a prospective, patient/evaluator-blinded, randomized, active-controlled, multicenter trial.The injected HA filler (Doublofill; Humedix, Co., Ltd., Anyang, Korea) is a newly developed PGE product consisting of 23 mg of cross-linked HA in 2 mL of saline.Furthermore, estethica integrates advanced techniques, such as microneedling, to improve skin texture and minimize scarring, enhancing the overall aesthetic outcome. The impact of procedures such as microblading on self-esteem underscores the broader influence of aesthetic enhancements on overall well-being. Numerous studies indicate that a significant proportion of men experience heightened self-assurance and sexual gratification following penile augmentation. At estethica, our experienced surgeons provide comprehensive consultations to help patients make informed decisions. Understanding the elements that influence the perceived value of penis enlargement surgery is essential for making an informed decision. Another patient might prioritize the expertise of a highly skilled surgeon, even if it means incurring higher expenses, believing that the quality of care justifies the additional cost. This collaborative approach ensures that each patient has a clear understanding of what to expect and can make an informed decision about whether to proceed with the surgery. It's crucial to discuss your expectations and concerns with your surgeon to ensure realistic outcomes for your male enhancement surgery. Undergoing penis enlargement surgery involves careful preparation and a thorough understanding of the recovery process. Only 1 enrolled patient had a medication history of phosphodiesterase-5 inhibitor for erectile dysfunction and there was no patient who had a medication history for other sexual dysfunctions. Ten patients dropped out (four withdrew informed consent and six were lost to follow-up), leaving 64 subjects (32 each in the HA and control groups) who completed the trial (Fig. 1). 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. At estethica, we recognize the sensitive nature of these concerns and provide a supportive environment where patients can openly discuss their feelings and expectations. Additionally, our study is the first to report the impact on ejaculation of PGE using HA filler and is expected to serve as a catalyst for future research on PGE for the treatment of PE. 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. Although a placebo-controlled study allows better evaluation of the clinical effectiveness of a new treatment, there is a higher risk that nontreatment would be deemed ethically unacceptable by an ethics commission. Second, it is possible to criticize the study design, which uses an active control rather than a placebo control. At estethica, we provide a detailed consultation process to determine the most appropriate surgical approach. We also emphasize the importance of choosing a qualified and experienced surgeon to minimize the risk of complications. Another instance might involve a patient whose expectations are managed through detailed consultations, leading to a well-informed decision about the best course of action. Consider, for example, a patient seeking increased length who benefits most from suspensory ligament release combined with skin grafting. In contrast, relying on unproven methods might lead to disappointment or even physical harm. Furthermore, estethica emphasizes the importance of post-operative care to ensure proper healing and long-term satisfaction.Furthermore, it is necessary to determine whether HA fillers with different properties (HA concentration and cross-linking degree) show similar effects and safety to those of previously studied HA fillers.Furthermore, PGE using filler improved clinical symptoms related to ejaculation.Another patient might prioritize the expertise of a highly skilled surgeon, even if it means incurring higher expenses, believing that the quality of care justifies the additional cost.A third patient may find that the comprehensive support and aftercare provided by estethica enhance the overall value of the procedure.The pursuit of penile augmentation is often intertwined with complex psychological factors that extend beyond mere physical appearance.Within PEP, the score for control over ejaculation improved significantly in both groups. Of the 78 subjects who were screened, 4 who met the exclusion criteria were excluded; thus, 74 subjects were enrolled in the study and randomly assigned to the HA or control group. After the procedure, a mild compressive dressing was applied to the penis and left in place overnight. Depending on the penile size, 15–22 mL of HA or PLA filler was injected. Our surgeons adhere to stringent safety protocols, maximizing the likelihood of success while prioritizing patient safety. At estethica, we are committed to continuous refinement, constantly striving to elevate our techniques and improve patient outcomes. Additionally, some men discover that the positive changes resulting from surgery lead to a more fulfilling and satisfying sex life. The enhancement of self-esteem often translates into improved interpersonal relationships and a more positive body image. Patient satisfaction rates exhibit variability, contingent upon individual goals and the ultimate results of the surgery. A comprehensive consultation is essential for determining the most suitable penile augmentation technique. Our comprehensive consultations include a thorough assessment of the patient's anatomy, medical history, and desired results. Consider a patient who benefits from suspensory ligament release, achieving a significant increase in visible length and improved confidence. For instance, suspensory ligament release can provide a noticeable increase in length, but the actual gain varies from patient to patient. Based on the properties of HA fillers, in 2011, a group of researchers reported the feasibility and safety of PGE using HA fillers . 