Picture of Dr. Joel Pash - Medical Director and CEO

Dr. Joel Pash - Medical Director and CEO

A closeup shot of a syringe without a needle

Botox or Xeomin are neuromodulators made from botulinum toxin.  These are commonly used in aesthetic medicine to decrease wrinkles on the face and in neurology to treat migraine headaches.  Based on the understanding that botulinum toxin causes a relaxation in smooth muscle, urologists considered using it with the intent of relaxing cavernosal smooth muscle in order to improve erections.  You may have heard the term Bocox.  This is a similar procedure to the above as it also uses botulinum toxin to relax cavernosal smooth muscle.

After Bryan Johnson (silicone valley biohacker / founder of Braintree) began using Botox on his penis in order to increase length and improve erections, Upsize took notice and developed the Firm-X procedure.  Dr. Pash then did a QA session with Mr. Johnson at a San Francisco event which was covered by the media resulting in an article in the San Francisco Standard.

Botox for ED (Bocox, Firm-X)

Botox (botulinum toxin) has been the focus of many academic studies to determine its effect on treating erectile dysunction (ED).  In one study on 60 men with ED, botulinum toxin injections into the corpus cavernosum (100 units) showed a significant improvement in erectile dysfunction with a peak effect occuring at 6 months post injection.

Secondary outcomes of the study included decreased dependence on ED drugs such as Viagra or Trimix and a small increase in erect length (1cm.)

In summary, this study, and several others, have shown that a simple procedure/injection can have a dramatic effect on ED and erections.

Botox for Length

As above, the secondary effect of intracavernosal botulinum toxin injections can be an increase in erect length of about 1cm.  Patients also notice that the relaxation of the vasculature results in decrease “shrinkage”.  Between the decrease in “shrinkage” and the 1cm erect length increase, there can be a reasonably noticeable length increase.

It is important to point out that the expectation for length increases needs to be reasonable.  1cm is not a huge change, but every cm counts.  There really is no way in the penile enhancement field to get dramatic increases in penis length (particularly any amount of erect length) therefore intracavernosal botulinum toxin really is a great options for those seeking length.

Scrotox (scrotal botulinum toxin)

Botulinum toxin injected into the scrotum can have a similar effect as to when its injected into the face.  Essentially, the intent is to get rid of wrinkles (or scrotal rejuvenation.). After injection of 30 or more units of Botox into the dartos muscle in the scrotum, it will appear larger and smoother.  As with most Botox procedures, the effects typically take about 3-10 days for peak effect.

How Does the Firm-X Procedure Work?

The procedure involves placing a tourniquet around the penis and then injecting botulinum toxin into the corpus cavernosum using a small needle. The theory behind this is that Botox can stay in the corpus cavernous due to the tourniquet to eventually relax the smooth muscle in the penis vasculature, thereby improving blood flow. Improving blood flow leads to firmer erections. The added bonus is that it is possible to get a slight increase in penile length.  We don’t want to get you too excited, as we are talking about 1cm or so, but every bit counts.  With the penile lengthening component, the rationale is that when the vasculature’s smooth muscle is relaxed, the penis appears larger (similar to having a partial erection.)  Potential Benefits

So in summary, potential benefits of penile botox injections (bocox) include:

  • Improved Erection Quality: As above, by increasing blood flow to the penis, erections become easier to get and maintain.  Studies have even shown that patients resistant to ED medications can benefit from this.
  • Increased Confidence: Even a small increase in penile length or improved erectile function can significantly increase confidence and satisfaction.
  • Non-Invasive Procedure: Compared to injectable medications for ED, Firm-X only needs to be done every 6 months or so.
  • Increased Penis Length: Although limited to 1cm in length, every cm counts and this is a far more straightforward process compared to stretching and surgeries.

Penis Botox (Firm-X) Results

As with any cosmetic procedure, results can vary amongst individuals. The typical patient however can expect:

  • Increased Flaccid Length – We have seen p[atients gain about 1cm in length.
  • Become a “Shower” rather than a “Grower”: Because the penis shrinks due to vasoconstriction when not excited, the neuromodulators will decrease this effect somewhat. Therefore we have seen the penis be more prominent when flaccid.
  • Improve Erection Quality, Firmness and Size – Because a firmer erection would typically be larger, we have seen patients report a larger appearing erection. Additionally, neuromodulators have been used as ED treatments making it easier to get an erection. For those who do not have ED, they can expect to see better, firmer erections.
  • Duration of 6-9 Months – We have seen the Neuromodulators last up to 6-9 months (again, results may vary – this is an average).

Further Questions about Penis Botox?

Visit our pricing page for further Length-X info or contact us for your free phone consultation.  Prices start at $1890 and appointments are available at all of our clinics nationwide.

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