Your experts in Germany for lasting results in penis thickening. Discreet expertise in sensitive matters.
A warm welcome!
Below we explain all the important points in detail, simply read them in full or select what you are interested in via the menu item “Content” at the top left. Do not hesitate to contact us at any time.
We look forward to seeing you!
Jörg Hagen, doctor
Head of UGRS
Penis thickening in Darmstadt
Your experts in Germany for lasting results in penis thickening. Discreet expertise in sensitive matters.
Your experts for evidence-based penis enlargement with lasting results.
The decision to undergo penis enlargement is highly individual. Our job is to take these worries away from you and provide you with conscientious, comprehensive and competent advice on the subject of permanent penis enlargement.
Our advice and surgical penis thickening are based on the latest scientific findings, evidence-based medicine, decades of experience and extensive patient surveys.
The head physician of the UGRS, Jörg Hagen, the author of the following text, has accompanied over 10,000 patients undergoing penis enlargement surgery together with his personal staff in the 30 years (as of 2025) of his UGRS membership.
In addition, he has advised well over 10,000 patients on various urological and plastic surgery problems.
And created a convincing treatment concept for over 3,000 patients with complex urological problems.
At UGRS, you are in exclusively experienced hands, especially when it comes to penis enlargement treatments.
The following description of penis thickening is based on a wealth of scientific evidence regarding the quality of the respective treatment step.
See also: References in the text and list of sources
Important note: The following information does not replace a personal consultation with our experienced doctors in Darmstadt. Arrange a discreet appointment for individual treatment planning.
Evidence-based answers to your questions about penis thickening:
Which doctor should perform penis thickening surgery?
Why penis thickening is not a harmless procedure
Many patients believe that penis thickening with autologous fat is a simple procedure without risk. Irresponsible advertising promises made by doctors today have no scientific basis. Read more about this below under “Why don’t we use other techniques, such as hyaluronic acid?”.
Competent advice and the safe, effective performance of penile thickening surgery should only be carried out by a doctor who is personally experienced in this procedure.
Why is many years of experience essential?
The study situation on surgical penis thickening is poor and shows contradictory results. Further research and the creation of guidelines for penile thickening surgery are necessary. When performed with extensive experience and using evidence-based techniques, the results are very good, with low risk and high patient satisfaction (Citation: 1).
Why is not every doctor proficient in penis thickening?
Surgical penis enlargement is not included in the training catalog of a urology specialist (Citation: 2, 3). Neither is penile thickening.
The assumption by patients that every specialist doctor is trained in this operation is wrong. Permanent penile thickening is a highly complex specialist operation and also a niche operation.
When an experienced doctor, like the one we have in Darmstadt, operates and uses evidence-based methods of high quality:
- Very good results with penis thickening
- Low risk
- Very high patient satisfaction after penis thickening
Important scientific findings on penis thickening:
- Current studies emphasize the particular importance of the personal experience of the operating surgeon and correct patient selection. To prevent risks and achieve good and lasting results (Citation: 4, 5, 6, 7, 8, 9, 10)
- In penis thickening (usually as part of penis enlargement), the same technique produces very different results, depending on the surgeon (Citation: 9). This finding shows that an inexperienced surgeon is often to blame for poor results.
- It depends on the personal case numbers of the surgeon, not on the case numbers of the clinic or the title of the doctor (Citation: 10, 11).
Risks? Of course - but controllable
Every medical procedure involves risks. However, thanks to our specialization, precise surgical technique and decades of experience, penis thickening is associated with a very low risk of complications. Our patients particularly appreciate the fact that we provide open and transparent information about possible side effects.
Conclusion: We focus on quality, sustainability and your long-term satisfaction with penis enlargement. That’s why we avoid trends and advertising promises. We also don’t use long-known techniques to sell you as a novelty. We focus on: safe, natural and permanent penis thickening. Evidence-based.
We answer your questions
Give us a call or write to us.
Your contact person is Mr. Felix Jung, Head of the Plastic Surgery Patient Secretariat, together with his team of exclusively male employees.
We will be happy to have one of our doctors call you back if you make an appointment.
We will be happy to take the time to answer your questions about penis enlargement surgery.
You can reach us from Monday to Friday, from 9:30 to 19:00 or individually by appointment.
Does the penis thicken even when erect?
Yes, penis thickening naturally also leads to more girth during an erection
Our experience and the application of the right evidence-based technique also leads to penis thickening in erection. This has been proven by independent scientific studies (Citation: 1).
We emphasize the importance of experience and competence for the result. Even when using the identical technique, different results are obtained depending on the doctor (Citation: 9)
What is our specialty?
