Dr. Perito collaborates with doctors abroad in Italy and Spain creating the first non-surgical office based approach to penile enhancement using hyaluronic acid fillers.

The GIRTHMAX Procedure for Penile Enhancement has been an international collaboration between Perito Urology and colleagues abroad in Italy and Spain. Previous “practices” for penile enhancement have proven inadequate. Using a proprietary filler to complete the enhancement Perito Urology has experienced physiologic resilience to compression, something the penis hopes to see every day. The bioelasticity of the material renders the penis with a natural feel both in the flaccid and tumesced state. Through a series of penile injections our patients have experienced safe and lasting results with outstanding cosmetic appearances.

Penile Dysmorphophopia

Penile Dysmorphophopia can be both a functional issue as well as an aesthetic issue.  Dr. Perito noticed early on in his penile implant practice that NO man was happy with his penile length or girth. In fact men of all ages have considerable concern for penis size dating back to the ancient Greeks. One of the factors making penile implant surgery so difficult is that impotence leads to penile atrophy through corporal fibrosis secondary to chronic hypoxia. We have shown through our radical prostatectomy patients that patients can lose between .5 and 5cm every 14 months once rendered impotent and similar losses occur with girth and these losses can be transposed to any patient with impotence. Literally if you do not use it you lose it.

Outcomes, Patient Satisfaction, and Retention

In total our centers treated 121 patients for girth enhancement.  Important fields to recognize include the mean number of cc’s administered per patient which was 10cc’s and I believe mathematically this is not an accident as I hope to demonstrate through our before and after pictures.  The mean follow-up was 21 months.  Most importantly there were NO complications, a finding similar to HA injections for naso-labial folds.  I will demonstrate one of the few cases with prepucial edema which, being a urologist, we considered a complication.  Most important to our findings were the telephone interviews regarding patient satisfaction and patient perception of filler retention.  It should be noted that 12.5% of our patient could not be contacted for these endpoints.

Over 85% of our patients were completely or mostly satisfied with over 70% completely satisfied.  Those that were not satisfied tended to be the patients with fewer than 5 injections suggesting that they may have not been satisfied because they could not complete their course of injections.  Only one patient was unhappy because he claimed that all of the two cc’s he had injected were re-absorbed.

Over 92% of our patients reported no filler loss or only mild filler loss.  Moderate filler loss was reported by only 7% of our patients and the same patient that was unhappy reported total filler loss.




Before and After Girth Enhancement

girth-8aWhat should be considered a successful increase in size when performing penile girth enhancement?  Truly, it is what the patient wants.  In this case where we only injected at 3 and 9 oclock the perceived increase from a dorsal view is from1.6 to 2.2 inches in diameter but as per 2 x pie x R from 5 to 6.9 inches in girth.  In reality the diameter is only increased along one axis after these first two injections.  But, after 10 injections, the mean number of injections our patients stopped at, the real increase in girth is by the tape 1.9 inches.


Before and After Girth EnhancementThis is a typical patient after a total of 4cc’s of HA injections.  This patient was pleased with his appearance and natural feel after the second round of injections and as you can see he demonstrates a significant increase of at least one inch in girth.


girth-11In this patient we have seen the largest increase in girth over the course of 4 years and at least 30 injections.  This patient represents a certain percentage of the population that will never get enough.


Dr. Perito’s Girth Enhancement Procedure can also be used to treat:

Post Implant Irregular Folds

girth-9This is a patient who was not happy with the natural folds that occur in some penile implants when in the flaccid position.  As you can see on both the right and left sides of the penis there are some irregularities.  This can be selectively improved upon with localized HA penile injections to smooth out the underlying defects.  One should be extremely cogniscient of the underlying implant.


Prepucial Edema & Prepucial Correction

prepucialThis is a patient that reported occasional prepucial edema, especially after sex.  With very selective placement of the HA we were able to render the penis with a more natural look precluding filling of the prepuce with edematous fluid after sex.

To see the official Perito Urology Girth Enhancement (GIRTHMAX) Press Release, click here.

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