Long before Ariana Grande injected "big dick energy" into the mainstream vernacular, the most desirable members — the pinnacle of penises, if you will — have usually been described as long, girthy, and maybe even a bit veiny. But, not every person with a penis has one with a length and circumference that could rival an extra-large bratwurst. In fact, a 2014 study published in the British Journal of Urology International reports that the average erect penis size is 5.16 inches in length and 4.59 inches in width. Yet, the endeavor for an above-average dick size seems to be never-ending: Penis fillers are not only on the rise, but multiple cosmetic surgeons say it's their most popular procedure.
According to Carla Manly, PhD, a clinical psychologist based in Sonoma County, California, the desire for a larger penis is more of a current phenomenon. "Ancient Greeks believed that those with smaller penises were more likely to possess positive traits such as intellectualism, restraint, and heightened wisdom," she says. So, how did we get to such a "bigger is better" mindset? "In today's culture, large penis size is associated with virility, strength, and manhood," says Dr. Manly. "Given that social media exposes the public to images that support the idea of a large penis, many men — be they cis or trans — feel that they should have larger penises to prove their virility or manliness."
Other mental health factors that could sway someone into exploring the procedure are gender dysphoria, body dysmorphia, or a simple desire to enhance their sexual appearance, according to Dr. Manly. "In my experience, individual choices are generally affected by personal preference, influences of cultural norms, and the individual's psychological history," she adds.
No matter what modern standards may make you feel, your worth, sexually and in general, is not defined by the size of your penis. With that being said, if the prospect of a girthier (and, potentially, longer) dick via a quick and, surprisingly, painless in-office treatment piques your interest, we tapped a few experts on the subject so you will know exactly what to expect. Read on for a crash course on penis filler, including results, risks, and costs.
Meet the experts:
- David Shafer, MD, is a double board-certified plastic surgeon located in New York City.
- Jason Emer, MD, is a board-certified dermatologist based in West Hollywood.
- Norman Rowe, MD, is a board-certified plastic surgeon located in New York City.
- David Goldberg, MD, is a board-certified dermatologist located in New York City.
- Hadley King, MD, is a board-certified dermatologist based in New York City.
- Justin Houman, MD, is a board-certified urologist at Tower Urology in Los Angeles.
- Carla Manly, PhD, is a clinical psychologist based in Sonoma County, California.
What is penis filler?
In its most basic explanation, penis fillers are injections into the penis shaft that can instantly increase its girth. According to David Shafer, MD, a double board-certified plastic surgeon in New York City, who happens to specialize in this procedure, both hyaluronic acid and biostimulatory fillers (ones that have an immediate plumping effect, but also prompt collagen production) can be used for this procedure — albeit off-label. As of now, the Food and Drug Administration has not approved any type of injectable for use on the penis. But Dr. Shafer recommends starting with hyaluronic acid fillers because their formula is dissolvable if patients aren't happy with a newly plumper look.
In case you're not familiar, hyaluronic acid is a molecule found in your skin and is known for its water-retaining properties. "In a laboratory, they make bonds between [hyaluronic acid] molecules to turn them into chains [that are used in filler]," says Dr. Shafer. However, not all hyaluronic acid fillers are created equal. "How thick the product is and how long the results will last depend on how long the [hyaluronic acid] chain is and how strong the bonds are between the molecules," he says. The chain's strength and length also impact how soft or stiff the results will be, so you can't just use any hyaluronic acid filler to get your ideal results. Dr. Shafer says he usually uses Juvéderm Voluma, a tried-and-true hyaluronic acid injectable usually used to enhance the chin and cheeks, or Juvéderm Volux, a newer formula that he says is three times as thick, has a longer staying power, and is less likely to migrate. It's extremely important to choose a filler with a lower risk of filler migration, as this issue can lead to a lumpy look or, in severe cases, a donut-like shape at the base of the penis. "Volux is going to stay where it is and give the penis more structure," he says.
Speaking of structure, penises don't stay in one position… According to Norman Rowe, MD, a board-certified plastic surgeon located in New York City, who also performs the procedure, fillers create a plumper appearance when the penis is both flaccid and erect, but how dramatic the results are depend on how much filler is used. "The filler doesn't enlarge when the penis is erect, so however big you are in girth in the flaccid state, you'll be that much bigger in the erect state," he says. Dr. Rowe also notes that his clients' circumference is usually increased to about 1.75 centimeters, which is just shy of an inch. "For lack of a better term, patients say it gives them a package," he adds.
