The first dermal filler made of bovine collagen was approved by the FDA in 1981. For decades before then, physicians had experimented with injectable silicone, collagen, petroleum, paraffin, etc many times with devastating results. Then in 2003 the FDA approved the first hyaluronic acid dermal filler, Restylane, followed by Juvederm Ultra in 2006. Since then, over a million HA filler procedures have been done safely in the United States mostly in the face and in women. The use however in men is growing at an impressively fast rate. We are now seeing men who feel it is there turn to have cosmetic work done, knowing that their partners are doing the same. Hyaluronic acid is a compound naturally found in the body as one of the chief components of the extracellular matrix (the component of tissue that cells live in.). It has a important function in wound repair, granulation, cell migration and skin healing. It is for this reason that the results of procedures using it look and feel natural. In addition to being used cosmetically in the penis and skin, it is approved for use in the knee joint to treat osteoarthritis and in the eye as artificial tears. Although other types of fillers are available such as bovine collagen, human collagen, PLLA, PMMA, HA (Hyaluronic acid) is the only one that is completely reversible in the rare event of a complication or non ideal cosmetic outcome. It is for this reason that it is the safest.
We are able to use any Juvederm product or Ravanesse Versa for the enlargement procedure. Although Juvederm Voluma is popular, we have found the same if not better results using Ravanesse Versa. The reason for this is that different HA fillers all have slightly different properties. Of the fillers we have used, Ravanesse Versa tends to feel the most natural after the filler has integrated into the penile tissue.
Beware of the current trend of physicians using injectable silicone preparations for penis enlargement which purport to cause the body to naturally produce penile collagen. These silicone products are only approved for intraocular (eye) use and specifically for retinal detachments. Silicone has long been known to be unsafe for direct injection into the skin, subcutaneous tissue, facia and anywhere else except the eye, and we therefore do not recommend its use or use it ourselves.
The first instances of physicians injected hyaluronic acid in the penis was likely in Asia in the early 2000s. There are many scientific papers that have come out of Asia addressing this relatively new technique*. In the past 5-10 years the procedure has been growing rapidly in the United States and we would anticipate this growth to continue.
Moon DG, Kwak TI, Kim JJ, Cho HY. Effects of hyaluronic acid gel in penile augmentation. Int J Impot Res. 2002;14(Suppl 3):S40.
