The border (corona) of the glans penis can be widened by injection with a filler in the office. Numbing cream makes the treatment painless. The diameter of the glans is widened relative to the diameter of the body of the penis.
A filler gel can be injected under the skin of the penile shaft outside the erectile bodies. This causes an enlargement that feels soft to touch and mainly changes the aspect of the penis in a flaccid state. The erectile columns in the penis determine length and hardness during erection, which is not changed by the treatment. Usually, 10 ml. of gel is injected. Extra injections may be performed a few weeks later. The filler material is resorbed over a period of two to three years. Top-up injections are usually performed after a year.
Depending on sexual habits, some of the filler material may gradually move towards the prepuce. Especially in case of a circumcised penis, this may cause unsightly enlargement of the remnants of the prepuce.
The subcutaneous dartos muscle contracts the penis under the influence of stress or cold. I a flaccid state, penile length therefore depends on the circumstances. After enlargement by injection, an increased length is often observed as well, when the penis is in a flaccid state. The dartos muscle tone at rest is probably lower after the treatment. Injections cannot increase the length during erection.
One milliliter corresponds to one cubic centimeter. Injection of 10 ml therefore enlarges the penis by 10 cm³ and potentially some extra fluid, which may be held in place by the filler or the surrounding tissues. The effect on penile girth (and, in a flaccid state, length) depends on the size of the area in which the filler is delivered, the tension of the dartos muscle and the degree of erection.
The body of the penis can be widened operatively by fat injection (lipofilling). General anaesthesia and admission in a hospital day clinic are required. The fat is harvested by careful liposuction from the abdomen or the thighs. It is injected under the skin of the penis. The erectile tissue itself (the cavernous and spongious bodies) cannot be enlarged by this operation. Deep injection in the penis is not possible.
Like for any operation there are temporary inconveniences such as pain, bruising and swelling and complications have been described, such as infection, irregular take of the fat grafts and the general complications of surgery under general anaesthesia.
