Is penis filler safe? Risks and side effects

What is common?

Swelling for days to a couple of weeks, bruising, and tenderness or firmness where the filler was placed. These are the tissue’s response to added volume, not complications, and they resolve on their own. The result can look larger in week one than it will settle to.

What is uncommon?

Unevenness — a ridge or a lump where filler has pooled. If it happens, it can be corrected: the physician smooths what needs smoothing, and occasionally a small amount of hyaluronidase is used to dissolve a lump. A follow-up visit is available at no extra charge if you want or need one. Sexual activity waits 7 days so the filler settles where it was placed.

What is rare but serious?

Three things. Infection at the injection site, treated with antibiotics. Migration, where filler moves from where it was placed and has to be dissolved or corrected. Vascular occlusion, where filler enters or compresses a blood vessel and starves the tissue beyond it — rare, but an emergency, and the reason the physician places filler with a blunt cannula, in a plane away from the main vessels, and keeps hyaluronidase in the room. Pain that increases rather than eases, or skin that turns pale, dusky or mottled, is the signal to call the same day.

Can filler travel to the lungs?

Filler can enter a vein and travel through the bloodstream to the lungs, where it lodges in the blood vessels. The medical term is pulmonary embolism, and it’s classed as non-thrombotic because the filler itself forms the blockage. It’s a separate event from vascular occlusion: occlusion happens at the injection site, and this happens in the lungs. It is extremely rare — only a small number of cases have been reported worldwide — but it can be fatal: deaths have been reported after hyaluronic acid filler injections into the penis.

Hyaluronidase, the enzyme that dissolves HA filler, works on filler where it was placed. Filler that has reached the lungs is a medical emergency, treated in hospital. Call 911 immediately if you have chest pain, shortness of breath, coughing or a racing heartbeat in the hours or days after treatment.

Who is not a candidate?

Men with an active infection in the area, certain bleeding disorders, or an unrealistic expectation the physician cannot meet honestly. Blood thinners, diabetes and every medication you take are discussed at the consult because they change the plan. Men with a penile implant are often candidates, with extra care — see filler with an implant.

Why hyaluronic acid?

Because it is reversible. HA is dissolved by hyaluronidase, so a result you do not like or a lump that will not smooth can be dissolved. Permanent fillers and silicone cannot be, and much of the practice’s correction work is on material placed elsewhere that no longer can be removed. Radiesse®, offered at select offices blended with HA, is calcium hydroxylapatite, not hyaluronic acid: it is longer-lasting, and hyaluronidase does not dissolve it — only its HA component dissolves.

Is it FDA-approved?

The HA products used are FDA-approved for facial cosmetic use; their use in penile enhancement is off-label, as it is at every clinic offering it. Off-label is a description of the approval status, not of the evidence — the physician explains what the published data show and where they stop.

What should I ask any provider?

Who does the procedure and what their training is. Which filler, by name. What happens if something goes wrong, and whether hyaluronidase is on site. Whether a follow-up visit is included.