November 05, 2026 | Male Procedures, Penis Enlargement
“Hi, this is [my nurse] from the office of Dr. Agullo from Southwest Plastic Surgery. I was calling regarding your consultation for the penile enlargement. Do you have time right now?”
That is how it starts. A man sends photos through a private text line, and one of my registered nurses calls him back. She has been in the room for these procedures for years and she places the local anesthetic before I inject.
I had three of those calls transcribed and took out every detail about the callers. What is left is her side of the conversation, with a few notes from me where the phone version needs tightening. Her name is out too, because the point is the call, not the people on it.
“What Is It That You’re Trying to Achieve?”
She asks it first on every call. The answers I heard were girth, length, both, and once, “trouble sometimes getting fully erect.”
“So for this procedure, it’s more to add girth. Because we’re adding volume, sometimes it elongates it a little bit, but it’s more for girth. There is another procedure that is called Bocox, which is Botox injected to the penis.”
“So we have two procedures that we can help you with what you’re trying to achieve. We have the penile enlargement that is done with hyaluronic acid.”
Men come to me for four different reasons, girth, length, erection quality, and libido, and I wrote about sorting them in the male enhancement post. Filler answers girth. Bocox I will come back to, because her phone version and my notes differ there.
“What Exactly Gets Injected?”
“The hyaluronic acid, it’s a biocompatible substance that is naturally found in the body. So it’s safely injected beneath the penile skin. He uses a cannula, where the cannula, it’s round. So when he’s injecting the filler, he doesn’t cut any blood vessels or anything like that.”
“It is injected beneath the skin of the shaft, and it’s a natural substance in the body that adds volume, and it’s a natural look and feel.”
The product is hyaluronic acid filler. Voluma, Volux, Defyne, or a mix of them. I pick per patient, and the price is the same whatever I pick. The cannula is blunt and round-tipped, so it slides through tissue instead of cutting it, which keeps bruising low and lets me lay the product in long even passes.
“It is injected in the shaft of the penis and in the crown. If it’s not injected in the crown, the penis can look different.”
The crown is the corona, the ridge at the base of the head. Treating both the shaft and the corona keeps the proportions natural.
“Wouldn’t It Be Better If It Was Erect?”
One caller asked the question most men are thinking.
“No, because when it’s erect, any penis, when it’s erect, it’s not symmetric. It can erect from one side more than the other. So if he injected erect, it can be very asymmetric.”
“So if he injects it like that, and the penis is not like that when it’s normal, it can make it look like that when it’s relaxed.”
Erections lean, so I inject at rest.
“How Big of a Difference?”
“It can give you between 1 to 2 centimeters, or up to 1 inch.”
“Of course, the more that you get, the better results that you have. I would recommend for you to start kind of like in the medium, so you can notice a very good difference.”
One caller wanted to know what two syringes would do, and she did not sell him two syringes.
“Two syringes, you will not notice a difference. It is doable, but it’ll be like a very minimal change.”
Ten syringes is the average for a moderate, visible result, which is also what my penis enlargement page has said for years.
“How Long Does It Last?”
HA filler lasts up to two years in this location.
“If you kind of take care of the filler, like you don’t wait the whole time, you kind of do it every 9 months. You don’t have to do as many as you do the first time, depending on the results that you want.”
“If you don’t like it, we have medicine to revert it.”
That medicine is hyaluronidase, the enzyme that dissolves hyaluronic acid filler. Being able to undo the result is one reason I start most men with filler rather than something permanent.
“What Does It Cost?”
“So we have a couple of packages. We consider it kind of like a small, medium, large, or extra large. The small, which is only 5 cc of Voluma, it costs you $3,500. The medium, it’s 10 Volumas, which is $6,750. We have the large, which is 15, which is $9,750.”
That was the quote on that call. We changed the fees on October 21, 2026, so the numbers she gave him are already old. I publish my fees, and the phone quote now matches the fees page. As of this writing every man hears two prices at every size, one for HA filler and one for Lipoderma. We pick the size at the consultation, not on the phone.
| Size | Volume | HA filler | Lipoderma |
|---|---|---|---|
| Small | 5 cc | $4,500 | $5,500 |
| Medium | 10 cc | $8,500 | $11,000 |
| Large | 15 cc | $12,000 | $16,500 |
| Extra Large | 20 cc | $15,500 | $22,000 |
Lipoderma runs $1,100 per cc at every size. It is the longer-lasting column.
“We do have financial assistance that we can help you apply for, like CareCredit, Cherry, Alphaeon. So they can help you pay for the procedure.”
PatientFi and in-house payment plans are available as well.