While the results of Voluma and Volux can last up to two years, Dr. Shafer says more seasoned veterans of penile enhancement fillers can opt for Bellafill, a semipermanent injectable (meaning it can last, on average, for five years) that contains nonbiodegradable acrylic beads (also known as polymethyl methacrylate) suspended in bovine-derived collagen. "Bellafill can't be melted or softened like the Voluma or the Volux, and that's why I always tell patients it's never a first-try filler," says Dr. Shafer. "After we know that you have a good result and you're happy with the effect from hyaluronic acid-based fillers, it's something that we can transition over to if desired."
This is not to say that penis filler is without risks (more on those below) — especially when a semipermanent filler is involved. David Goldberg, MD, a board-certified dermatologist in New York City, used to perform penile injections but has refused to perform the procedure in the past six years due to the health risks, including infection and even tissue death. He says semipermanent injectables are not a good option for this area, noting that if your results aren't up to par, you'll be stuck with the Bellafill injectable for at least half a decade since it cannot be dissolved. "I think Bellafill's a great filler for acne scars, but I would never ever use it on a penis," he says. "Legally, someone can inject Bellafill into a penis for off-label use, but do I think it's smart? No."
What are the benefits of penis filler?
TL;DR: fillers aren't going to add inches in length to your penis, but as Dr. Rowe noted before, girth will be expanded. Though Dr. Shafer notes that a few of his patients have seen a slight increase in length of up to an inch after a few years of routine injections, Dr. Rowe says a significant difference in length is highly unlikely unless you decide to undergo a surgical procedure. This could entail an implant, and the experts we talked to all say to proceed with extreme caution here, because of the risk of infection (albeit infections can develop on injection sites alone) and implant malfunction. The girth effects can last anywhere from two to five years, depending on the filler you choose.
If you've had a phalloplasty (masculinizing gender-affirmation surgery), Dr. Rowe, Dr. Shafer, and Jason Emer, MD, a board-certified dermatologist based in West Hollywood, say you can explore this procedure. However, Dr. Emer suggests patients who have undergone a phalloplasty opt for reversible hyaluronic acid fillers rather than permanent options like Bellafill or silicone-based fillers. "I don't do silicone and I wouldn't do it in that type of patient because they have a reconstruction there and I wouldn't want to risk a migration or some long-term issue, especially when they've spent a lot of money and it's psychologically for them, very important," he says. "I would rather have something there that could potentially be reversed if there was ever an issue."
Dr. Rowe also notes that those who have undergone a phalloplasty have scar tissue, which can make injection sites harder to puncture. He also says that many patients who have undergone a phalloplasty have a pump in their penis for erectile purposes, which is something their provider should be cognisant of.
What does a penis filler procedure involve?
If you're used to filler injections elsewhere on your face or body, the technique is similar to injecting those areas, according to both Dr. Shafer and Dr. Rowe. "You're using those same skills and techniques that you would use elsewhere, but for another purpose, if that makes sense," says Dr. Shafer.
So, here's what you can expect: On the day of the treatment, you'll come into the office and will be taken to a private treatment room, where you change into a medical gown. Then, you'll lay down on a treatment table and a sterile drape with a hole in the middle for the penis to come through will be placed over your body.
Once you're in position and fully draped, the skin of your penis is cleansed with a sterilizing agent, similar to the skin prep before surgery. A small needle about the size of an insulin or Botox syringe is injected at the base of the penis and acts as a nerve block throughout the entire area, so you shouldn't feel pain during the procedure (but you'll definitely feel that first pinch). Once the local anesthetic is injected, the penis goes numb for about an hour — more than enough time to perform the treatment, since Dr. Shafer says that it takes approximately 15 minutes to do.
Dr. Rowe notes that a special cannula is then used to inject the dermal filler under the skin. The tip of the cannula is injected subcutaneously and well away from the erectile tissue of the penis "The injections are performed from the base toward the glans, otherwise known as the head of the penis and from the glans toward the base," says Dr. Shafer.
Rather than injecting the entire perimeter of the penis, the injections are performed 270 degrees around the circumference for a natural-looking shape, "similar to a cylinder, while staying clear of the urethra on the underside of the penis," says Dr. Shafer. Once the injections are done, the penis is then cleansed and antibiotic ointment is applied, followed by a sterile wrap dressing, which is kept in place for 24 hours. If you'd like a visual, both Dr. Emer and Dr. Rowe have videos of themselves performing the procedure (Warning: They're pretty NSFW).
