Penis Size: Myth, Mystery and Misinformation

Does size really matter? What is the average length and girth of a penis? Many clinical assessments are not entirely accurate due to a number of different reasons (e.g. standardization in measuring length, girth, and penile rigidity, etc.). Based on a meta-analysis of over thirty-years of clinical studies, proper patient expectations include1:

  1. The length of a flaccid penis varies considerably but the average is 3.5.”
  2. The average length of an erect penis is 5.5” (only 1 in 30 men have >7”).
  3. The average erect penile girth is 5.0”. There is little variance on the larger or smaller side of the average.

Despite the previous information, men and their partners often desire “more of everything”. For penile length there is little if any option to truly increase one’s natural anatomy2. Only by removing the fat from the mons area above the penis can one render unseen length. This procedure can only be accomplished by liposuction, cool sculpting or the surgical removal of overhanging tissue. Surprisingly, this visual effect can also be accomplished by simply losing weight. On the other hand, treatments for penile girth enhancement have been experimental at best. Previous treatments for penile girth enhancement gained little traction for a variety of reasons related to safety and efficacy.

There are a small number of centers that report favorable results with “free fat transfer” surgery. Unfortunately, surgeons and patients must be concerned about the development of granulomatous changes in the fat occurring after the natural (and expected) revascularization of the fatty deposits. It is important to note that several sites reported up to 70% loss of the transferred fat within one year3. Some centers previously reported on the use of dermal fat grafts taken from the groin, gluteal creases or acellular dermal matrix. Again, both the surgeon and patient must be concerned about a long post-operative recovery period and potential for serious complications like penile shortening, curvature, loss of the graft and devastating infections4.

There are also “experimental” treatments (e.g. silicone, paraffin wax, etc.) which are often performed by uncertified practitioners. Addressing your penile girth is a personal choice that only you can make.


So what is the UroFill™ technology ?
The UroFill  patented technique is based on similar tissue enhancement techniques used on the lips, face, neck or other sensitive areas of the body. The UroFill technique is unique in its delivery of the material and its adaptation to the penis.

With over eight years of clinical review5, UroFill™ has developed the appropriate technique to safely enhance penile girth. Now, a series of simple, office-based injections can provide almost any penile girth a man may desire. The injections are done under local anesthesia and the patient can return to work immediately after the procedure (without restrictions). In our clinical studies, most patients resumed sexual intercourse after 72 hours.

Who are the right candidates for the UroFill™ Technology?
Men around the world have expressed interest in greater penile girth. The UroFill™ technique can assist those men who want “a little more” or those who suffer from minor anxiety related to overall penis size, however, men must also have realistic expectations. We help those who want increased penile girth and similarly help their partners who desire the same.

How much girth does it add?
The UroFill technique can be used to add nearly as much girth as the patient desires. Realistic goals should be discussed between the patient and his health care provider. When following the (patented) protocol of staged injections, a patient may continue treatments until the desired girth is accomplished. Patients must understand that any asymmetry can and will be addressed, as sculpting of the penis is an important part of the staging process. Sculpting and modeling can be further explained by your provider.

How much girth is accomplished with each injection?
Because penises vary in length, the increase in girth after each round of injections using the UroFill™ technique varies. Most patients will experience an increase of approximately 0.25” to 0.5” with each staged injection of 2-6cc’s. The staging process allows you, the patient, the opportunity to achieve your desired goal.

Is there any loss of girth after injections?
Dissipation and local migration of dermal fillers are potential hurdles with nearly any filler procedure. It is not uncommon to have a reduction of approximately 10% of the initial gains in the first month. This potential occurrence is actually due to dispersal of the local anesthetic and resolution of any inflammation from the injection process. Further loss is minimal and current clinical data supports four-year retention rates of nearly 90%5.

Where can I receive the UroFill™ technique?
The UroFill patented systems approach can only be administered by a Board Certified Urologic, Plastic or Cosmetic Surgeon trained in the patented technique. These designated UroFill providers have been trained and certified through UroFill’s stringent training modules. Each of these specialists have a verified understanding of the techniques and materials, making this procedure a safe and efficacious way of achieving penile girth enhancement. Each of these specialists has ongoing access to Dr. Perito’s 8-year (and growing) experience, as he and his colleagues have refined the UroFill approach.  Dr. Perito’s data includes >500 patients with 4+ years of results. Some facilities may advertise procedures similar to UroFill yet they do not have the credentialing necessary to offer predictable and lasting results as described and presented in our experience. Other techniques may not have the same peer review assessments as UroFill. Our directory of trained physicians is constantly updated for your convenience and can be accessed under the patients tab – Find a Provider. The UroFill approach is available in select markets outside of United States.  These sites have trained providers and utilize a variety of dermal filler products. The UroFill platform has been adopted by providers in the United States, Europe and Latin America.  Email info@urofill.com for access to a provider near you.