“Is There Something Longer Lasting?”
On one call she walked through Lipoderma, a processed donor fat graft.
“It’s harvested fat, donated, that has been processed, and the cells and the DNA of the person that donated has been removed. So it’s the pure fat that he’ll inject to the penis.”
“Let’s pretend, for example, you select to do the 10 syringes. From those 10 syringes, only between 70 to 75 percent will survive, and that fat will become part of your own fat.”
“It’s a little bit more pricier because it’s fat that has been really well processed. The actual fluid that he’s gonna inject, the fat, that is what is pricey.”
“The Lipoderma and the Juvederm, one of them is not gonna look different than the other one, because they’re both for the same thing. Both of them are injected in the same technique. The only thing that is different is just the material.”
The fat that takes stays. Long-lasting, with the potential to be permanent, and no PLLA foreign body response. It cannot be dissolved, and some men still want a touch-up down the road. Bellafill is the other long-duration option. Both are consultation conversations, not phone quotes.
“What About Length?”
Here is where I tighten the phone version. On the calls, filler is for girth and Bocox is “for length.” That is close, and it is not quite the medicine.
Bocox is botulinum toxin injected into the corpora cavernosa, the two erectile bodies that run the length of the shaft. It relaxes the smooth muscle there and lets more blood in. The first thing most men notice is a harder erection. The second is about a centimeter of added length at rest, because relaxed tissue hangs fuller. It lasts three to four months, and then it needs repeating. So it is an erection-quality treatment with a resting-length bonus, and many of my patients stack it with filler because the two do different jobs. The third tool, for sensation and libido, is the P-Shot. I wrote about how the three fit together after Playboy asked me about it.
“Does It Hurt?”
Every caller asked, usually twice.
“The only thing that you feel is when we do the local anesthetic, when we do the penile block. After the penile block, you don’t feel anything.”
“We do a lot of them a week, and the patients are very, very comfortable. They don’t feel the procedure at all. The only thing that they feel is the local anesthetic, the penile block, which is only 2 injections.”
To one nervous caller, in Spanish, she put it this way: “It is a very, very safe procedure. It is done by Dr. Agullo, who is a double board-certified plastic surgeon. We do between two and three a week and we have not had major complications. Sometimes it is riskier to put you under anesthesia than the procedure itself.”
I agree with every word of that. This is done awake, with local, in my office.
“You can drive yourself. If you want to bring somebody with you, they can go ahead and do so. The whole thing is approximately between 45 minutes to 1 hour.”
“What Happens Afterward?”
“The results are immediate. They’re immediate. You just have to have some postoperative care, which is going to be: you’re going to have to avoid sexual activity for 1 to 2 weeks after the procedure. You also have to avoid strenuous exercises at least for 48 hours. You do have to massage after, because at the beginning the penis does get swollen, and you have to massage it.”
“You don’t feel nothing after they do the block, but the anesthesia probably wears off in 4 hours. Then you can use Tylenol, not ibuprofen, because we do need the swelling process to take effect.”
“At the beginning, there might be some asymmetries, but we monitor you for everything.”
Most men are back at a desk the same day. We teach the massage in the room before you leave.
“Can I See Results First?”
“If you log in into his actual website, because all the other social media platforms, Instagram, Snapchat, Facebook, they will close his accounts if he shows before and afters. But if you go into his actual website and you go to the menu, he has a photo gallery. He has male procedures, and then male enhancement or penile enhancement. He has photos of doing 10, 15, 20 syringes so you can see the difference.”
“For the Bocox, no, because we don’t take pictures when the penis is erected.”
“I’m usually the one that goes in with Dr. Agullo to the procedure, and the results are very, very good. We have a lot of patients from out of town, and they are very, very happy with the results.”
Who Is a Candidate?
Almost any man who wants more girth is a candidate for filler. What I screen for is expectations. I hold off for open wounds, skin irritation, and sometimes for scarring from a procedure done somewhere else. If the complaint is the erection or the drive, Bocox and the P-Shot come first.
Why Choose Dr. Agullo?
I am a double board-certified plastic surgeon, a Mayo Clinic fellowship alum, and a Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center. Castle Connolly has named me a Top Doctor every year from 2014 through 2026. I do every one of these injections myself, and the nurse who took your call is in the room.
The call comes first on purpose. A man who will not say the word out loud to a surgeon will say it to a nurse, and by the time he reaches me he already knows what the procedure does and what it does not.
Ready to Talk?
Call my office at (915) 590-7900, text the consult line at 1-866-814-0038, or book a consultation at agulloplasticsurgery.com. Photos can be sent privately through the text line before your call.
@RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.
