GO BIG OR GO HOME: THE HISTORY OF PENILE GIRTH AUGMENTATION

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INTRODUCTION AND OBJECTIVE

Penile appearance is a source of anxiety among men and has led to the development of diverse penile enhancement approaches. The goal of this study was to examine the history of penile girth enhancement procedures.


METHODS

Peer-reviewed literature in PubMed and EMBASE as well as medical practice webpages offering penile enhancement were examined to describe the history of penile girth enhancement.


RESULTS

There are multiple cross-cultural accounts of penile enhancement throughout history. The Cholomec tribe from Peru used stones as weights to increase penile length. In the 16th century, the Topirama tribe of Brazil allowed poisonous snakes to bite their penises in an effort for penile enlargement. Since then, penile enhancement practices have continued to evolve.The first human adipose tissue transfer was attempted by Neuber in 1893. Then, in 1959 Sahwney et al. described the use of dermal grafts for penile girth enhancement (Figure 1). The use of an allograft dermal matrix graft (AlloDerm®) for penile girth procedures was introduced in 2004. Reported complications include: infection, fibrosis, and skin loss. Concurrently in 2004, the silicone penile implant known as Penuma® (now termed HimplantTM) was developed by Dr. James Elist in an effort to increase flaccid penile length and girth. In 2018, it became the first FDA-approved penile enlargement implant. Since then, thousands of patients have undergone implant placement and reported complications include device erosion, flaring, infection, fibrosis, and seroma formation. Penile injections offer a less invasive approach to penile girth enhancement. Human fat injections were first described by Dimitrije E. Panfilov in 1996. Since its first description in the 1940s, silicone penile injections have been performed with accounts of severely disfiguring granulomatous reactions. In 2005, Kim et. al. reported the use of hyaluronic acid fillers for glans penis augmentation in 187 men. By 2015, Dr. Paul Perito introduced the use of hyaluronic acid fillers (UrofillTM) for penile enhancement in 121 men with 71.4% patient satisfaction and low complication rates.


CONCLUSIONS

There is a long-standing cross-cultural history of penile enhancement procedures. Future research endeavors should focus on the development of techniques that lead to low complication rates and improved patient satisfaction.
 

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Figure 1. Timeline of Penile Girth Enhancement Approaches
Screenshot (34841).png
 
*The first human adipose tissue transfer was attempted by Neuber in 1893.

*Then, in 1959 Sahwney et al. described the use of dermal grafts for penile girth enhancement (Figure 1).

*The use of an allograft dermal matrix graft (AlloDerm®) for penile girth procedures was introduced in 2004. Reported complications include: infection, fibrosis, and skin loss.

*Concurrently in 2004, the silicone penile implant known as Penuma® (now termed HimplantTM) was developed by Dr. James Elist in an effort to increase flaccid penile length and girth. In 2018, it became the first FDA-approved penile enlargement implant. Since then, thousands of patients have undergone implant placement and reported complications include device erosion, flaring, infection, fibrosis, and seroma formation.

*Penile injections offer a less invasive approach to penile girth enhancement. Human fat injections were first described by Dimitrije E. Panfilov in 1996.

*Since its first description in the 1940s, silicone penile injections have been performed with accounts of severely disfiguring granulomatous reactions.


*In 2005, Kim et. al. reported the use of hyaluronic acid fillers for glans penis augmentation in 187 men.

*By 2015, Dr. Paul Perito introduced the use of hyaluronic acid fillers (UrofillTM) for penile enhancement in 121 men with 71.4% patient satisfaction and low complication rates.
 
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Penuma® (now termed HimplantTM)

*Concurrently in 2004, the silicone penile implant known as Penuma® (now termed HimplantTM) was developed by Dr. James Elist in an effort to increase flaccid penile length and girth. In 2018, it became the first FDA-approved penile enlargement implant. Since then, thousands of patients have undergone implant placement and reported complications include device erosion, flaring, infection, fibrosis, and seroma formation.
 
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