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 . PGE for cosmetic purposes requires clarification on various aspects, such as standardized methods and performing the procedure in patients with psychiatric distress . Safety Another individual may experience reduced anxiety about sexual performance, fostering a healthier and more satisfying sex life. By addressing the psychological aspects, we aim to enhance not only physical appearance but also emotional and psychological health. Concerns about penis size can significantly impact mental well-being, leading to feelings of inadequacy, anxiety, and even depression. It is well known that one of the two axons of the dorsal nerve is located along the dorsal midline and terminates in the glans, while the other group radiates from the main trunk over the lateral and ventral aspects of the penile shaft . This was considered to be due to the difference in the properties of the HA filler used in this study and in previous studies. Recent studies on PGE used HA fillers from different manufacturers, differing in HA concentration and degree of cross-linking, which determine the physical properties of HA fillers 13,14,15. We also address the issue of "how much does penis enlargement surgery cost" during these sessions, providing a transparent overview of the financial aspects involved.Thus, PLA filler was selected as a control to evaluate the effect and safety of HA filler injection for PGE in this study.Vardi Y, Har-Shai Y, Gil T, et al.In fact, the HA concentration of the filler in this study was 23 mg/mL, which was higher than the 20 mg/mL HA concentration in previous studies, and the cross-linking degree was 12%, which was higher than the 6%–10% reported in previous studies.Undergoing penis enlargement surgery involves careful preparation and a thorough understanding of the recovery process.Additionally, our study is the first to report the impact on ejaculation of PGE using HA filler and is expected to serve as a catalyst for future research on PGE for the treatment of PE.Esthetic PGE in patients with small penis syndrome who wish to have a penis enlargement despite a normal penis size requires a careful approach.Two subjects in each group reported inflammation at the site of injection that was mild and improved with conservative treatment. What is penile augmentation and who is a good candidate for male enhancement surgery? At estethica, we provide comprehensive support and guidance to ensure that our patients achieve their desired outcomes with confidence. In some cases, patients might consider complementary procedures like microneedling to improve skin texture and appearance after surgery. Furthermore, estethica's patient-centered approach ensures that each patient receives personalized care and attention throughout the entire process. Or, another patient might discover that non surgical penis enlargement methods like lip filler are not suitable for their specific goals, leading them to opt for a surgical solution. Advanced Penile Augmentation: Combining Suspensory Ligament Release with Fat Transfer for Enhanced Results At estethica, our experienced surgeons conduct thorough evaluations to determine the most suitable approach for each patient, ensuring realistic expectations and optimal outcomes. Navigating the landscape of penis enlargement surgery requires a clear understanding of safe and effective techniques. Or the individual who, through counseling, developed a more realistic expectation of the surgery's outcome, leading to greater satisfaction with the results. 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. These procedures typically include the release of the suspensory ligament to enhance length and the use of fat transfer or dermal filler penis injections for girth enhancement. The satisfaction level of the subjects on penile appearance and sexual life at 12 and 24 weeks post-injection significantly increased in both groups compared to that at baseline. This was designed as a prospective, patient/evaluator-blinded, randomized, active-controlled, multicenter trial to evaluate the efficacy, safety, and clinical impact of ejaculation following PGE using injectable filler 24 weeks after the injection. In addition to these, dermal filler penis injections offer a less invasive option for girth enhancement. Additionally, estethica provides comprehensive aftercare instructions to support optimal healing and long-term satisfaction. This expertise ensures that the procedures are performed with precision and care, reducing the likelihood of adverse effects. At estethica, we prioritize a holistic approach that addresses both the physical and emotional aspects of the procedure. As the PGE procedure was expected to increase the entire penile circumference, the mean penile girth was defined as the mean of the proximal, mid, and distal circumference measurements of the penis. Briefly, under local anesthesia with the application of EMLA cream (EMLA 5% cream; AstraZeneca Korea, Co., Ltd., Korea) or penile dorsal nerve block, patients were placed in the supine position, and a medical curtain was placed at the umbilical level for a patient-blinded procedure. 