ANSWERS FROM DR. VICTOR LIU
Penis Enlargement – The Head
Patients who achieve significant increases in girth without proportionate glans enlargement may notice the glans looks small next to the now larger shaft. As a board-certified plastic and reconstructive surgeon with over 25 years of experience,
I am always very mindful or symmetry, proportion, and the general appearance of the penis. I, therefore, recommend to
most patients to undergo simultaneous shaft and glans enhancement to achieve a balanced, symmetrical, and esthetically pleasing result.
Penile Glans and Penile Shaft Simultaneous Treatment
There are several methods to augment the glans. The most common is injection with hyaluronic acid, such as Voluma. The reason for its popularity is that it is a very safe and very easily done procedure. However, due to its limited life span, reinjection is necessary every 18 to 24 months. Other fillers that can be used, which are permanent, include Bellafill. Filler can be injected into the skin itself but not into the spongiosum (the deep part of the glans) due to potential problems with migration. However, because very little filler can be injected into the skin itself, or into a small area between the skin and the spongiosum, the amount of increase is minimal.
The patient’s own fat can also be used for injection into the glans. The same limitation as with other fillers apply, and that is, very little can be injected. Additionally, because part, or all, of the fat injected may be absorbed, the patient’s own fat is unreliable for glans enlargement.
Common Enlargement Questions
Over the last 25 years, the number of male patients seeking aesthetic, cosmetic and plastic surgery services has increased by 500% — from 3% of patients to more than 15% and growing every year. Not only are we seeing an increase in cosmetic procedures that enhance men’s physiques, but we are also seeing a growing number of procedures that improve men’s physical and sexual health as well as libido.
If I had other treatments (fat injections, Penuma, etc.) and am not happy with it, can I still get filler injections?
Generally, filler injection after a person had surgical insertion of Penuma or Surgimend for penis augmentation is safe and do able. However, it is not advisable to do surgical insertion after the person had filler injection because of the adhesions resulting from the injections making it very difficult and even unsafe to perform. One of the problems with Penuma is that it is firm and
sometimes it is palpable on the skin surface and does not look natural. One way to treat this would be with filler injections. Some patients had fat injection for girth enlargement and complain that the penis feels too soft and looks uneven. This is a common problem with fat injections because some of the fat may be absorbed unevenly and of course fat feels soft. This
can be improved by injecting filler intradermally (inside the skin) to give a “shell” and also inject subdermally (underneath the skin) to even out. It is best to see and be examined by the treating surgeon before a final decision on what is best for you.
Can I have ligament detachment and Surgimend insertion done at the same time?
Yes, this can be done and is frequently done together, saving the patient a lot of time. The anesthesia and surgical incision at the base of the penis can be used for both procedures, and the recovery period for both procedures simultaneously is the same as doing the procedures separately. For instance, following a procedure, the patient should abstain from sex for at least 35 days. Therefore, if the two procedures are done at the same time, abstinence from sex is 35 days, but if done separately, the patient will undergo two 35-day recovery periods.sometimes it is palpable on the skin surface and does not look natural. One way to treat this would be with filler injections. Some patients had fat injection for girth enlargement and complain that the penis feels too soft and looks uneven. This is a common problem with fat injections because some of the fat may be absorbed unevenly and of course fat feels soft. This can be improved by injecting filler intradermally (inside the skin) to give a “shell” and also inject subdermally (underneath the skin) to even out. It is best to see and be examined by the treating surgeon before a final decision on what is best for you.
I had a penile implant surgery and my penis seems to be generally shrunken especially the head of the penis. Can this be corrected?
When a penile implant is inserted, it sometimes does not fit perfectly, resulting in areas of pressure and protrusion which may cause problems and deformity. Even when the implant is put in perfectly, there may still be problems because while the implant remains unchanging, the penis will change in shape and deteriorate with age. For example, the head of the penis, the
glans, has engorgement of blood during a normal erection, but in the case of erectile dysfunction, there is no engorgement. Therefore, this will atrophy with time. The outline of the implant may become visible or palpable, causing pain to the patient or his partner. This can be corrected with filler injection into the area, smoothing out the edges and enlarging the penis as well, often a very welcome addition to the treatment for the patient.sometimes it is palpable on the skin surface and does not look natural. One way to treat this would be with filler injections. Some patients had fat injection for girth enlargement and complain that the penis feels too soft and looks uneven. This is a common problem with fat injections because some of the fat may be absorbed unevenly and of course fat feels soft. This can be improved by injecting filler intradermally (inside the skin) to give a “shell” and also inject subdermally (underneath the skin) to even out. It is best to see and be examined by the treating surgeon before a final decision on what is best for you.
I am 60 years old and am having issues with my erection. Can I have ED treatment and penis enlargement done at the same time?
Yes. Erectile dysfunction can be treated at the same time as penile enlargement. Usually, this is done with shock wave treatment followed by injection with PRP or bone marrow aspirate and then the injection for the filler can be done after that, or even the Surgimend procedure can be done at the same time.