01
Assessment
Examination, baseline measurement, medical history, previous procedures and circumcision status. Volume is decided here.
Hyaluronic Acid Penile Filler
What hyaluronic acid is, how it is used to increase penile girth, what published studies report, and where its limits lie — written for men considering treatment.
- Medical reviewer
- Assoc. Prof. Dr. Zulfu Sertkaya, urologist and andrologist, FEBU
- Published
- Last medically reviewed
- Physician review pending
- Last updated
In brief
The short answer
Short answer
Hyaluronic acid (HA) penile filler is a cross-linked gel injected into the loose layer beneath the skin of the penile shaft to increase its circumference. It is performed under local anaesthesia, it is temporary, and it can usually be dissolved with an enzyme called hyaluronidase. Published studies most often report a mean flaccid girth gain of around 2–2.5 cm; results vary between individuals.
Treatment
What hyaluronic acid is
Hyaluronic acid is a sugar molecule (a glycosaminoglycan) that occurs naturally in skin and connective tissue, where it binds water and gives tissue volume. On its own it is broken down within days, so injectable fillers use hyaluronic acid that has been chemically cross-linked into a gel. Cross-linking is what lets the gel hold its shape and resist breakdown for months rather than days.
Fillers differ in concentration, degree of cross-linking and particle structure. Those properties determine a gel’s firmness (often described by its elastic modulus, G′), how well it holds together (cohesivity) and how it behaves under pressure. Reviews of filler rheology describe how firmer, more cohesive gels are generally chosen for deep volume support, while softer gels are used for fine lines.
The same class of gel is used widely in facial aesthetic medicine. Using it in the penis is an off-label application: no hyaluronic acid filler we are aware of carries an approved indication for penile use, and a physician who uses one there takes clinical responsibility for doing so.
Treatment
How it increases girth
The gel is placed in the dartos layer — the loose, mobile tissue between the skin and Buck fascia. That plane sits outside the erectile bodies (corpora cavernosa) and the urethra, which are not entered. Because the layer is mobile, the gel can be moulded after injection to spread it evenly around the shaft.
The treatment adds circumference. It does not lengthen the erect penis, it does not change erectile function, and it is not a treatment for erectile dysfunction or curvature.
Circumference is related to area rather than volume alone, so the same amount of gel spread over a longer or already-wider shaft produces a smaller measured change. That is one reason two men receiving the same volume can measure differently afterwards. The volume comparison guide explains how 10, 15 and 20 ml are chosen.
Treatment
How the procedure is performed at Hardrock Clinic
02
Local anaesthesia
Local anaesthesia is used and the gel itself contains lidocaine. No general anaesthesia or sedation is required.
03
Injection and moulding
Small amounts are placed through several entry points using a fan technique, then moulded and checked for symmetry.
The procedure takes approximately 30–45 minutes depending on volume and anatomy. A light dressing is applied, written aftercare instructions and a direct contact number are given, and patients go home the same day. The recovery guide covers the following weeks.
Treatment
What the published evidence shows
| Study | Design | Patients | Key finding |
|---|---|---|---|
| Yang et al., J Sex Med 2019 | Randomised trial, HA vs polylactic acid | 72 | Mean girth gain at 48 weeks: 16.95 mm with HA, 13.49 mm with PLA |
| Yang et al., J Clin Med 2020 | Randomised trial, HA vs polylactic acid | 67 | Girth still above baseline at 18 months after a single treatment; no serious adverse events |
| Zhang et al., Asian J Androl 2022 | Case series | 38 | Girth gain of 2.44 cm at 12 months |
| Raheem et al., J Sex Med 2025 (abstract) | Retrospective single-centre audit | 324 | Mean flaccid gain 2.5 cm (range 1.5–4 cm) at a mean of 15 ml; mean longevity 12 months |
A 2021 systematic review of penile enhancement procedures in BJU International covered 57 studies and concluded that the overall quality of evidence was low: many series are small, follow-up is short and measurement methods vary. A 2023 meta-analysis of hyaluronic acid and polylactic acid trials pooled four studies with 283 participants. These are the honest limits of the literature, and they are why this site distinguishes published figures from the clinic’s own.
The clinic reports approximately +4 cm, +6 cm and +8 cm of circumference from 10, 15 and 20 ml respectively. Those are clinic-reported figures from its own caseload, not trial results, and they sit above the published means. See penile filler results for how to read both.
Treatment
Reversibility and hyaluronidase
The main practical advantage of hyaluronic acid over permanent materials is that it can usually be broken down. Hyaluronidase is an enzyme that dissolves hyaluronic acid gel; it is used to correct lumps, asymmetry or overfilling, and it is part of the published guidance on managing filler complications. More than one session is sometimes needed.
Permanent materials such as PMMA, silicone or paraffin have no equivalent. When they cause problems, correction is usually surgical. The filler vs PMMA comparison covers this in detail.
Treatment
Risks, limits and who should not be treated
Documented risks
Swelling, bruising, lumps, asymmetry, migration of gel towards the foreskin, infection and, rarely, vascular complications. In the 324-patient audit, foreskin migration occurred in 7.7%, asymmetry in 6.1%, lumps in 4.6% and infection in 1.5%.