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). The subjects' penile girth was measured at baseline (before the procedure) and at 4, 12, and 24 weeks after the procedure. Therefore, in this randomized controlled trial, we aimed to evaluate the efficacy and safety of PGE using HA filler and its clinical impact on ejaculation. How long does penis enlargement surgery take and what is the recovery process like? During the study period, treatment-related AEs were assessed through vital signs, physical examination, and medical history obtained at each visit.The impact of procedures such as microblading on self-esteem underscores the broader influence of aesthetic enhancements on overall well-being.This was considered to be due to the difference in the properties of the HA filler used in this study and in previous studies.Briefly, under local anesthesia with the application of EMLA cream (EMLA 5% cream; AstraZeneca Korea, Co., Ltd., Korea) or penile dorsal nerve block, patients were placed in the supine position, and a medical curtain was placed at the umbilical level for a patient-blinded procedure.At estethica, we provide detailed pre- and post-operative instructions to ensure a smooth and successful recovery.Entry sites were made using 21-gauge or 18-gauge needles for the HA or PLA filler, respectively.Both groups showed significantly improved PEP index scores at 24 weeks post-injection; no significant differences were observed between the groups (Table 3). Furthermore, we use advanced techniques like microblading to enhance the aesthetic outcome, ensuring patient satisfaction. At estethica, we guide our patients through this process, providing them with the information and support they need to make informed decisions. For example, patients receive detailed instructions on wound care and activity restrictions to promote optimal recovery. The realm of penis enlargement surgery offers various techniques, each designed to address specific patient needs and anatomical considerations. For example, post-operative care might include specific exercises and skincare routines to promote healing and maintain the enhanced appearance. Techniques like microneedling can improve skin texture and appearance post-surgery, further boosting confidence. These psychological underpinnings are crucial for both patients and surgeons to understand, ensuring a holistic approach to treatment. The pursuit of penile augmentation is often intertwined with complex psychological factors that extend beyond mere physical appearance. However, since 2000, various soft fillers for minimally invasive procedures have been approved by the FDA, leading to several trials of dermal fillers that offer a less invasive alternative to the traditional surgical interventions for PGE. As a result, we achieved a high satisfaction rate for penile appearance during the post-injection follow-up period. These patients might suffer from a penile dysmorphophobic disorder, which might lead to poor satisfaction with penile enlargement treatment due to their unrealistic expectations of penile size . The satisfaction levels regarding penile appearance and sexual life during the study period are summarized in Table 2. The mean penile girth at 4, 12, and 24 weeks increased significantly in both groups compared to that at baseline (pFig. 3). Indeed, in the initial feasibility study of PGE using HA filler, most patients experienced decreased tactile sensation of the shaft . Several studies have demonstrated the therapeutic efficacy of glans penis augmentation using HA filler for premature ejaculation (PE) 3,23; however, the effect on ejaculation of PGE using HA filler without injection into the glans is unknown. Another interesting aspect of this study is that PGE improved clinical symptoms related to ejaculation in several patients. 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 . In this study, patients with psychiatric disorders were excluded, and procedures were performed after careful advice on the potential results of treatment and potential complications during the screening period. Or, a patient desiring girth enhancement who achieves satisfying results with carefully administered fat injections.The mean penile girth at 4, 12, and 24 weeks increased significantly in both groups compared to that at baseline (pFig. 3).