Hyaluronic acid filler
A cross-linked gel injected beneath the skin of the shaft under local anaesthesia. Temporary, and usually reversible with hyaluronidase.
Penile Girth Enhancement in Turkey
Several methods are used to increase penile girth. They differ in whether the result is temporary or permanent, whether it can be reversed, what the procedure involves and how strong the evidence is.
- 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
Penile girth can be increased with hyaluronic acid filler, fat transfer, permanent injectable materials such as PMMA, or surgical grafting. Hyaluronic acid is temporary and can usually be dissolved; fat transfer and permanent injectables cannot be dissolved, and surgery is a larger undertaking. Across all methods the overall quality of published evidence is low. Hardrock Clinic’s Fill in Istanbul programme is hyaluronic acid filler; other options are discussed at consultation where relevant.
Comparisons
The main options
Fat transfer
The patient’s own fat is harvested from elsewhere in the body and injected into the shaft. There is no enzyme that dissolves it if the result is uneven.
Permanent injectables
Materials such as PMMA-based fillers are intended to stay permanently. Complications cannot be dissolved and are often managed surgically.
Surgical grafting
Graft material is placed around the shaft through an operation. Techniques and graft types vary between surgeons.
Injected substances that are not medical fillers — such as paraffin or oils — are not treatment options. They are associated with sclerosing lipogranuloma and paraffinoma, which often require surgery to correct.
Comparisons
Side-by-side comparison
| Option | Temporary or permanent | Reversible | Anaesthesia | Recovery | Evidence notes |
|---|---|---|---|---|---|
| Hyaluronic acid filler | Temporary; published follow-up around 12–18 months | Usually, with hyaluronidase (more than one session may be needed) | Local; the gel contains lidocaine | Same-day return to daily activities; about 7–10 days’ sexual abstinence (clinic protocol) | Randomised trials and case series; 2.44–2.5 cm mean gains in two series; local adverse events 7.2% in one comparison |
| Fat transfer | Uses the patient’s own tissue; longevity not settled by the sources cited here | Cannot be dissolved with an enzyme | Varies by technique and provider | Includes recovery from the fat harvest site; ask the treating surgeon | Case series: mean 2.65 cm gain in 88 men; 7.01 → 9.29 cm proximal girth at 6 months in 52 men |
| Permanent injectables (e.g. PMMA) | Permanent | No; complications often need surgery | Varies by provider | Varies; ask the treating provider | Large series of 752 men: 10.2 → 13.7 cm, about half noticed irregularities; local adverse events 14.3% in one comparison |
| Surgical grafting | Intended to be permanent | Removal would require further surgery | Decided by the surgeon | Involves an operation; set by the surgeon | Techniques differ widely; includes a retrospective single-centre study of 456 patients (Sertkaya et al. 2025) |
The hyaluronic acid figures come from a 12-month series of 38 men (2.44 cm) and a 324-patient audit presented as a conference abstract (2.5 cm). The adverse-event rates are from a single-surgeon study of 301 men comparing hyaluronic acid, polylactic acid and PMMA. Detailed head-to-head guides cover penile filler vs fat transfer and penile filler vs PMMA.
Comparisons
Hyaluronic acid filler: what this clinic offers
Hardrock Clinic’s Fill in Istanbul programme is hyaluronic acid penile filler. The clinic uses Teosyal Ultra Deep in 10, 15 or 20 cc volumes; its approved indications are facial and penile use is off-label. The gel is placed in the dartos layer outside Buck fascia, and the erectile bodies and urethra are not entered.
The main reasons men choose hyaluronic acid over other options are that it is performed under local anaesthesia with same-day discharge, and that it can usually be dissolved if there is a problem. The trade-off is that it is temporary. The hyaluronic acid penile filler guide covers the treatment in full, how long penile filler lasts covers duration, and the risks page covers complications.
The clinic reports approximately +4 cm, +6 cm and +8 cm of circumference from 10, 15 and 20 cc. These are clinic-reported figures from its own caseload, not guaranteed, and above the published means. Individual results vary.
Comparisons
Surgical and other options
Surgical girth techniques generally involve placing graft material around the shaft. They are intended to be permanent, involve an operation, and cannot be undone as simply as hyaluronic acid. Anaesthesia, recovery and suitability are specific to each technique and surgeon.