It's worth noting that it takes about one to two weeks for the filler to completely settle, according to Dr. Shafer. "The filler is moldable during the first several days and the patient is encouraged to massage the areas to help keep the results smooth," he says. He also suggests booking a follow-up appointment scheduled three to four weeks after the treatment so your practitioner can ensure that everything is going smoothly.
Does penis filler hurt?
This is probably the biggest question on your mind and the answer is: duh. Yes, all our experts who perform this procedure say that, usually, a numbing agent like a nerve-blocking injection or a topical numbing cream is applied before the procedure begins, so you shouldn't feel anything or, at most, slight but tolerable discomfort during the procedure.
However, Dr. Goldberg notes that the pain after the procedure shouldn't be overlooked. The numbing agents wear off about an hour after the procedure, so mild swelling and bruising will probably happen by the time you step out of the office. "Typically, they get very black and blue. You can imagine what it feels like," he warns.
Dr. Rowe does have a few tips for minimizing the pain and bruising, though. He recommends avoiding blood thinners like Advil or aspirin for two weeks before the procedure since they can increase your chance of bruising. To minimize pain, he suggests patients use an arnica-infused topical to reduce swelling and redness. Sex and working out can also increase the chances of filler migration and bruising, so Dr. Rowe suggests staying away from both for two weeks.
Are there any risks, side effects, or downsides to penis filler?
First off, you need to go to someone who can perform the procedure properly — always by a board-certified dermatologist or cosmetic surgeon, never ever at a medi-spa. But even so, there are risks you should know about. "You don't want to inject any filler of any kind into a blood vessel, and the penis contains very large ones," says Dr. Emer. "If filler were to get into there, you could cause necrosis [tissue death] or damage to the penis itself."
As if necrosis isn't frightening enough, Dr. Goldberg says that hygiene of the genital area alone was enough to make him stop performing the procedure for good. Since the skin around your groin has more bacteria than the skin on your face, it's more susceptible to gnarly infections in the injection site. Another issue Dr. Goldberg has seen with penis injectables are unnatural shapes. "The skin of the penis is extremely thin and the skin of the face, overall, is not. If you put fillers in lips, the skin holds structure better and looks natural. It's very hard to do that on the penis because the skin is so thin.” he says. "You [can] end up getting some asymmetry."
Hadley King, MD, a board-certified dermatologist based in New York City, adds: "A 2021 study published by the Asian Journal of Andrology that followed 230 patients who had penile augmentation with hyaluronic acid fillers showed 4.3 percent experienced complications such as subcutaneous bleeding, nodules, and infection. These complications were treated and no severe outcomes were seen." To avoid issues like this, Dr. King says it's crucial to always have your filler injections done by a professional who's knowledgeable and certified in performing this intricate procedure: Once again, that's a board-certified plastic surgeon or dermatologist. (You can check a provider's certification at certificationmatters.org.)
While some of the plastic surgeons we spoke to say they've performed the procedure with no problems on uncircumcised members, both Dr. Goldberg and Justin Houman, MD, a board-certified urologist at Tower Urology in Los Angeles, say there is added risk to this procedure if you're uncircumcised. "When patients with foreskin undergo these injections, they are at additional risk of more penile swelling and post-procedure gel migration, creating a 'lumpy-dumpy' appearance to the penis," says Dr. Houman. The probability of infection is also increased, adds Dr. Goldberg, since the foreskin has bacteria and is harder to clean.
How much does it cost to get penis filler?
A word of caution to your pockets: Penis filler is not cheap. Dr. Shafer notes that your first treatment may take upwards of 20 syringes of hyaluronic acid filler — way more than the usual one or two for face injections — which is why you can spend approximately $15,000 if you request this treatment at his office. Keep in mind that pricing depends on your location, how much filler is used, and which type of filler is used. But keep in mind that this is definitely not the type of procedure you want to penny-pinch on. Remember, you want it to be done by skilled hands, even if that means shelling out a few more bucks.
Another thing to remember: Since hyaluronic acid filler dissolves over time, you'll have to get touch-ups about once a year, which Dr. Shafer says could involve up to an additional 10 syringes. After all, "When the tank is going down, you got to fill it back up," he says. So, ponder on whether you can afford the annual maintenance on top of the initial procedure before you dive headfirst into this treatment.
Read more about top-trending cosmetic procedures:
- I Tried the Famous "Lip Flip" This Year — Here's Why I Wish I Hadn't
- The Unlikely Rise of Forehead-Reduction Surgery
- What's the Difference Between Botox and Other Wrinkle-Relaxing Injectables?
Don't forget to follow Allure on Instagram, Twitter, and TikTok, or subscribe to our newsletter to stay up to date on all things beauty.
