Penis enlargement surgery can have serious complications, and men should be aware of them before undergoing any procedure, according to a recent Journal of Sexual Medicine study.

Penis enlargement surgery aims to increase length and/or girth, often because the man is not satisfied with the size of his penis. Augmentation may involve injections of silicone, injections of hyaluronic acid, fat transplantation or other methods.

While not all men experience complications, some outcomes are severe. Scarring, buildup of fat, and movement of materials can lead to sexual problems, decreased sensation, and penile deformity.

For example, substances in silicone injections can damage blood vessels and nerves, leading to poor penile sensation or erectile dysfunction (ED). Men who have these injections may also have swelling and see the material shift in location. Fat injections have been linked to fat necrosis (cell death) or reabsorption by the body.

The study involved 11 men with an average age of 47 years who sought treatment for complications after a penis enlargement procedure. Original procedures were not performed at the treatment location.

Four men injected materials themselves (silicone or saline), without the guidance of a physician.  Another three men had doctors conduct the injections [silicone, fat, and acellular dermis (tissues from other mammals)]. The remaining four received silicone implants provided by a physician.

Complications included swelling, infections, abscesses or nodules beneath the skin, penile shortening, gangrene, and erectile dysfunction (ED).

Ten patients had corrective surgery to remove the enlargement materials. Penile appearance and function improved, but none of the men had a “completely normal penis” afterward.

The authors noted that penile enhancement surgery is experimental and that dermal fillers are not approved by the U.S. Food and Drug Administration (FDA) for this purpose.

They added that most men seeking such procedures have normal penises, both in size and structure. These men may benefit from counseling to help them understand the range of normal penis size.

“Instead of risking the potentially detrimental complications of penile enhancement surgery, men with normal penile size and anatomy may experience benefit from less risky alternatives,” they explained.

They also pointed out that it was not known how many men have problems after penile enhancement surgeries or what overall safety or satisfaction rates might be, as the study focused primarily on specific men who had developed complications.

“We hope our experience can provide examples of poor outcomes and allow for more complete perioperative counseling,” they wrote.

Resources

• The Journal of Sexual Medicine - “Complications of Genital Enlargement Surgery” Furr, James, MD, et al.
  (Full-text. November 13, 2018)
  https://www.jsm.jsexmed.org/article/S1743-6095(18)31256-6/fulltext

• Medscape - “The Popularity of Penis Fillers – and When Things Go Wrong”
  Harris, Siobhan
  (November 26, 2018)
  https://www.medscape.com/viewarticle/905058