The first time Steven signed up to inject his penis with filler in 2019, he was afraid he would permanently mutilate it. There wasn’t a lot of reliable information about the procedure online, and he had come across a few horror stories about doctors injecting silicone into penises, causing their patients to lose sensation.

Still, he had wanted his penis to be bigger for years and was finally approved for a circumcision in Canada, where he lives. This, he had read, reduced some of the risks associated with the penile filler procedure, in which a solution — anything from silicone to hyaluronic acid (HA), a natural substance found in the eyes and joints — is injected into the penis to adjust its girth and shape. With few options nearby at the time, he booked a flight to Mexico, where he had found a clinic that seemed to be reliable.

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“I remember sitting on a plane … and being absolutely terrified — like, is this going to be a nightmare experience that’s going to ruin my life?” Steven, who is using a pseudonym to protect his privacy, told Salon in a phone interview. “You get scared.”

There’s not a central database that tracks the number of these procedures done, but the rise in penile augmentation in recent years has been described as a “boom,” and doctors interviewed for this story said they have been seeing a rise in the demand for it.

"You name it and someone has put it in their penis, or tried to."

Besides HA, doctors have injected several products into the penis. Permanent fillers like silicone or paraffin have been used but are not recommended, as they have been associated with long-term complications like necrosis and deformities. Other semi-permanent solutions like polymethylmethacrylate (PMMA) microspheres or fats are often used as well, although they can also cause lumps that may be harder to remove than less permanent solutions like HA.

“You name it and someone has put it in their penis, or tried to,” said Dr. Amy Pearlman, a urologist at the Prime Institute. “People are talking about [penile augmentation] and certainly a lot of patients are asking providers about it.”

In the research that has been published on these procedures, several studies show the risks are relatively low for injecting HA, which can be dissolved. However, the more........

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