In studies and surveys conducted during 2017-2020 involving 25, 594 men, 45% indicated that they would like to have a larger penis. However, few people decide to undergo surgery. Today, there is an alternative to surgical intervention - penis enlargement with hyaluronic acid (HA-hyaluronic acid). In the article we will understand all aspects of this technique, its effectiveness and safety.
What is this procedure
Penis enlargement with hyaluronic acid is a minimally invasive procedure that involves introducing a biocompatible filler under the skin of the penis or glans with thin needles or Venfor (cannulas). The result after correction appears immediately and lasts from one to two years, depending on the characteristics of the filler itself.
Hyaluronate is a temporary filler and has been approved as a safe and effective soft tissue plumping agent. In this way, you can increase the circumference of the penis by 2-3 cm, and the length by 1-3 cm. Moreover, in the first month the effect constantly increases. This is because hyaluronic acid attaches and holds water molecules, increasing the volume of the penis.
In aesthetic medicine, several names are used for this method of penis enlargement:
- intimate contour plastic surgery;
- penis augmentation with hyaluronate;
- intimate filling;
- injection phalloplasty.
Increasing the size of the penis with hyaluronic acid is a non-surgical procedure, performed on an outpatient basis, and the patient can return home immediately after administration of the drug.
Increasing penis size with hyaluronic acid is a safe procedure. The need for safer and more effective, less invasive treatments has increased in all areas of modern medicine. Penis enlargement with hyaluronic acid solves three problems at once: medical, psychological and aesthetic. In the United States, soft tissue fillers are the second most popular minimally invasive procedure, with more than 2. 6 million such fillers performed in 2019.
Is it necessary to enlarge the penis with fillers?
Each case is individual, and it is impossible to give a universal answer. With a good erection, even a small penis can give pleasure to a woman and bring her to orgasm. This is due to the fact that the most sensitive G spot is located on the front wall at the entrance to the vagina. You can learn more about normal penis size in this article.
Indications for injections into the shaft of the penis
The introduction of hyaluronate into the shaft of the genital organ is carried out for several indications:
- psychological problems associated with small penis size;
- insignificant thickness of the penis, or the so-called "thin penis";
- insufficient stimulation of the partner’s vagina during intercourse and her dissatisfaction;
- disproportion of the parameters of the partners’ genital organs (large vaginal volume and small penis);
- erectile dysfunction of a psychogenic nature associated with the syndrome of expectation of failure due to the small size of the penis;
- Peyronie's disease - curvature of the shaft of the penis;
- defects of the urethra;
- consequences of unsuccessful operations on the genital organ;
- fibrosis of the cavernous bodies;
- genetic and hormonal pathologies leading to underdevelopment of the penis, micropenis.
It should be noted that the correction of hyaluronic acid into the shaft of the penis does not increase the length of the penis, but only gives it volume, increasing the size of the girth and diameter, although visually the penis looks more impressive in a calm state and during an erection.
Indications for injections into the head of the penis
Minimally invasive enlargement of the head of the penis with hyaluronic acid is performed for the following indications:
- small size of the head of the penis relative to the shaft (thin head);
- the crown of the head is insufficiently pronounced;
- smoothed frenulum;
- wrinkled mucous membrane of the head;
- deformation of the head of the penis after injury;
- premature ejaculation.
This correction of the head can not only improve its shape, but also increase its length.
What results can you expect after injections?
After introducing filler into the shaft, its girth increases by 1-2 cm, and the procedure in the glans not only improves its aesthetic qualities, but also lengthens the penis by 3-5 cm. Once under the skin, hyaluronate is evenly distributed, smoothes the skin and mucous membranes, improvingappearance of the penis. Administering the gel helps to increase the relief of the corolla of the head, its width, highlight the frenulum, make it more convex, change the shape and volume of the head.
At rest, the penis filled with hyaluronate is heavier, so it appears longer, due to the fact that it is not retracted into the groin. When erect, it looks thicker than before the injections, but the length remains the same.
Gel injections into the head of the penis help men suffering from premature ejaculation cope with this problem. Hyaluronate is injected into the sensitive part of the head - the frenulum. The substance penetrates the subcutaneous layer and is distributed in the intercellular space, shifting some of the receptors to the lower subcutaneous layers. As a result, the sensitivity of the penis decreases, and the man can control the onset of orgasm.
How long does the effect last?
The results of the first filler injection last from nine months to two years. Moreover, the volume constantly increases during the first six months due to the fact that the disintegrated short units of hyaluronate retain more water. The enzyme dehyaluronidase then gradually breaks down the acid. After 12 months, more than 30% of the gel disintegrates. To restore volume, it is recommended to repeat the procedure. Hyaluronate tends to break down less with repeated injections.
