September 07, 2026 | Uncategorized
A patient sat down across from me, put his phone face down on the desk, and said he wanted filler. He had rehearsed the sentence in the parking lot. You could tell.
Playboy quoted me last month on rising demand for these treatments. The magazine had room for one line. This is the longer answer, the one I give in the room.
Men Are Not All Here for the Same Thing
“I see many men come in for male enhancement. Some are looking for increased girth, some want increased length, others are more concerned with treating erectile dysfunction, and a good number are interested in increasing libido and sexual drive. Today, we have many options that we can use to treat these patients, and these procedures have a very high satisfaction rate.”
Four different complaints share one name. The first job of the consult is figuring out which one you have.
Who Is a Candidate for Filler
“Any patient looking for increased girth of the penis is a good candidate for hyaluronic acid, or filler. Contraindications include any open wounds, skin irritation, and sometimes previous scarring from other procedures. I find most men are good candidates, as long as you have the right expectations, that is, there’s an improvement in girth and a slight improvement in length at rest.”
How long it lasts:
“Most hyaluronic acid filler procedures will last at least a year, sometimes more. There are more permanent solutions, such as Lipoderma, which is a donor fat graft, or Bellafill.”
I say the expectation part out loud in the first ten minutes. Non-surgical penile enhancement gives you girth and a slight gain in length at rest. If you are picturing something else, I would rather tell you now.
The P-Shot
“The P-Shot is the injection of platelet-rich plasma into the corpora cavernosa and the tip of the penis. It will increase sensation and sexual arousal. It’s an infusion of growth factors into the penis. It can help with erectile dysfunction and increase libido and sensation.”
Bocox
“Bocox is a term used for injections of botulinum toxin, Botox, Dysport, or Jeuveau, into the corpora cavernosa. It’s like a long-term Viagra or Cialis, which lasts between three and four months. It relaxes the smooth muscle of the cavernosal arteries, creating harder erections and a slight increase in length of about one centimeter, longer penis length at rest, and many men use it to treat flaccid erections.”
Most Men Leave With More Than One
“Yes, it is important to note that in many men we combine all the procedures.”
Filler handles girth and resting length. Bocox handles erection quality and how things look soft. The P-Shot handles sensation, arousal and drive. If your complaint has three parts, one treatment covers a third of it.
The schedule that comes with that:
“The P-Shot is usually done once or twice per year, and Bocox is usually recommended every three to four months depending on how long it lasts on each individual.”
Filler runs a year or more. You should hear all three intervals at the first visit, not in month five.
The Risk Is the Injector, Not the Injection
“These procedures are overall low risk, and the main risk comes from using non-FDA-approved substances, or injections by non-licensed providers. The main risks are infection, bumps and nodules, and bruising. All of these can be prevented by an experienced provider.”
Ask who is holding the syringe and what is in it. That is the whole safety question.
Why More Men Are Asking
“The demand for both is up as men are more self-aware of the treatments and options available.”
The treatments did not change. Awareness did.
Frank Agullo, MD, FACS, is double board-certified by the American Board of Plastic Surgery and the American Board of Surgery, completed his plastic surgery fellowship at Mayo Clinic, and is a Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center Paul L. Foster School of Medicine.
See our full menu of male procedures or book a consultation in El Paso. Call (915) 590-7900 or text 1-866-814-0038.