The founding father of UGRS, Dr. Jörn Siana, who is responsible for penis enlargement, performed surgical penis enlargement as early as 1993 and played a decisive role in developing the modern technique for penis enlargement and thickening. He was socially criticized for years for performing this operation.
He trained the current UGRS surgeon Dr. Jethon in this operation between 2002 and 2006.
UGRS doctors and the UGRS team have 20 years of experience, expertise and skill in penis thickening compared to most other surgeons in Germany.
Milestones of our expertise:
- 1993: First surgical penis enlargement by Dr. Jörn Siana
- 2002-2006: Training of the current UGRS surgeon Dr. Jethon in penis enlargement
- 2006-today: Over 8,000 documented penis enlargement operations
Our evidence-based treatment approach combines:
- Highest level of experience (8,000+ operations)
- Medical precision through evidence-based methods
- High-quality materials
- Human empathy
- Maximum discretion
- Specialized penis enlargement team
What thickening can we achieve?
Our method is based exclusively on the body’s own tissue. This allows us to achieve a natural result with penis thickening that is visually impressive.
Penis thickening: approx. 2.8 cm increase in girth (in aesthetic proportion to penis length)
We offer penis thickening as an outpatient procedure under local anesthesia with twilight sleep. Thanks to our “speed recovery” technique, you will be ready for everyday life again quickly after the penis thickening procedure.
Your advantages at a glance
- Permanent penis thickening without foreign materials such as silicone or filler
- Outpatient procedure with local anesthesia and twilight sleep (no general anesthesia required)
- Aesthetically natural result of penis thickening
What is the organizational procedure for penis thickening?
Transparency from the initial consultation to aftercare
Every penis thickening treatment begins with a detailed personal consultation. Together with you, we clarify your goals, discuss possible results and openly answer all your questions. Your decision on penis thickening should be informed and well-founded.
Before the operation
- Anonymous, free and non-binding advice, by telephone or e-mail
- Medical evaluation of your health situation
- Detailed consultation with Dr. Christoph Jethon, the surgeon responsible for penis enlargement in our clinic
- Discussion of your initial anatomical situation and medical history
- Clarification of the process and the exact procedure
The penis thickening procedure itself
- Duration: approx. 60 minutes
- Local anesthesia with gentle twilight sleep. Naturally performed by our experienced anesthetists. General anesthesia is possible on request.
- You can find out how we perform penis thickening surgery under the menu item "Our method"
After penile thickening surgery (on the day of the operation)
- Recovery time on site after the operation (approx. 1 hour)
- Return to the hotel (hospital stay possible but not necessary)
After the operation (day after)
- Wound control
- You will receive detailed aftercare instructions (e.g. abstaining from sport and sex for approx. 5 weeks)
- Follow-up appointments are not necessary but are of course possible at any time free of charge
Thanks to our special technique, many patients report minimal pain, rapid recovery and a high level of fitness for everyday life just a few days after the procedure.
What type of anesthesia is used?
We have been performing penis thickening (as well as penis enlargement) on an outpatient basis in twilight sleep for around 20 years. Our experience and expertise make this possible.
You will experience the penis thickening in a relaxed manner, will not notice it and will be fit again very quickly.
Of course, the anesthesiologist is always present.
Scientific basis for these benefits:
What technique do we use for penis thickening?
Gold standard method: Autologous fat tissue transplantation according to Dr. Siana
The penis thickening method we use was developed by UGRS founding father Dr. Jörn Siana. He had special surgical instruments produced by the industry for this purpose – proof of our innovative strength in penis enlargement.
This is how our proven penis thickening technique works:
- Harvesting: Living adipose tissue with stem cells from the thigh or abdomen
- Preparation: Nowadays it would be described as a mixture of macrofat, microfat, nanofat plus stem cells
- Transplantation: Precisely coordinated injection under the skin of the penis
- Healing: Natural fusion with surrounding tissue
Our method of penis thickening was described early on as the gold standard for penis thickening (see Krupp/Rennekampff “Plastische Chirurgie”, medical reference book).
Experience determines the result: This penis thickening technique requires a great deal of experience. This is the only way to achieve natural results without unsightly dents, lumps or loss of sensation. Thanks to continuous further development and decades of experience, we ensure maximum safety and patient satisfaction with penis thickening.
Scientifically proven advantages:
- When performed professionally and with the correct patient selection, this technique of autologous fat tissue transplantation for penis thickening as part of penis enlargement leads to very good and long-lasting results, with low risk (Citation: 16, 17, 18).
- Processed fatty tissue is now successfully used in plastic surgery in many areas of the body (Citation: 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29), which underlines the safety and professionalism of our technique.
Thanks to continuous further development of our penis thickening technique and years of experience, we are able to offer the highest level of safety, sustainability and patient satisfaction.