According to reviews, such penis enlargement with hyaluronic acid increases a man’s sexual attractiveness, increases the quantity and quality of sexual intercourse, while experiencing more vivid sensations from additional stimulation and giving pleasure to his partner, which also increases a man’s self-esteem.
Is hyaluronic acid safe?
Hyaluronic acid (hyaluronate, hyaluronic acid) belongs to mucopolysaccharides and is part of the epithelium, nervous and connective tissues. It is contained in the extracellular space, in biological fluid, including biological lubricant. The body of an average weight person contains about 16 g of this substance. Hyaluronate is involved in tissue hydrodynamics and cell reproduction. It is with this feature that its regenerating effect is associated.
The substance contains up to 25, 000 disaccharide units and is capable of holding the same amount of water. It is this ability of the polysaccharide that gives the hyaluronate and penile tissues additional volume. Therefore, the introduction of exogenous hyaluronic acid is absolutely safe for humans.
This compound is not rejected by the body and does not cause allergies. It has been used in medicine since the 80s of the last century to increase the viscosity of synovial fluid in joints. The technique of increasing the volume and length of the penis with hyaluronic gel appeared relatively recently, but has gained the trust of men as an effective procedure that does not require surgery.
Recommendations for choosing hyaluronic acid filler
The choice of filler is up to the doctor. Gels differ in composition, density, and percentage of hyaluronic acid. Some fillers add a local anesthetic to reduce pain after the procedure, but such formulations are more expensive. The density is chosen by the doctor in accordance with the objectives and the injection site.
Many fillers for injection into the penis indicate that the product contains cross-linked hyaluronic acid. It consists of alternating monomers of D-N-acetylglucosamine and D-glucuronic acid. The monomer units are cross-linked into a polymer using biocompatible urea. Such cross-linked biopolymers tend to last longer in the implanted area compared to conventional hyaluronate and improve the quality of filling of penile tissue.
How to perform penis enlargement with hyaluronic acid
The procedure itself is preceded by a preparatory stage. The andrologist collects anamnesis, asks about systemic and chronic diseases, psychological problems, and conducts an examination. Patients consent to the processing of their personal data. Before the procedure, tests are taken:
- general blood analysis;
- urine test;
- blood test for clotting.
Additional studies may be needed according to indications.
Penis augmentation with hyaluronate is performed on an outpatient basis. Before correction, the hair in the groin area is shaved. The procedure is performed under local anesthesia.
The introduction of filler into the penis takes place in several stages:
- The groin area is treated with an antiseptic and covered with a sterile disposable diaper.
- An anesthetic gel is applied to the penis, which takes effect after 15 minutes.
- The required amount of the drug with hyaluronic acid is drawn into the syringe. A thin needle is inserted into the subcutaneous layer and filler is slowly injected. The doctor ensures that the hyaluronate is evenly distributed in the injection area.
- An aseptic bandage and patch are applied to the injection site.
The duration of the procedure depends on the number of injections and takes from half an hour to an hour, taking into account the time for anesthesia at the sites for introducing hyaluronic acid
Methods of administration
There are several methods for introducing filler into the head of the penis. The doctor chooses the technique according to indications. More often, several methods are combined to improve the aesthetics of the head of the penis:
- Fan method— hyaluronate is injected with a thin needle in different directions through one fan-type puncture.
- Spot method- the injection is performed on a limited part of the penis to eliminate irregularities or deformation.
- Contour introductionThe filler is applied along the crown of the head, after which the contour becomes voluminous and more pronounced.
Features of the recovery period
After correction, pain may occur at the injection sites, which can be easily relieved with lidocaine spray. The penis looks swollen, and small hematomas may appear. Swelling can persist for up to 5 days, hematomas resolve on the 6th day. There is slight redness at the injection site. All these changes should not be scary. It must be taken into account that this is a very sensitive organ with a large number of nerve endings and small vessels. Many men report frequent nighttime erections after the procedure. Serious complications are extremely rare and are most often associated with poor hygiene and infection of injection sites, which become entry points for microorganisms. Sometimes hyperpigmentation may be observed at the site of the hematoma.
Restrictions after the procedure
After the introduction of hyaluronic acid, there are a number of restrictions and recommendations:
- interrupt intimate life for two weeks;
- antibiotics are required for 5 days, then as indicated;
- be sure to treat the penis with anti-inflammatory and antiseptic agents;
- do not take hot baths, exclude baths and saunas for a week.
