Playboy ran a piece on August 11 called The Penis Has Entered Its Filler Era. Rachel Khona wrote it, four of us were quoted, and the magazine had room for one line from me on rising demand.
Here is the version with the rest of it.
Four Complaints, One Name
“I see many men come in for male enhancement. Some are looking for increased girth, some want increased length, others are more concerned with treating erectile dysfunction, and a good number are interested in increasing libido and sexual drive. Today, we have many options that we can use to treat these patients, and these procedures have a very high satisfaction rate.”
Four motivations, not one. Sorting out which one a man actually walked in with is most of the work.
What Filler Does
“Any patient looking for increased girth of the penis is a good candidate for hyaluronic acid, or filler. Contraindications include any open wounds, skin irritation, and sometimes previous scarring from other procedures. I find most men are good candidates, as long as you have the right expectations, that is, there’s an improvement in girth and a slight improvement in length at rest.”
On duration:
“Most hyaluronic acid filler procedures will last at least a year, sometimes more. There are more permanent solutions, such as Lipoderma, which is a donor fat graft, or Bellafill.”
Candidacy here is almost never limited by anatomy. It is limited by expectation.
What the P-Shot Does
“The P-Shot is the injection of platelet-rich plasma into the corpora cavernosa and the tip of the penis. It will increase sensation and sexual arousal. It’s an infusion of growth factors into the penis. It can help with erectile dysfunction and increase libido and sensation.”
I have offered PRP in this area for over ten years. I describe the mechanism as proposed rather than proven, and I say the same thing to patients.
What Bocox Does
“Bocox is a term used for injections of botulinum toxin, Botox, Dysport, or Jeuveau, into the corpora cavernosa. It’s like a long-term Viagra or Cialis, which lasts between three and four months. It relaxes the smooth muscle of the cavernosal arteries, creating harder erections and a slight increase in length of about one centimeter, longer penis length at rest, and many men use it to treat flaccid erections.”
Why the Combination Is the Story
“Yes, it is important to note that in many men we combine all the procedures.”
Filler is volume. The P-Shot is biology. Bocox is hemodynamics. A man with three components to his complaint gets all three.
Which means three clocks running at once:
“The P-Shot is usually done once or twice per year, and Bocox is usually recommended every three to four months depending on how long it lasts on each individual.”
Filler sits at a year or more. Lay that out at the first visit or the patient discovers it piecemeal and feels like the goalposts moved.
Where the Risk Actually Lives
“These procedures are overall low risk, and the main risk comes from using non-FDA-approved substances, or injections by non-licensed providers. The main risks are infection, bumps and nodules, and bruising. All of these can be prevented by an experienced provider.”
I have made this same argument about at-home injectables, about jaw shapers, and about hand filler. The pattern does not change by anatomy. The treatment is rarely the danger. The syringe holder and the contents are.
Why Now
“The demand for both is up as men are more self-aware of the treatments and options available.”
Nothing changed technically. Awareness did, and Playboy running the piece at all is part of that shift rather than separate from it.
Frank Agullo, MD, FACS. Double board-certified by the American Board of Plastic Surgery and the American Board of Surgery, plastic surgery fellowship at Mayo Clinic, Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center Paul L. Foster School of Medicine.
Consults at Southwest Plastic Surgery in El Paso. Call (915) 590-7900 or text 1-866-814-0038. Full list of male procedures on the practice site.
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