Medical ethics before profit: While dubious doctors often exaggerate, we rely on scientifically sound measurements for optimal results with minimal risks. We perform penis thickening in aesthetic proportion to the lengthening achieved.
Much more would be possible with penis enlargement, but it is risky: from a quantity of approx. 300 ml of transplanted fatty tissue, the risk of penis thickening surgery increases significantly (Citation: 30).
Why we reject other thickening techniques
Other penis thickening techniques often have hidden, sometimes significant risks and side effects. Hyaluronic acid on the penis can even cause fatal complications. This is why we only use our tried and tested autologous fat technique. In our experience and according to scientific findings, this has a lower risk than other fillers when carried out correctly (Citation: 20).
Find out more under “Why don’t we use other penis thickening techniques?”.
Why don't we use hyaluronic acid, silicone or artificial skin?
Concealed risks and major dangers
Since around 2014, other sometimes questionable doctors have discovered penis thickening for themselves and advertise with irresponsible, scientifically unproven promises and clear false statements. We take a stand on the other penis thickening techniques in the order we feel they are most dangerous for patients.
Scientific evaluation of other methods for penis thickening according to risk
We list methods offered as an alternative to the technique we use and evaluate them according to scientific knowledge and personal experience.
Is hyaluronic acid for penis thickening really harmless and low-risk?
Hyaluronic acid for penis thickening is advertised as a harmless, risk-free, cost-effective alternative to complex penis thickening surgery. In our opinion, this is irresponsible. Scientific findings support our opinion.
What key facts speak against hyaluronic acid for penis thickening?
The key facts here are:
- No approval: There is (as of 5/2025) no hyaluronic acid product explicitly approved for use in penis thickening. It is used by the respective doctor in so-called off-label use, i.e. the manufacturer assumes no liability, which can be of enormous consequence for the patient in the event of complications.
- Deaths documented: There are even scientifically reported cases of death after using hyaluronic acid for penis thickening (Citation: 31, 32)
Risk-free and harmless looks different!
What are the known risks of hyaluronic acid?
Depending on the area of application and the quality of the application, hyaluronic acid can lead to:
- Infections
- Biofilms caused by bacteria, especially when large quantities are used
- Necrosis (dying off) of the skin
- and in particular cause vascular occlusions
Hyaluronic acid and its risks have long been known (Citation: 33, 34, 35, 36).
When applied to the face, blindness occurred repeatedly (Citation: 37, 38).
What are the consequences of off-label use of hyaluronic acid for penis thickening?
It can be assumed that a vascular occlusion in the penis leads to erectile dysfunction, possibly permanently.
This assumption was made in particular because vascular occlusions in the face caused by hyaluronic acid also affected veins as a late reaction (Citation: 39). Veins in the penis are responsible for erection control.
Is hyaluronic acid really a cost-effective alternative to penis thickening?
The statement that it is a cost-effective alternative to penis enlargement is also not true. It is in fact a dubious advertising promise.
Why the cost statement is wrong:
Hyaluronic acid is a degradable filler, which means that the respective treatment for penis thickening must be repeated at intervals. This means that the costs add up over time.
The skin of the penis is also thin and the amount of hyaluronic acid required for treatment is relatively large. There is a risk that the penis skin will stretch out over time. This means that if the replenishments are not carried out, there is a risk that the penis skin will hang down wrinkled. This makes the penis look old and misshapen.
What is problematic about brand names for hyaluronic acid on the penis?
We find it reprehensible for doctors to register brand names for the use of hyaluronic acid on the penis if they use these brand names as long as hyaluronic acid on the penis has not been approved.
The brand name “AndroFill”, for example, does not describe an approved product for penis thickening, as patients repeatedly think when they ask us about it, but merely the technique of holding the needle during injection. Due to the fact that patients repeatedly believe that it is an approved penis thickening product in its own right, we can only assume that this was the intention.
Important to know: No medical procedure is without risk. It becomes problematic when risks are concealed to promote sales or the existence of products is feigned in the eyes of patients.
So why don't we use hyaluronic acid to thicken the penis?
Our method for penis thickening with autologous fat is permanent. Fatty tissue is also the body’s own living tissue. Hyaluronic acid is a liquid that breaks down again.
Why don't we use silicone sleeves for penis thickening?
In the USA in particular, silicone plates for penis enlargement are offered under different product names, even by the same manufacturer. Similar to hyaluronic acid, these products are also often marketed as simple, low-risk and with equivalent results.
What important scientific findings are there on silicone sleeves?
Important scientific findings:
- Enlargement mainly in the flaccid state: The silicone sleeves lead to a thickening in the flaccid state (Citation: 40). In our experience, many patients are not even aware of this.