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).At estethica, we recognize the sensitive nature of these concerns and provide a supportive environment where patients can openly discuss their feelings and expectations.We also consider innovative approaches, such as the use of dermal filler penis injections, to provide tailored solutions that meet individual needs.Understanding these elements can help individuals make informed decisions about whether penis enlargement surgery is a worthwhile investment for their personal well-being.At estethica, we guide our patients through this process, providing them with the information and support they need to make informed decisions. Esthetic PGE in patients with small penis syndrome who wish to have a penis enlargement despite a normal penis size requires a careful approach. 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. 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. Additionally, the patients' self-estimated intravaginal ejaculation latency time (IELT) was documented at baseline and 24 weeks after the procedure. While certain procedures offer substantial enhancements in both length and girth, others yield more modest improvements. At estethica, we are committed to providing exceptional care and results that align with each patient's unique needs and expectations. Furthermore, we offer services such as microblading to enhance overall aesthetic satisfaction, ensuring a holistic approach to patient care. At estethica, we strive to maximize the perceived value of our services by providing personalized care, utilizing advanced surgical techniques, and ensuring patient satisfaction. At estethica, we focus on providing exceptional care and results that align with each patient's unique needs and expectations. 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. We believe that our study will provide useful information for clinicians to choose HA fillers among various available products. Despite these limitations, the present study showed the efficacy and safety of PGE using HA fillers with properties different from those of previous studies. At baseline, 18 subjects (8 in the HA group and 10 in the control group) reported a self-estimated IELT of At baseline, 20 subjects (10 each in the HA and control groups) reported a PEDT score ≥9. APaired t-test; bAnalysis of covariance test (injected volume of filler as a covariate). Baseline demographic and clinical characteristics were not significantly different between the groups (Table 1). For instance, suspensory ligament release can provide a noticeable increase in length, but the actual gain varies from patient to patient.Despite these limitations, the present study showed the efficacy and safety of PGE using HA fillers with properties different from those of previous studies.This commitment to patient safety and meticulous surgical practices ensures that individuals receive the highest standard of care.Assessing the value of penile augmentation involves careful consideration of various factors.Understanding the elements that influence the perceived value of penis enlargement surgery is essential for making an informed decision.Additionally, the patients' self-estimated intravaginal ejaculation latency time (IELT) was documented at baseline and 24 weeks after the procedure. Additionally, among the subjects who completed the ejaculation assessment, less than half showed clinical PE. Therefore, the current study used active treatment in the control group, as in previous studies. First, the study duration limits drawing a strong conclusion regarding the long-term efficacy of PGE using HA filler. Understanding the facts about safe penis enlargement surgery options is the first step towards making an informed decision. Furthermore, estethica integrates advanced techniques, such as microneedling, to improve skin texture and minimize scarring, enhancing the overall aesthetic outcome. Our commitment is to offer safe, effective, and natural-looking results, helping patients achieve their desired outcomes with confidence. There was no statistically significant difference between the groups with respect to change in the subjects' satisfaction with penile appearance compared to the baseline value at 12 and 24 weeks post-injection. On gross examination, injected fillers were well distributed throughout the penile shaft, enhancing penile girth, which was maintained for up to 24 weeks (Fig. 2). Although previous approval studies have evaluated subjective satisfaction regarding sexual performance, detailed information regarding ejaculation after PGE using injectable fillers is still unknown. Penile girth, satisfaction level, Premature Ejaculation Profile (PEP), and self-estimated intravaginal ejaculation latency time (IELT) were assessed at baseline and at 24 weeks post-injection. All subjects were informed and instructed about the objectives and procedures of the current clinical trial. During the study period, treatment-related AEs were assessed through vital signs, physical examination, and medical history obtained at each visit. Entry sites were made using 21-gauge or 18-gauge needles for the HA or PLA filler, respectively. Among voluntary applicants for the clinical trial, healthy men aged between 20 and 65 years