Problems After Penile Filler Injections: What to Do

Many men decide to have substances injected to enlarge the penis, and later find lumps, an uneven shape, pain during erections, or feel even less confident than before. Some are too embarrassed to see a doctor. I want to tell you that you are not alone, and many of these problems can be fixed with the right assessment.

There are many injected substances, and it matters a lot

Treatment depends on what was injected.

If you are not sure what was injected, try to get the information from the place where it was done, such as the product name, the batch sticker or the receipt. This helps the doctor a great deal. But even without it, we can still assess you with a physical examination and ultrasound.

Can be dissolved

HA filler

• Hyaluronic acid
• Dissolved with the enzyme hyaluronidase
• The body also breaks it down over several months

Cannot be dissolved

Silicone, paraffin, PMMA

• Liquid silicone: chronic inflamed lumps
• Paraffin, Vaseline, oils: severe inflamed lumps
• PMMA/semi-permanent: hard, misshapen lumps
• Usually needs a surgeon

vs

If the substance is unknown, a doctor can still assess it by examination and ultrasound.

Problems that can occur after injection

• Lumps or an uneven surface where the substance has clumped
• Asymmetry, or the substance moving elsewhere, for example down into the scrotum
• Swelling, inflammation or inflammatory nodules (granulomas), which can appear early or months to years after injection
• Infection: swelling, redness, heat, pus or fever
• Pain or bending during erections, making sex difficult
• Poor blood supply: uncommon but dangerous, with pale, darkened, purple or cold skin and pain out of proportion
• Psychological effects, such as low confidence and avoiding intimacy

Emergency symptoms: go to hospital urgently

Dissolving HA filler with hyaluronidase

Hyaluronidase is an enzyme that breaks down hyaluronic acid. It is used to correct lumps or asymmetry, or when a patient wants the filler removed.

The usual steps

1. Take a history of the substance, when it was injected and the symptoms.
2. Physical examination, and ultrasound when needed, to see where the substance is and what it looks like.
3. Ask about allergies, such as severe reactions to insect stings, because some enzyme products can cause allergic reactions.
4. Inject the enzyme into the lump using sterile technique.
5. Arrange follow-up; some men need more than one session.

Things to know

• It only works for HA filler, not for silicone or paraffin
• There may be temporary swelling, bruising or pain
• Allergic reactions can occur, although they are uncommon
• If there is also an infection, that must be treated too

1. 1HistorySubstance, when injected, symptoms
2. 2ExaminationUltrasound if needed to locate the material
3. 3Allergy historySome enzymes can cause allergy
4. 4Enzyme injectionInto the lump, using sterile technique
5. 5Follow-upSome men need more than one injection

Severe pain, pale or dark-purple skin, fever or inability to pass urine: go to the ER or call 1669 (emergency).

If the substance can't be dissolved

Silicone, paraffin, petroleum jelly or semi-permanent substances usually need care from a urologist or plastic surgeon. Treatment may involve anti-inflammatory medicine in some cases, or surgery to remove the affected tissue and repair the skin. Seeing a doctor early means more treatment options.

Before you think about injections for enlargement

Many men who worry about size are actually within the normal range. The worry may come from comparing themselves with porn. Talking to a doctor or sexologist helps you see the real picture more clearly. Read Sex isn't perfect like in the movies and What makes a man attractive?

If you decide to go ahead, have it done by a doctor in a licensed healthcare facility, using registered products, and never allow injection of an unknown substance.

Effects on your sex life

Problems after injection can lead to erection difficulties, pain during sex or loss of confidence. These can be cared for alongside correcting the filler. Read more in Erectile dysfunction (ED) and When to see a clinical sexologist.

How the clinic can help

At Dr. Kris Clinic we assess problems after penile filler injections privately and without judgement. If it is HA filler and appropriate, the doctor can consider dissolving it with hyaluronidase. If the substance can't be dissolved, or there is a serious complication, we will help refer you to a suitable urologist or surgeon, and look after your confidence and sex life at the same time. Consultations in English are available at our clinic in Surat Thani.