- Significant risks: The insertion of silicone sleeves can involve considerable risks and complications. These include infections and foreign body reactions (Citation: 41, 42). These risks can lead to shortening and curvature of the penis (Citation: 43).
- Risk of erosion: Since the penis is a highly flexible organ and the silicone plate is not, the skin may be penetrated by the implant (erosion). (Citation: 44)
So why don't we use silicone sleeves to thicken the penis?
Our technique leads to an enlargement in the flaccid AND erect state and does not involve the risks of foreign material.
Why don't we use artificial skin strips (pig) or autologous skin strips for penis thickening?
The study situation on this new penis thickening procedure is extremely poor. Some studies report an implausibly low complication rate and only a small increase in the circumference of the penis when erect (Citation: 45).
Contradictory study results
Other studies report a high complication rate, as we would expect, as infections, unsightly appearance and penile curvature can occur (Citation: 46, 47, 48). There are also reports that patients who have undergone this new technique for penis thickening regret it (Citation: 47).
So why don't we use skin strips for penis thickening in Darmstadt?
We consider the risk of infection to be too high. Your own skin strips also have to be taken from a place where scars occur – in addition to the risks on the penis itself.
Why don't we use vein interposition devices for penis thickening?
Intervention in the organ:
These vein implants or vein interpositions are a far-reaching intervention in the penis itself. The cavernous body is altered in the depth of the organ. If carried out successfully without the sometimes considerable risks, the result is an enlargement exclusively in erection (Citation: 49).
For us, the risk and expense of this experimental procedure for penis thickening is disproportionate to the result.
What happens before & after penis thickening surgery?
Well prepared = relaxed through the procedure.
Good preparation and clear aftercare are crucial for an optimal surgical result in penis thickening. Our aim is for you to feel well informed, safe and accompanied at all times. That is why you will not only receive medical care from us, but also clear, understandable instructions for each phase.
Before the penis thickening operation
- Take your time to make your decision - we will advise you without pressure.
- Our special feature: patients can cancel up to the last second free of charge. We do not pressure or persuade anyone to undergo surgery.
- Plan your penis thickening as stress-free as possible: Many patients do not require a vacation, as the procedure is performed on an outpatient basis.
- Avoid alcohol and nicotine from 24 hours before the operation. You should refrain from taking blood-thinning medication (after consulting your family doctor!) for 10 days before the operation.
- Bring comfortable clothing, ideally with a wide waistband.
- Our secretarial staff will be happy to help you with your travel planning and accommodation.
After the penis thickening operation
Speed recovery: Why our patients are fit so quickly after penis thickening
Many are able to return to work after just a few days – depending on the workload. That’s what we call medical efficiency in terms of your quality of life.
Our promise: We will not leave you alone after the procedure. You will receive written aftercare instructions, a contact person for queries – and, if necessary, a short-term check-up.
Costs of penis thickening & financing
Clarity right from the start – without hidden fees.
High-quality medical services have their price – but with us, you know where you stand right from the start. We focus on fair, transparent pricing without unexpected additional costs. Because trust begins with openness.
How much does a penis enlargement cost?
-
Penis thickening only:
approx. 6,600 euros -
Combination of penis enlargement & penis thickening:
approx. 10,800 euros
The combination of both procedures not only saves time and the healing phase, but also significantly reduces the overall costs. All prices include surgery, anesthesia, aftercare and medical care.
Payment options
- Bank transfer
- EC or credit card
- Cash payment (anonymous, possible without notification)
- 0 % installment payment with a 12-month term: In cooperation with our financing providers, we offer you interest-free installment models - flexible and plannable.
Why quality has its price
Our surgical technique for penis thickening is based on over two decades of research, development and international exchange. We work exclusively with qualified personnel, high-quality materials and state-of-the-art instruments. All of this is incorporated into the costs – as well as your safety, satisfaction and a lasting result.
Our promise
- No hidden costs
- No additional fees for aftercare
- No compromises on quality and safety
If you are considering penis thickening, do it right – with a specialized team that does not compromise.
Is penis size important?
Based on our decades of evidence-based work, extensive experience and interviews with patients and their partners, we can clearly answer this question with “yes”.
What does science say about the importance of penis size?
There are very few studies and publications from the past.
Which current studies confirm the importance of penis size?
Studies confirm that penis size plays a role in women’s choice of partner (Citation: 50, 51).
A study by the California State University and the University of California, which analyzed a survey of around 52,000 men and women in partner relationships, confirms that 84% of women are generally satisfied with the size of their partner’s penis, but also reports that 14% of women would like their partner to have a larger penis (Citation: 52).
Why is 14% dissatisfied women a significant number?
