Why We Don't Use Other Penis Enlargement Techniques

Scientific Assessment of Other Methods by Risk

Below, we list methods offered as an "alternative" to the technique we use for penis enlargement, and assess them according to the current state of scientific knowledge and our personal experience.

Hyaluronic Acid

Hyaluronic acid is advertised as a harmless, risk-free, cost-effective alternative to complex surgical penis enlargement. In our opinion, this is irresponsible. Scientific findings support our view.

What Key Facts Speak Against Hyaluronic Acid for Penis Enlargement?

• No approval: as of 5/2025, there is no hyaluronic acid product explicitly approved for penis enlargement. Its use by the respective physician takes place in what is known as off-label use, meaning the manufacturer assumes no liability – which can be of enormous consequence for the patient in the event of complications from penis enlargement.
• Documented deaths: there are even scientifically reported deaths following the use of hyaluronic acid for penis girth enhancement.

What Risks of Hyaluronic Acid Have Long Been Known?

Depending on the area of application and the quality of the treatment, hyaluronic acid can cause:

• Infections
• Bacterial biofilms, especially when larger quantities are used
• Necrosis (tissue death) of the skin
• and, in particular, vascular occlusions

Hyaluronic acid and its risks have long been known^{[34][35][36][37]}.

When used in the face, it has repeatedly caused blindness^[38][39].

What are the consequences of off-label use of hyaluronic acid on the penis? It can be assumed that a vascular occlusion in the penis, as a side effect of hyaluronic acid treatment for penis enlargement, leads to erectile dysfunction, possibly permanently. This assumption is supported in particular by the fact that, in the face, hyaluronic acid-related vascular occlusions have, as a delayed reaction, also affected veins^[40]. In the penis, veins are responsible for controlling erection.

Is hyaluronic acid really a cost-effective alternative for penis enlargement? Nor is it true that this represents a cost-effective alternative to penis enlargement. It is, in fact, a disreputable advertising promise.

Why the cost claim is false: hyaluronic acid is a biodegradable filler, meaning the respective penis enlargement treatment must be repeated at intervals. This means the costs are not incurred just once, but repeatedly, and quickly add up over time. Because the penile skin is thin and the amount of hyaluronic acid needed for penis enlargement is comparatively large, the penile skin stretches out over time. This means that if the refill treatments are discontinued, there is a risk that the penile skin becomes too loose and hangs down in folds. As a result, the penis looks old and misshapen.

What's problematic about brand names for hyaluronic acid used in penis enlargement?We consider it reprehensible when physicians register brand names for the use of hyaluronic acid in penis enlargement, and use those brand names, as long as hyaluronic acid has no approval for use on the penis. The brand name "AndroFill," for example, does not describe a product approved for penis enlargement, as patients repeatedly assume when they ask us about it, but merely a technique for how the needle is held during injection. Given that patients repeatedly believe it to be a separate, approved product for penis enlargement, we can only suspect that this was precisely the intention.

Important to know: no medical procedure is without risk. It becomes problematic when risks are concealed to promote sales, or when the existence of products is feigned in the eyes of patients.

So why don't we use hyaluronic acid? Our method for girth enhancement using the patient's own fat, as part of a penis enlargement, is permanent. Fat tissue is also the body's own living tissue. Hyaluronic acid is a substance that breaks down again over time.

Silicone Sleeves

Particularly in the USA, silicone sheets are offered for penis enlargement, under changing product names, even from the same manufacturer. Like hyaluronic acid, these products are also often marketed as simple, low-risk, and delivering an equivalent result.

What Important Scientific Findings Exist on Silicone Sleeves?

• Enlargement in the flaccid state: silicone sleeves often only lead to penis enlargement in the flaccid state^[41]. In our experience, many patients aren't even aware of this.
• Significant risks: the insertion of silicone sleeves can carry significant risks and complications. These include bacterial biofilm formation, infections, and foreign body reactions^[42][43]. These risks can additionally lead to shortening and curvature of the penis^[44]. Foreign materials, especially at mechanically stressed locations such as the penis, can also shift out of place.
• Risk of erosion: because the penis is a highly flexible organ and the silicone sheet is not, the implant can pierce through the skin (erosion) or disrupt underlying structures important for penile function. A very extensive scientific study on the topic of silicone sleeves for penis enlargement concludes that, in particular, the risk of erosion was likely underreported in earlier publications^[45].

So why don't we use silicone sleeves for penis enlargement? Our technique results in penis enlargement in both the flaccid AND the erect state and does not carry the risks of foreign material. While the autologous fat tissue transplantation we perform is a minimally invasive procedure, inserting a silicone sheet requires a larger operation with corresponding surgical risks.

Silicone Balls

A silicone ball used for penis enlargement is likewise an artificial foreign body, and there is a risk of biofilm formation, infection, foreign body reaction, and a systemic reaction to the introduction of silicone.

What mechanical risks do silicone balls carry during intercourse? In addition, considerable mechanical force occurs at the point between the penis and the pelvic bone during sexual intercourse. In the worst case, the implant can shift out of place.

Conclusion: our lengthening technique, as part of a penis enlargement, relies solely on the body's own tissue. This eliminates additional risks from artificial material. Thanks to our experience and skill, we have no need to use a silicone ball in penis enlargement.

Artificial or Autologous Skin Strips

The body of research on this experimental penis enlargement procedure is extremely poor. Some studies report an implausibly low complication rate and only a minor increase in erect penile girth.

What conflicting study results exist on skin strips for penis enlargement? Other studies report a high complication rate, as we would also expect, since infections, unappealing appearance, and penile curvature can occur after this type of penis enlargement^[48][49][50]. There are also reports that patients who have undergone this experimental technique regret it^[49].

So why don't we use skin strips for penis enlargement? We consider the risk of infection too high. In addition, the patient's own skin strips for penis enlargement must be harvested from a site where scarring occurs – on top of the risks at the penis itself.

Vein Implants

These vein implants, or vein interposition grafts, for penis enlargement represent a deep intervention into the penis itself. This alters the erectile tissue deep within the organ. If successfully performed without the sometimes considerable risks occurring, the result is a penis enlargement that is visible only during erection^[51].

For us, the risk and the effort involved in this experimental penis enlargement procedure are out of proportion to the result.

Options for Penis Enlargement Without Surgery

To answer this question, we don't even need to draw on science – we can answer it using general logic and common knowledge: if there were something simple and inexpensive for penis enlargement, we doctors wouldn't be standing in the operating room from morning to night performing penis enlargement surgeries.

Hormone Pills or Hormone Patches

If hormone pills or hormone patches caused penis enlargement, then many professional bodybuilders and millions of older men who take these tablets due to age-related hormone deficiency would have very large penises, since they take these tablets for years. The opposite is the case.

Penis Stretching Devices

Regarding penis stretching devices, it should be noted that the best-known one claims an FDA approval that doesn't actually exist, and presents a study on its effectiveness for penis enlargement that, firstly, relates to a different product and, secondly, is disputed within the scientific community.

Whether it's credible that pulling the penis to the side for hours every day, for six months or longer, would be risk-free for the purpose of penis enlargement – that question you can surely answer for yourself.