When treatment may be declined
Active genital infection, certain bleeding or immune conditions, unrealistic expectations, or a concern that appears body-dysmorphic in character. European urology guidelines recommend psychological evaluation for men of normal size who seek augmentation.
Full detail, including warning signs that need urgent attention, is on the risks and safety page. Professional societies — including the Sexual Medicine Society of North America and the International Consultation on Sexual Medicine — have published position statements urging caution and careful patient selection for cosmetic penile procedures.
Questions
Common questions
Is hyaluronic acid penile filler permanent?
No. The gel is gradually broken down by the body. Published follow-up commonly shows results lasting around 12–18 months, with wide individual variation.
Does it make the penis longer?
No. Hyaluronic acid filler adds circumference only. It does not lengthen the erect penis.
Can it be removed if I am unhappy?
Usually, yes. Hyaluronidase can dissolve hyaluronic acid gel where this is medically appropriate, although more than one session may be needed.
Which product does the clinic use?
Hardrock Clinic uses Teosyal Ultra Deep. Its approved indications are facial; penile use is off-label. See the Teosyal Ultra Deep guide for details.
More answers are collected on the penile filler FAQ page.
Next step
Ask about your own anatomy
General information cannot tell you whether this treatment suits you. The patient coordination team can answer practical questions, and suitability and volume are decided by the physician at an in-person assessment.
Sources
References
Published sources cited on this page. Conference abstracts are identified as such; they have not been through full peer review as journal articles.
- Yang DY, Ko K, Lee SH, Lee WK. A comparison of the efficacy and safety between hyaluronic acid and polylactic acid filler injection in penile augmentation: a multicenter, patient/evaluator-blinded, randomized trial. J Sex Med. 2019;16(4):577-585. doi:10.1016/j.jsxm.2019.01.310 · PubMed 30833149
- Yang DY, Jeong HC, Ko K, Lee SH, Lee YG, Lee WK. Comparison of clinical outcomes between hyaluronic and polylactic acid filler injections for penile augmentation in men reporting a small penis: a multicenter, patient-blinded/evaluator-blinded, non-inferiority, randomized comparative trial with 18 months of follow-up. J Clin Med. 2020;9(4):1024. doi:10.3390/jcm9041024 · PubMed 32260508
- Zhang CL, Quan Y, Li H, et al.. Penile augmentation with injectable hyaluronic acid gel: an alternative choice for small penis syndrome. Asian J Androl. 2022;24(6):601-606. doi:10.4103/aja20223 · PubMed 35417989
- Raheem A, Konstantinidis C, Abdel-Raheem T. Penile girth enhancement with hyaluronic acid injection: a single-center study. J Sex Med. 2025;22(Suppl 2):qdaf077.122 (conference abstract). doi:10.1093/jsxmed/qdaf077.122
- Romero-Otero J, Manfredi C, Ralph D, et al.. Non-invasive and surgical penile enhancement interventions for aesthetic or therapeutic purposes: a systematic review. BJU Int. 2021;127(3):269-291. doi:10.1111/bju.15145 · PubMed 32575166
- Kusumaputra A, Setiawan MR, Soebadi MA, Wirjopranoto S. Efficacy and complications of hyaluronic acid and polylactic acid for penile augmentation: a systematic review and meta-analysis. Ann Med Surg (Lond). 2023;85(9):4531-4538. doi:10.1097/MS9.0000000000001094 · PubMed 37663705
- Fundarò SP, Salti G, Malgapo DMH, Innocenti S. The rheology and physicochemical characteristics of hyaluronic acid fillers: their clinical implications. Int J Mol Sci. 2022;23(18):10518. doi:10.3390/ijms231810518 · PubMed 36142430
- Tezel A, Fredrickson GH. The science of hyaluronic acid dermal fillers. J Cosmet Laser Ther. 2008;10(1):35-42. doi:10.1080/14764170701774901 · PubMed 18330796
- King M, Convery C, Davies E. This month’s guideline: the use of hyaluronidase in aesthetic practice (v2.4). J Clin Aesthet Dermatol. 2018;11(6):E61-E68. PubMed 29942426
- Falcone M, Bettocchi C, Carvalho J, et al.. European Association of Urology guidelines on penile size abnormalities and dysmorphophobia: summary of the 2023 guidelines. Eur Urol Focus. 2024;10(3):432-441. doi:10.1016/j.euf.2023.08.012 · PubMed 37709592
- Trost L, Watter DN, Carrier S, et al.. Cosmetic penile enhancement procedures: an SMSNA position statement. J Sex Med. 2024;21(6):573-578. doi:10.1093/jsxmed/qdae045 · PubMed 38654638
- Chung E, Jenkins L, Moon DG, et al.. Penile augmentation and cosmetic surgery: recommendations from the Fifth International Consultation on Sexual Medicine (ICSM 2024). Sex Med Rev. 2026;14(1):qeaf067. doi:10.1093/sxmrev/qeaf067 · PubMed 41344863