14% may not sound like much at first, but in reality it is a lot, making the issue of penis size very important for women and their sexual satisfaction. Because 14% means more than 8 million women in the USA alone and more than 12 million women in Europe.
Does the preference for larger penises have an evolutionary advantage?
How has the female body influenced penis size in evolutionary terms?
The female body seems to have had a decisive evolutionary influence on penis size. The penis appears to have increased in size because the human vagina is larger than that of primates, so that the larger head of a human child, which results from the larger brain, can fit through it. In order for the human penis to continue to fill the vagina during sexual intercourse, it inevitably had to become larger (Citation: 53).
What role does the size variance of the vagina play?
Studies confirm a considerable variance in the size of the female vagina (Citation: 54, 55). Consequently, it is probably correct to assume that penis size also plays a role in finding a suitable partner.
Is the thickness of the penis more important than the length?
Study results suggest that penis thickness may be more important for women than penis length (Citation: 51). This could indicate that the vagina is supplied with a large number of nerve receptors that react to stretching in width.
What should society and science do?
Society and science should make further efforts to promote equal rights for women, including in sexual matters.
Since the penis is a mechanical instrument for obtaining pleasure, we believe that an emancipated woman is also entitled to express dissatisfaction with her partner’s penis.
Do women become active in penis enlargement decisions?
Who makes appointments for penis thickening surgery?
Women are becoming active: We can report from our evidence-based medical practice that more and more women are making an appointment for penis enlargement surgery for their partner.
Penis thickening surgery is not a male issue, as was long assumed, but affects both partners equally.
The medical information provided on this website is for general information purposes only and does not replace a personal consultation with our doctors. As a tertiary medical center, we are also available for second opinions.
© Copyright Jörg Hagen, Doctor
About the author
Jörg Hagen, doctor
The author Jörg Hagen has been the medical director of UGRS International Germany since 1995 and has over 30 years of experience in penis enlargement and complex urological issues. He is regarded as one of the leading experts in the interests of patients in Europe. His international activities, excellent diagnostics and legal successes in patient rights make his assessments particularly well-founded. Patients appreciate his scientifically based, discreet and trustworthy care. His articles are based on many years of practice and well-founded information at the highest level.
List of sources:
1 Littara A, Melone R, Morales-Medina JC, Iannitti T, Palmieri B. (2019) Cosmetic penile enhancement surgery: a 3-year single-center retrospective clinical evaluation of 355 cases. Sci Rep. 2019 Apr 19;9(1):6323.
DOI: Link
PubMed: Link
2 American Board of Urology. (2024 ) Residency Requirements and Training Standards. [Online PDF]. Headquarters: American Board of Urology. Retrieved from
Link: ABU Residency Requirements
3. McDougall EM, Watters TJ, Clayman RV. (2007) 4-year curriculum for urology residency training. J Urol. 2007 Dec;178(6):2540-4.
DOI: Link
PubMed: Link
4 Trost L, Watter DN, Carrier S, Khera M, Yafi FA, Bernie HL, Ziegelmann M, Köhler T. (2024 ) Cosmetic penile enhancement procedures: an SMSNA position statement. J Sex Med. 2024 May 28;21(6):573-578.
DOI: Link
PubMed: Link
5 Vardi Y, Har-Shai Y, Gil T, Gruenwald I. (2008) A critical analysis of penile enhancement procedures for patients with normal penile size: surgical techniques, success, and complications. Eur Urol. 2008 Nov;54(5):1042-50.
DOI: Link
PubMed: Link
6 Falagario UG, Piramide F, Pang KH, Durukan E, Tzelves L, Ricapito A, Baekelandt L, Checcucci E, Carrion DM, Bettocchi C, Esperto F. (2024) Techniques for Penile Augmentation Surgery: A Systematic Review of Surgical Outcomes, Complications, and Quality of Life. Medicina (Kaunas). 2024 May 2;60(5):758.
DOI: Link
PubMed: Link
7. Xing MH, Hou SW, Raheem OA. (2022) Aesthetic Penile Augmentation Procedures: A Comprehensive and Current Perspective. Curr Urol Rep. 2022 Dec;23(12):355-361.
DOI: Link
PubMed: Link
8 Colombo F, Casarico A. (2008) Penile enlargement. Curr Opin Urol. 2008 Nov;18(6):583-8.
DOI: Link
PubMed: Link
9 Manfredi C, Romero Otero J, Djinovic R. (2022) Penile girth enhancement procedures for aesthetic purposes. Int J Impot Res. 2022 May;34(4):337-342.
DOI: Link
PubMed: Link
10. Birkmeyer JD, Stukel TA, Siewers AE, Goodney PP, Wennberg DE, Lucas FL. (2003) Surgeon volume and operative mortality in the United States. N Engl J Med. 2003 Nov 27;349(22):2117-27.