Contraindications
Like any other procedure, filler injection has a number of contraindications:
- exacerbation of chronic diseases;
- blood diseases, including bleeding disorders;
- inflammatory diseases and acute viral infections (fever, fever);
- taking antibiotics and anticoagulants;
- diseases of the immune system;
- herpes in the acute stage;
- malignant tumors;
- diabetes.
Hyaluronate injections are not carried out if a man at this time has an elevated body temperature, fever, or if there are rashes or ulcerations on the penis.
Clinical studies of the results of filler injections
Fillers appeared in our country relatively recently, so long-term clinical studies in this area have not been conducted. However, such experience has been accumulated in foreign clinics. The results of one of the long-term observations conducted in the Department of Urology of the Cha Meditech Co. , Ltd. Clinic, Korea by scientists led by Professor De Yul Yang have already been published. These studies aimed to summarize the long-term clinical results of hyaluronic acid (HA) injections.
The multicenter, randomized trial was conducted for 18 months after a single filler injection between November 2016 and May 2018. It included 67 healthy men aged 20 to 66 years who considered their penis to be smaller than normal for an adult. .
All observed men underwent an initial examination before the study, and a detailed medical history was compiled on them with an emphasis on psychiatric and psychological problems. They consented to the processing of their personal information.
The study was conducted using SAS version 9. 4 (SAS Institute Inc. , Cary, NC, USA) by an independent biostatistician. During the blinded portion of the study, all post-injection assessments at each site were performed by an independent physician who was not involved in screening or injection of excipients.
Research results
Overall, the penises were smooth, natural and pliable, and the increase in girth was maintained for up to a year and a half after the filler injections. No unevenness, retraction, hardening or deformation of the penis, or migration of fillers was observed. Six months after the injection, the average increase in penile girth was 1. 91 cm. Then the average girth gradually decreased until 18 months and after one and a half years it was +1. 79 ± 1. 41 cm.
Dynamics of increase in penile girth after injection of filler with hyaluronic acid:
| Study period after administration | Average girth of the penis in the group (cm) | Deviation from the average value (cm) |
| Before injection | 7. 74 | ±1. 40 |
| 1 month | 10. 15 | ±1. 57 |
| 3 months | 10. 25 | ±1. 64 |
| 6 months | 9. 74 | ±1. 83 |
| 18 months | 9. 08 | ±1. 87 |
Satisfaction level
After one month, the indicators of the appearance of the penis increased significantly. This improvement lasted up to six months. Thereafter, they gradually decreased until 18 months, but scores at one and a half years were significantly higher than at baseline. After three months, rates of sexual activity increased significantly. This increase lasted up to one and a half years.
Results of the study
The study found that the hyaluronic acid filler resulted in a significant increase in penile girth and increased satisfaction associated with the injection. The procedure was tolerable and no major complications were observed over 18 months.
Hyaluronic acid consists of natural ingredients and has a direct and passive effect. After injection, the filler is gradually absorbed by the surrounding tissues. As hyaluronate breaks down into smaller fragments, the molecules bind more water; the same volume can be maintained with less hyaluronic acid for several months. Then the result steadily decreases. The enhancing effect of the filler lasts up to 18 months.
The results of the present study are comparable to the results of previous trials and prove the clinical utility of the gel, its effectiveness and safety. Because hyaluronic fillers are temporary, long-term follow-up after injection is of utmost importance. Regarding the augmentative effect, penile girth after filler injection increased to a maximum within about one month. Satisfaction with the appearance of the penis increased significantly approximately one month after the filler injections. This increase lasted approximately 6 to 12 months. Then they gradually decreased until one and a half years; however, satisfaction levels were still higher than at baseline.
The study demonstrated that increased satisfaction with sexual activity after filler injections lasted 18 months, despite the increased penile girth gradually decreasing over time. The discovery suggests that injecting the filler may alleviate the psychological stress associated with sexual activity. This also supports the idea that men who want to enlarge their penis experience psychological stress. They often require psychological counseling or psychotherapy.
Compatibility of hyaluronate injection with other types of augmentation
The introduction of hyaluronate into the penis can be combined with other surgical interventions:
- ligamentotomy— surgical intervention to intersect the ligament supporting the penis;
- liposuction in the pubic area— extraction of adipose tissue that hides the penis in obese men;
- lipofilling- increasing the girth of the penis shaft with subcutaneous injections of its own lipids;
- scrotal plastic surgery- removal of the scrotal sail, which hides centimeters of the genital organ;
- circumcision of the foreskin- excision of the dermis around the head;
- denervation of the head- reduction of sensitivity by excision of part of the nerves of the penis.
The decision on the compatibility of certain types of penile correction and the need for such surgical interventions is decided by the doctor separately in each specific case.