seeking cosmetic PGE and having a heterosexual and stable sexual relationship were included. Additionally, the slow degradation of the HA filler through cross-linkage increases its longevity by a hundred times compared to that of natural polymer implants, without a decrease in biocompatibility . A major advantage of HA filler over temporary fillers such as fat and collagen is its low complication rate . Food and Drug Administration (FDA) in 2003, it has become the filler of choice in the dermal filler market and clinical practice . Furthermore, PGE using filler improved clinical symptoms related to ejaculation. Our commitment to excellence extends to every aspect of the treatment process, from the initial consultation to the post-operative follow-up. We also offer ongoing support and guidance to address any questions or concerns that may arise. A third patient might benefit from a detailed explanation of the potential risks and complications, helping them make a more informed decision. For instance, a patient might learn about the benefits of combining suspensory ligament release with fat transfer for optimal results. However, further studies are recommended regarding the efficacy and safety of PGE using fillers in patients with severe PE.Our comprehensive approach includes a thorough psychological assessment to determine if penis enlargement surgery aligns with the patient's overall well-being.Health information on this website has been obtained from health professionals specialised in their own fields.Patients were advised to abstain from sexual intercourse for 4 weeks after the procedure.At estethica, we prioritize a holistic approach that addresses both the physical and emotional aspects of the procedure.Patient satisfaction rates exhibit variability, contingent upon individual goals and the ultimate results of the surgery.Recent studies on PGE used HA fillers from different manufacturers, differing in HA concentration and degree of cross-linking, which determine the physical properties of HA fillers 13,14,15. Factors Influencing Satisfaction After Surgery Evaluating success rates and patient satisfaction is essential for determining whether penis enlargement surgery is the right choice for you. At estethica, we leverage advanced techniques like microneedling to optimize skin texture post-surgery, further boosting patient confidence. For instance, a patient who undergoes successful girth enhancement may report increased comfort and confidence during intimate encounters. Exploring Surgical Options for Penile Enhancement Vardi Y. Is penile enlargement an ethical procedure for patients with a normal-sized penis? At estethica, we prioritize open communication, personalized care, and continuous improvement to ensure the best possible outcomes for our patients. Achieving high levels of patient satisfaction in penis enlargement surgery requires a multifaceted approach. We also consider innovative approaches, such as the use of dermal filler penis injections, to provide tailored solutions that meet individual needs. At estethica, our experienced surgeons take the time to understand each patient's unique needs and goals. Additionally, estethica integrates advanced techniques, such as microneedling, to improve skin texture and minimize scarring, enhancing the overall aesthetic outcome. We prioritize patient safety and employ state-of-the-art equipment to minimize risks and maximize outcomes. Additionally, estethica offers counseling services to help patients manage their expectations and adjust to the changes following surgery.Therefore, in this randomized controlled trial, we aimed to evaluate the efficacy and safety of PGE using HA filler and its clinical impact on ejaculation.Understanding the psychological impact of male enhancement surgery is essential for ensuring patient satisfaction and overall well-being.Additionally, even if nontreatment does not harm the patients, it is difficult to conduct a blinded study using saline injection as a placebo control because volume expansion disappears soon in saline-injected patents.Choosing the right male enhancement surgery technique requires careful consideration of various factors.Our commitment to excellence extends to every aspect of the treatment process, from the initial consultation to the post-operative follow-up.Or, another patient might discover that non surgical penis enlargement methods like lip filler are not suitable for their specific goals, leading them to opt for a surgical solution. The natural-state HA filler, which is considered the most ideal filler, has a short half-life, which is a major drawback; however, a cross-linking process is used during manufacturing to stabilize the HA, leading to increased longevity . In particular, a major concern is that PGE is mainly performed for cosmetic purposes, unlike penile lengthening . Another limitation of conventional PA is that the procedure is invasive . This is consistent with other recent studies on PGE using HA and PLA fillers 13,14,15. Therefore, esthetic PGE should not be performed in patients with psychiatric disorders, and a multidisciplinary approach, including psychological counseling, is necessary. Consider