DOI: Link
PubMed: Link
11 Chowdhury MM, Dagash H, Pierro A. (2007) A systematic review of the impact of volume of surgery and specialization on patient outcome. Br J Surg. 2007 Feb;94(2):145-61.
DOI: Link
PubMed: Link
12 Mitchell P, Gottschalk M, Butts G, Xerogeanes J. (2013) Surgical site infection: A comparison of multispecialty and single specialty outpatient facilities. J Orthop. 2013 Sep 5;10(3):111-4.
DOI: Link
PubMed: Link
13. Pang G, Kwong M, Schlachta CM, Alkhamesi NA, Hawel JD, Elnahas AI. (2021) Safety of Same-day Discharge in High-risk Patients Undergoing Ambulatory General Surgery. J Surg Res. 2021 Jul;263:71-77.
DOI: Link
PubMed: Link
14 Su X, Zhao Z, Zhang W, Tian Y, Wang X, Yuan X, Tian S. (2024) Sedation versus general anesthesia on all-cause mortality in patients undergoing percutaneous procedures: a systematic review and meta-analysis. BMC Anesthesiol. 2024 Apr 2;24(1):126.
DOI: Link
PubMed: Link
15. Fedok FG, Ferraro RE, Kingsley CP, Fornadley JA. (2000) Operative times, postanesthesia recovery times, and complications during sinonasal surgery using general anesthesia and local anesthesia with sedation. Otolaryngol Head Neck Surg. 2000 Apr;122(4):560-6.
DOI: Link
PubMed: Link
16 Xu L, Zhao M, Yang Z, Chen W, Li Y, Ma N, Wang W, Feng J, Liu Q, Ma T. (2016) Modified Penile Augmentation by Dermal-Fat Graft in Post-Hypospadias Adults. Aesthetic Plast Surg. 2016 Feb;40(1):120-9.
DOI: Link
PubMed: Link
17 Xu L, Zhao M, Chen W, Li Y, Yang Z, Ma N, Wang W, Feng J, Liu Q, Ma T. (2016) Augmentation Phalloplasty With Autologous Dermal Fat Graft in the Treatment of “Small Penis”. Ann Plast Surg. 2016 Feb;77 Suppl 1:S60-5.
DOI: Link
PubMed: Link
18. Kang DH, Chung JH, Kim YJ, Lee HN, Cho SH, Chang TH, Lee SW. (2012) Efficacy and safety of penile girth enhancement by autologous fat injection for patients with thin penises. Aesthetic Plast Surg. 2012 Aug;36(4):813-8.
DOI: Link
PubMed: Link
19. Strong AL, Rohrich RJ, Tonnard PL, Vargo JD, Cederna PS. (2024) Technical Precision with Autologous Fat Grafting for Facial Rejuvenation: A Review of the Evolving Science. Plast Reconstr Surg. 2024 Feb 1;153(2):360-377.
DOI: Link
PubMed: Link
20. Groen JW, Krastev TK, Hommes J, Wilschut JA, Ritt MJPF, van der Hulst RRJW. (2017) Autologous Fat Transfer for Facial Rejuvenation: A Systematic Review on Technique, Efficacy, and Satisfaction. Plast Reconstr Surg Glob Open. 2017 Dec 22;5(12):e1606.
DOI: Link
PubMed: Link
21 Zhao J, Chen C, Lan XD, Qin X, Li D, Zheng Y. (2025 ) Facial Rejuvenation Strategy in Asian Women with Autologous Fat Transplantation. Aesthetic Plast Surg. 2025 Apr;49(7):1797-1807.
DOI: Link
PubMed: Link
22 Mamsen FPW, Fischer-Nielsen A, Svalgaard JD, Jensen JD, Jønsson B, Duscher D, Christensen J, Van Leeuwen M, Kiilerich CH, Roider L, Sterodimas A, Munthe-Fog L, Kølle ST. (2024) Correction: Cosmetic Breast Augmentation with Autologous Ex Vivo-Expanded Adipose-Derived Mesenchymal Stem/Stromal Cell (Stemform®)-Enriched Fat Grafts: A Study of the First Twenty-Two Real-World Patients. Aesthetic Plast Surg. 2024 Jan;48(2):241-242.
DOI: Link
PubMed: Link
23 Li FC, Chen B, Cheng L. (2014) Breast augmentation with autologous fat injection: a report of 105 cases. Ann Plast Surg. 2014 Sep;73 Suppl 1(Suppl 1):S37-42.
