Penis Enlargement Options: How the Methods Compare

Hyaluronic Acid Filler (Upsize™ — Urosculpt™ Certified)

The Upsize™ procedure uses premium, FDA-approved hyaluronic acid dermal filler delivered via a proprietary cannula-based technique under local anesthesia. Performed exclusively by Urosculpt™ certified physicians, the technique achieves even filler distribution and significantly lower correction rates than conventional injection approaches.

Key advantages: 30-minute procedure, same-day return to activity, no general anesthesia, no incisions, fully reversible with hyaluronidase, natural look and feel, ~24-month average duration, available at 19+ locations. Learn more →

Ligamentolysis (Suspensory Ligament Release)

A surgical procedure that severs the suspensory ligament connecting the penis to the pubic bone, allowing the internal portion to extend further forward. This can add 1–2 cm of flaccid length but does not affect erect length and offers no girth enhancement.

Considerations: Requires general anesthesia, 4–6 weeks recovery, risk of erection angle change (downward deflection), potential scar tissue formation, and irreversibility. Studies show inconsistent patient satisfaction. Months of post-surgical stretching or traction may be needed to prevent reattachment.

Silicone Implants (Penuma, Custom Prostheses)

Surgical insertion of a custom silicone sleeve beneath the penile skin to increase both girth and, in some cases, perceived length. This is a major operation performed under general anesthesia with a significant recovery period.

Considerations: 2–3 hour surgery, 4–8 weeks recovery, risk of infection, implant migration, erosion, reduced sensation, and extrusion. Irreversible — revision surgery is complex and outcomes are unpredictable. Limited long-term safety data for cosmetic penile implants.

Biological Mesh Implants

A surgical technique using acellular dermal matrix or other biological scaffolding wrapped around the penile shaft beneath the skin to add girth. The body gradually integrates the mesh into native tissue over time.

Considerations: Requires general anesthesia, 4–6 weeks recovery. Risk of uneven tissue integration, fibrosis, and contour irregularities. Irreversible. Outcomes depend heavily on the individual surgeon's experience with this specific technique, which is not widely standardized.

Fat Transfer (Autologous Lipofilling)

Fat is harvested from another body area (typically abdomen or thighs) via liposuction, processed, and injected into the penile shaft. This two-site procedure is performed under general anesthesia.

Considerations: The primary concern is reabsorption — the body reabsorbs 30–70% of transferred fat within the first year, producing unpredictable and often asymmetric results. May require multiple sessions. Risk of fat necrosis, cyst formation, and irregularities. Not reversible in the way HA filler is.

⚠ Permanent Fillers (Silicone Oil, PMMA, Non-Resorbable Materials)

Upsize™ strongly advises against permanent injectable fillers for penile enhancement. Liquid silicone oil, PMMA (polymethyl methacrylate), and other non-resorbable materials carry severe, well-documented risks when injected into penile tissue.

Known risks include: granuloma formation (chronic inflammatory nodules), filler migration through tissue planes, disfigurement, chronic pain, fibrosis, tissue necrosis, and in severe cases, partial or complete loss of penile tissue requiring reconstructive surgery. These complications may appear months or years after injection and are extremely difficult — sometimes impossible — to correct.

If you have received permanent filler and are experiencing complications, contact us about correction options.