the case of a patient who, after undergoing penile augmentation, felt a renewed sense of self-assurance, which positively influenced his career and personal life. Furthermore, some men find that addressing their concerns about penis size helps them overcome long-standing feelings of body image dissatisfaction. Our comprehensive approach includes a thorough psychological assessment to determine if penis enlargement surgery aligns with the patient's overall well-being. The Role of Consultation in Selecting the Right Procedure At estethica, our surgeons are skilled in all these techniques, ensuring that patients receive the best possible care. Understanding the psychological impact of male enhancement surgery is essential for ensuring patient satisfaction and overall well-being. Additionally, estethica offers counseling services to help patients manage their expectations and adjust to the changes following surgery. However, further studies are recommended regarding the efficacy and safety of PGE using fillers in patients with severe PE. In addition, in this study, we found that the effect on ejaculation did not negatively affect satisfaction with sexual life. Recently, several studies have demonstrated the efficacy and safety of PGE using HA fillers 13,14,15. There was no statistically significant difference between the groups in terms of increase in penile girth or change in satisfaction level. Additionally, estethica integrates advanced techniques, such as lip filler, to improve overall aesthetic satisfaction. Managing expectations is crucial for ensuring patient satisfaction with penile augmentation. This commitment to excellence ensures that each patient receives the highest standard of care and achieves the best possible results. Pain at the injection site was reported in one subject in the control group, and it was transient and self-limited. Two subjects in each group reported inflammation at the site of injection that was mild and improved with conservative treatment. Filler injection-related AEs in the HA and control groups were reported in two (6.3%) and three (9.4%) subjects, respectively. Within PEP, the score for control over ejaculation improved significantly in both groups. The ejaculation assessment was completed by 44 subjects (22 in the HA group and 22 in the control group). Four entry sites were made on the penile base and distal penile shaft at the 2 o'clock and 10 o'clock positions, respectively. Although the composition of the PLA filler is different from that of the HA filler, the application methods and expected effects are identical. The control group was injected with polylactic acid (PLA) filler, previously approved by the KMFDS for PGE. We ensure that every patient is well-informed and comfortable with the process, from the initial consultation to the post-operative care. This personalized approach ensures that patients receive the best possible care and achieve satisfying results. Choosing the right male enhancement surgery technique requires careful consideration of various factors. At estethica, we provide detailed pre- and post-operative instructions to ensure a smooth and successful recovery. The recovery period typically lasts several weeks, during which it's important to follow the surgeon's instructions carefully. We also address the issue of "how much does penis enlargement surgery cost" during these sessions, providing a transparent overview of the financial aspects involved. It is a biphasic HA product with a particle size of approximately 700 μm. The injected HA filler (Doublofill; Humedix, Co., Ltd., Anyang, Korea) is a newly developed PGE product consisting of 23 mg of cross-linked HA in 2 mL of saline. Additionally, we evaluated the clinical impact on ejaculation after PGE. In this article, we consider patient selection, outcome evaluation, and techniques applied. Surgery is thus far the only proven scientific method for penile enlargement. Patients were observed for 30 minutes after the PGE procedure to monitor injection site complications such as hemorrhage, pain, induration, swelling, and redness. The primary outcome was the difference in the change in mean penile girth in the HA and PLA groups at each follow-up visit. Patients were advised to abstain from sexual intercourse for 4 weeks after the procedure. Or, a patient desiring girth enhancement who achieves satisfying results with carefully administered fat injections. Although an ideal penile filler has not yet been established, PGE with HA and PLA filler resulted in significant PGE for 24 weeks post-injection and appears to be safe and stable. Additionally, even if nontreatment does not harm the patients, it is difficult to conduct a blinded study using saline injection as a placebo control because volume expansion disappears soon in saline-injected patents. 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. Furthermore, it is necessary to determine whether HA fillers with different properties (HA concentration and cross-linking degree) show similar effects and safety to those of previously studied HA fillers. Consequently, the Korean Ministry of Food and Drug Safety has approved several HA fillers for PGE.