DOI: Link
PubMed: Link
24 Abu Alqam R, Alkhwildi LA, Almaghrabi MT, Alali FK, Khashab RM, Bamatraf MS, Altamimi LA, Alshammari AJ, Alsuhaim A, Fadel ZT. (2025 ) Hand Rejuvenation Using Autologous Fat Grafting: A Systematic Review of Recommended Doses, Complications, and Patient Satisfaction. Aesthetic Plast Surg. 2025 Mar;49(6):1734-1749.
DOI: Link
PubMed: Link
25 La Padula S, Ponzo M, Lombardi M, Iazzetta V, Errico C, Polverino G, Russo F, D’Andrea L, Hersant B, Meningaud JP, Salzano G, Pensato R. (2023 ) Nanofat in Plastic Reconstructive, Regenerative, and Aesthetic Surgery: A Review of Advancements in Face-Focused Applications. J Clin Med. 2023 Jun 28;12(13):4351.
DOI: Link
PubMed: Link
26. Lo Furno D, Tamburino S, Mannino G, Gili E, Lombardo G, Tarico MS, Vancheri C, Giuffrida R, Perrotta RE. (2017) Nanofat 2.0: experimental evidence for a fat grafting rich in mesenchymal stem cells. Physiol Res. 2017 Sep 22;66(4):663-671.
DOI: Link
PubMed: Link
27 Tonnard P, Verpaele A, Peeters G, Hamdi M, Cornelissen M, Declercq H. (2013) Nanofat grafting: basic research and clinical applications. Plast Reconstr Surg. 2013 Oct;132(4):1017-1026.
DOI: Link
PubMed: Link
28 Quintero Sierra LA, Biswas R, Conti A, Busato A, Ossanna R, Zingaretti N, Parodi PC, Conti G, Riccio M, Sbarbati A, De Francesco F. (2023 ) Highly Pluripotent Adipose-Derived Stem Cell-Enriched Nanofat: A Novel Translational System in Stem Cell Therapy. Cell Transplant. 2023 Jan-Dec;32:9636897231175968.
DOI: Link
PubMed: Link
29. Dayal A, Bhatia A, Hsu JT. (2022) Fat grafting in aesthetics. Clin Dermatol. 2022 Jan-Feb;40(1):35-44.
DOI: Link
PubMed: Link
30. Seth I, Bulloch G, Gibson D, Chow O, Seth N, Mann GB, Hunter-Smith DJ, Rozen WM. (2024) Autologous Fat Grafting in Breast Augmentation: A Systematic Review Highlighting the Need for Clinical Caution. Plast Reconstr Surg. 2024 Mar 1;153(3):527e-538e.
DOI: Link
PubMed: Link
31 Khor NWM, Dhar A, Cameron-Strange A. (2021) The perils of penile enhancement: case report of a fulminant penile infection. BMC Urol. 2021 Aug 24;21(1):115.
DOI: Link
PubMed: Link
32. Shigeev SV, Morozov YE, Gornostaev DV, Uspekhova OA. (2025) Fatal’naya netromboticheskaya legochnaya emboliya pri augmentatsii polovogo chlena in “ektsiyami preparatov gialuronovoi kisloty [Fatal non-thrombotic pulmonary embolism in penis enlargement with injections of hyaluronic acid-based drugs]. Sud Med Ekspert. 2025;68(1):59-62. russian.
DOI: Link
PubMed: Link
33. Zhang YL, Sun ZS, Hong WJ, Chen Y, Zhou YF, Luo SK. (2024) Biofilm formation is a risk factor for late and delayed complications of filler injection. Front Microbiol. 2024 Jan 8;14:1297948.
DOI: Link
PubMed: Link
34. Shahrabi Farahani S, Sexton J, Stone JD, Quinn K, Woo SB. (2012) Lip nodules caused by hyaluronic acid filler injection: report of three cases. Head Neck Pathol. 2012 Mar;6(1):16-20.
DOI: Link
PubMed: Link
35 Wang R, Li Y, Li Z, Yao H, Zhai Z. (2024) Hyaluronic acid filler-induced vascular occlusion-Three case reports and overview of prevention and treatment. J Cosmet Dermatol. 2024 Apr;23(4):1217-1223.
DOI: Link
PubMed: Link
36. Zhang YL, Chen Y, Sun ZS, Luo SK. (2023) Retrospective Study of Vascular Complications Caused by Hyaluronic Acid Injection. Aesthetic Plast Surg. 2023 Dec;47(6):2745-2753. doi: 10.1007/s00266-023-03522-9. Epub 2023 Aug 14.
DOI: Link
PubMed: Link
37 Kapoor KM, Kapoor P, Heydenrych I, Bertossi D. (2020) Vision Loss Associated with Hyaluronic Acid Fillers: A Systematic Review of Literature. Aesthetic Plast Surg. 2020 Jun;44(3):929-944.