Dr. Sertkaya has published on a surgical girth technique: Sertkaya et al., International Journal of Impotence Research, 2025, a retrospective single-centre study of 456 patients describing the “Hardrock Sandwich Technique”, which combines bovine pericardial grafts with autologous plasma gel. It is mentioned here as a publication, not as a service offered through the Fill in Istanbul programme.
If you are weighing hyaluronic acid against a permanent option, the physician can discuss the alternatives at consultation where they are relevant to your situation.
Comparisons
How to think about the choice
- Reversibility: if you are unsure about the result, a temporary, dissolvable option leaves you more room to change your mind.
- Permanence: a permanent result also means permanent complications if they occur. Permanent injectables and foreign substances are a recognised cause of problems that need surgical repair.
- Evidence: a 2021 systematic review of 57 studies rated the overall evidence for penile enhancement as low. Professional bodies, including the Sexual Medicine Society of North America and the International Consultation on Sexual Medicine, urge caution and careful selection.
- Normal size: the average flaccid circumference in a nomogram of 9,407 men was 9.31 cm, and erect circumference 11.66 cm. European urology guidelines recommend psychological evaluation for men of normal size who seek augmentation.
The guide to non-surgical penis enlargement explains what injections, devices and pills can and cannot change.
Comparisons
Having girth enhancement in Turkey
Whatever method you consider, the same checks apply to any clinic: who performs the procedure, which product or graft is used and whether it is traceable, whether an injectable is hyaluronic acid or a permanent material, how aftercare works once you are home, and whether the price is transparent. These are explained on the penile filler in Turkey page.
For the hyaluronic acid packages, prices and what they include are on the cost page.
Questions
Common questions
Does Hardrock Clinic offer surgical girth enhancement?
The Fill in Istanbul programme is hyaluronic acid filler. Other options are discussed at consultation where relevant.
Which girth enhancement method is permanent?
Permanent injectables such as PMMA and surgical grafting are intended to be permanent. Fat transfer uses your own tissue and cannot be dissolved. Hyaluronic acid is temporary.
Which option can be reversed?
Hyaluronic acid can usually be dissolved with hyaluronidase. Fat, permanent injectables and grafts cannot be dissolved; correcting them usually requires surgery.
Is one method clearly best?
No. The evidence for all methods is limited, and the right choice depends on your anatomy, goals and tolerance of risk. The physician discusses this at assessment.
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.
- 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
- Kim DW, Jeong HC, Ko K, Yang DY, et al.. Which dermal filler is better for penile augmentation for aesthetic purposes? A prospective, single-surgeon study based on real-world experience. World J Mens Health. 2025;43(2):428-436. doi:10.5534/wjmh.240105 · PubMed 39344108
- Kang DH, Chung JH, Kim YJ, et al.. Efficacy and safety of penile girth enhancement by autologous fat injection for patients with thin penises. Aesthetic Plast Surg. 2012;36(4):813-818. doi:10.1007/s00266-012-9891-4 · PubMed 22527585
- Panfilov DE. Augmentative phalloplasty. Aesthetic Plast Surg. 2006;30(2):183-197. doi:10.1007/s00266-004-0153-y · PubMed 16547638
- Casavantes L, Lemperle G, Morales P. Penile girth enhancement with polymethylmethacrylate-based soft tissue fillers. J Sex Med. 2016;13(9):1414-1422. doi:10.1016/j.jsxm.2016.06.008 · PubMed 27461963
- Soebhali B, Felicio J, Oliveira P, Martins FE. Sclerosing lipogranuloma of the penis: a narrative review of complications and treatment. Transl Androl Urol. 2021;10(6):2705-2714. doi:10.21037/tau-21-228 · PubMed 34295755
- Downey AP, Osman NI, Mangera A, et al.. Penile paraffinoma. Eur Urol Focus. 2019;5(5):894-898. doi:10.1016/j.euf.2018.06.013 · PubMed 30007541
- 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
- Veale D, Miles S, Bramley S, Muir G, Hodsoll J. Am I normal? A systematic review and construction of nomograms for flaccid and erect penis length and circumference in up to 15,521 men. BJU Int. 2015;115(6):978-986. doi:10.1111/bju.13010 · PubMed 25487360
- 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
- Sertkaya Z, Albayrak AT, Başağa Y, Sökmen D. A retrospective evaluation of the safety and effectiveness of an innovative penile enlargement approach: the Hardrock Sandwich Technique. Int J Impot Res. 2025;published online. doi:10.1038/s41443-025-01172-w · PubMed 40983673