How long does the procedure take?
The UroFill™ procedure is performed in-office and requires about 10 minutes. If your surgeon begins the procedure with an artificial erection, the entire procedure may take 30-40 minutes.

Is it a surgical procedure?
The UroFill technique is a proven method for safely injecting HA into the penis for girth enhancement in the office setting.

Do I need anesthesia?
Small amounts of local anesthetic are used during the procedure for patient comfort. Most patients are able to drive themselves home immediately following the procedure.

What care will I need after the procedure?
The penis will have a loosely applied gauze wrap for 24 hours to minimize bruising.

How long will I need to refrain from sexual contact?
We strongly recommend 72 hours before engaging in any sexual contact.

Is it safe?
All patients who have followed the recommended post-procedure protocol have had a complete recovery6. Before having penile girth enhancement utilizing the UroFill Technique - every patient should read and sign with their doctor the attached consent form.

Are there any side effects?
One should expect bruising and some irregularities in the soft tissues of the penis for approximately one week. To date there have been no serious side effects or complications related to the UroFill™ injection using UroFill™’s patented technique. Any irregularities are addressed on your follow-up visits for sculpting. Early modeling (see below) without re-injection is possible when desired by the patient.

Will it look natural?
With the help of your health care provider you should be able to accomplish almost any look you desire. The goal is to obtain increased girth without the appearance of anything unnatural. The biophysical properties of UroFill™ closely resemble the normal soft tissues of the penis.

What if I do not like something about the appearance of my penis after a UroFill injection?
Patients may find some areas to be more prominent than others after the first or any subsequent round of injections. The patient then has two options:

  1. Modeling - A patient may return to the office within a week of the procedure to have gentle massaging of the injected filler to correct any irregularities.
  2. Sculpting – A patient may wait two weeks for a second round of UroFill™ to be injected in areas lacking uniformity thus rendering the patient pleased with his continued gains (increased girth) and correction of the irregularity.

After hundreds of patients, and thousands of injections, only a handful of patients have requested a reduction in girth, which is done using a simple injection in the desired area. These patients were eventually satisfied with their outcomes. All patients should understand that this is a safe and easy option for any undesirable effect related to a UroFill™ injection. Unlike any previously used materials for girth enhancement, if a patient so desires, all filler can be removed in the office. We have never had a patient request the complete removal of UroFill™.

How does this compare to silicone implants, pills and pumps?
Silicone implants and pills can be grouped amongst the other failed attempts to increase penile girth. Our research team could not find clinical references (such as studies, presentations or peer review papers) supporting the use of pills for penile girth enhancement. One single-center study of a silicone graft for girth enhancement had only a small number of respondents and was not statistically significant7. Our experience with removing surgically implanted devices has demonstrated a poor anatomical result and difficulties with the mesh used to anchor the device. Regarding Vacuum Erection Devices (VED) - Most literature related to vacuum pumps supports some minimal increases in both length and girth and is a modality that does NOT preclude the use of UroFill™ and the UroFill™ technique.

Partner Satisfaction
Before a patient begins treatment with the UroFill™ procedure, it is important to understand that researchers have repeatedly shown that penis size does not affect partner satisfaction during sexual intercourse, although this may be changing alongside other societal norms8.  We are currently studying changes in patient satisfaction after the UroFill™ procedure and anticipate an increase in satisfaction for both the patient and their partner.

References

  1. Wessells, H.; Lue, T. F.; McAninch, J. W. (1996). "Penile length in the flaccid and erect states: Guidelines for penile augmentation". The Journal of Urology. 156 (3): 995–997.
  2. Alter, J.G. Penile enlargement surgery. Tech Urol. 1998; 4: 70
  3. Trockman, B.A., Berman, C.J., Sendelbach, K., and Canning, J.R. Complications of penile injection of autologous fat. J Urol. 1994; 151: 429–430
  4. Perovic, S.V., Byun, J.S., Scheplev, P., Djordjevic, M.L., Kim, J.H., and Bubanj, T.New perspectives of penile enhancement surgery tissue engineering with biodegradable scaffolds. Eur Urol. 2006; 49: 139
  5. Paul Perito; Gabrielle Antonini: Introduction of a Novel Office Based Non-Surgical Procedure Using Hyaluronic Acid Fillers for Aesthetic Penile Enhancement IV World Congress of Medical Sexology Meeting, Miami 2015
  6. Elist et al. J Sex Med. 2018
  7. Vardi Y, Lowenstein L. Penile enlargement surgery—Fact or illusion? Nat Clin Pract Urol 2005;2:114–5.
  8. Katharine A Phillips, Understanding Body Dysmorphic Disorder: An Essential Guide (New York: Oxford University Press, 2009), pp 50–51.
  9. Position Paper: Management of Men Complaining of a Small Penis Despite an Actually Normal Size. jsm_2Hussein Ghanem, MD,* Sidney Glina, J Sex Med 2013;10:294–303.