DOI: Link
PubMed: Link
38 Chatrath V, Banerjee PS, Goodman GJ, Rahman E. (2019) Soft-tissue Filler-associated Blindness: A Systematic Review of Case Reports and Case Series. Plast Reconstr Surg Glob Open. 2019 Apr 2;7(4):e2173.
DOI: Link
PubMed: Link
39 Gabrielpillai J, Salamat A, Schaefer C, Kania A, Lunatschek C, Eichhorn KW, Bootz F, Send T. (2020) Hyaluronic Acid-based Filler Injection: Late-onset Thrombosis of the Frontal Vein. Plast Reconstr Surg Glob Open. 2020 Nov 25;8(11):e3216.
DOI: Link
PubMed: Link
40 Elist JJ, Valenzuela R, Hillelsohn J, Feng T, Hosseini A. (2018) A Single-Surgeon Retrospective and Preliminary Evaluation of the Safety and Effectiveness of the Penuma Silicone Sleeve Implant for Elective Cosmetic Correction of the Flaccid Penis. J Sex Med. 2018 Sep;15(9):1216-1223.
DOI: Link
PubMed: Link
41 Anderson JM, Rodriguez A, Chang DT. (2008) Foreign body reaction to biomaterials. Semin Immunol. 2008 Apr;20(2):86-100.
DOI: Link
PubMed: Link
42 Arciola CR, Campoccia D, Ehrlich GD, Montanaro L. (2015) Biofilm-based implant infections in orthopaedics. Adv Exp Med Biol. 2015;830:29-46.
DOI: Link
PubMed: Link
43 Juwono T, Buscaino K, Fernandez-Crespo R, Carrion R. (2021) Infection of the Penuma penile implant and associated post-operative complications: A case report. Urol Case Rep. 2021 Sep 9;39:101846.
DOI: Link
PubMed: Link
44. Siegal AR, Celtik KE, Razdan S, Sljivich M, Kansas B, Shah B, Levine LA, Valenzuela RJ. (2024) A multi-institutional update on surgical outcomes after penile silicone sleeve implantation. Ther Adv Urol. 2024 Apr 2;16:17562872241241858.
DOI: Link
PubMed: Link
45 Alei G, Letizia P, Ricottilli F, Simone P, Alei L, Massoni F, Ricci S. (2012) Original technique for penile girth augmentation through porcine dermal acellular grafts: results in a 69-patient series. J Sex Med. 2012 Jul;9(7):1945-53.
DOI: Link
PubMed: Link
46 Xu T, Zhang G, Bai W, Li Q, Yang A, Lin Q, Xu T, Zhang X. (2019) Complications and Management of Penile Girth Enhancement with Acellular Dermal Matrix. J Sex Med. 2019 Dec;16(12):2011-2017.
DOI: Link
PubMed: Link
47. Zhang CL, Li H, Li Q, Bai WJ, Xu T, Zhang XW. (2020) [Decision regret analysis among Chinese patients receiving penile girth enhancement with acellular dermal matrix]. Beijing Da Xue Xue Bao Yi Xue Ban. 2020 Aug 18;52(4):678-683. Chinese.
DOI: Link
PubMed: Link
48 Adhikari S. (2023) Penile Girth Augmentation Using SEPA Flap and Dermofat Grafts. J Cutan Aesthet Surg. 2023 Jul-Sep;16(3):198-204.
DOI: Link
PubMed: Link
49 Austoni E, Guarneri A, Cazzaniga A. (2002) A new technique for augmentation phalloplasty: albugineal surgery with bilateral saphenous grafts–three years of experience. Eur Urol. 2002 Sep;42(3):245-53; discussion 252-3.
DOI: Link
PubMed: Link
50. Mautz BS, Wong BB, Peters RA, Jennions MD. (2013) Penis size interacts with body shape and height to influence male attractiveness. Proc Natl Acad Sci U S A. 2013 Apr 23;110(17):6925-30.
DOI: Link
PubMed: Link
51 Prause N, Park J, Leung S, Miller G. (2015) Women’s Preferences for Penis Size: A New Research Method Using Selection among 3D Models. PLoS One. 2015 Sep 2;10(9):e0133079.
DOI: Link
PubMed: Link
52 Lever, J., Frederick, D. A., & Peplau, L. A. (2006) Does Size Matter? Men’s and Women’s Views on Penis Size Across the Lifespan. Psychology of Men & Masculinity, 7(3), 129-143
Full-text PDF (UCLA)
53 Dixson, A. F. (2009). Sexual Selection and the Origins of Human Mating Systems. Oxford University Press.
DOI: Link
