History of Penuma ®
Penuma® is the first FDA-cleared penile implant for cosmetic male enhancement. Developed by world-renowned urologists and scientists, Penuma® has been successfully implanted in thousands of men since 2004.
The Penuma implant is made of medical-grade silicone and is inserted through a small incision typically made along the scrotum.
The “concealed scar” technique typically leaves little to no scarring on the area due to the texture of the scrotum. While individual results may vary, past patients have typically seen an average girth increase of one to two inches, with flaccid length increases also reported.
Penuma® is cleared by the FDA for the aesthetic augmentation of the penis.
Penuma® patients have reported high satisfaction and improved confidence and self-esteem – you can find more information by reviewing the IRB-approved, 400-patient, 5-year retrospective review, as well as our patient reviews.
Based on a multi-year study, girth increased by one to two inches on average. Penile length (flaccid) increases were also reported. Individual results may vary, and all potential risks and complications will be discussed in advance.
Penuma® Implant Design
The Penuma® implant is composed of a soft medical-grade silicone sleeve and is intended to provide a natural feel similar to the texture of the penis.
The implant contains no liquids or gels, meaning it does not dissolve over time like other penile enlargement methods.
It is manufactured at an ISO-certified facility under U.S. quality controls.
The Penuma® implant hugs the penile shaft in a way that avoids placing pressure on the urethra, which serves ejaculatory and urinary functions.
The implant is also tapered towards the top of the shaft for a more natural look, as the thinner edges allow for more contrast between the glans (head) and the body of the penis. The central ridge atop the implant allows the implant to open like a butterfly - this design is intended to help the patient to achieve an erection normally.
The Penuma® implant is designed to provide a natural-looking and feeling enhancement. After a consultation, we will determine if you are a candidate for the short operation.
With the aid of anesthesia, the patented, medical-grade silicone Penuma® implant is placed along the shaft of your penis through an incision on the scrotum (no incisions on the penis). Patients are typically walking on the day of the procedure.
Penuma® Implant Procedure Details
Unlike other penile enhancement options, Penuma® has a long track record of patient-reported satisfaction. Like any other medical implant, there are potential risks and complications associated with Penuma®, including seroma, scar formation, and infection.
All potential risks, complications, benefits, and alternatives (including no procedure) will be discussed in detail with patients in advance. The clinics have found that complications can typically be mitigated by adherence to all pre-and post-operative instructions.
Fat, silicone injections, and other fillers run the risk of being absorbed into the body and, like dermal fat grafting, can lead to deformities and damaged skin and the need for multiple treatments. This is why the American Urological Association discourages fat injection in the penis as well as the division of the suspensory ligament.
We generally don’t provide Penuma® implants for people who have had filler, fat, silicone gel, and similar procedures because the skin of the penis simply can’t accommodate the Penuma® implant.
The Penuma® implant is a subcutaneous penile implant, meaning that it's inserted beneath the skin of the penis.
Your Penuma® surgeon makes a small incision along the upper part of the scrotum. By accessing the shaft through the scrotum, the chances of forming scar tissue in the pubic area are reduced. Additionally, due to the texture of the scrotal skin, the incision line typically conceals well after full recovery.
Once inside, the Penuma® implant is placed beneath the skin of the shaft.
The Penuma® implant is 270 degrees and wraps around the shaft of the penis to ensure that it does not cover the urethra.
Once in place, the implant is secured with stitches behind the head of the penis, allowing the implant to stretch forward when you achieve an erection.
The implant is reinforced with surgical mesh for stability. The surgeon then closes the incision and inserts a JP (Jackson-Pratt) drain, which typically stays in place for 2-3 days to assist healing (though this time period may differ by patient).
The procedure generally takes around 1 hour.
Penuma® Implant Results and Function
Based on historical results, we have seen an average increase of 1" to 2" of added girth to the penis. Flaccid penile length gains have also been reported. Erect length increases, if any, are unpredictable and depend on the individual patient's anatomy. Individual results may vary.
What size of the Penuma® implant is right for me?
The implant is available in multiple sizes, including Large, Extra Large, and Extra Extra Large.
Your physician will determine the best size for your individual anatomy to ensure patient satisfaction and safety.
Patient safety is our number one priority; your physician will consider the flexibility of your skin, the amount of loose skin, and the initial size of the shaft, including the internal portion of the shaft, to choose the safest size for you. Each implant will be tailored to ensure that you receive the largest that you can safely accommodate, considering your anatomy, safety, and penile appearance.
There are various factors that can contribute to the result, including skin flexibility and the stretchiness of the ligament due to the implant's weight. Historically, we have seen similar results for all different sizes of the Penuma implant.
As with any procedure, there are possible benefits and potential risks.
An IRB-approved, retrospective clinical study found that patients experienced high levels of satisfaction and self-confidence as a result of the implant.
There were a small number of adverse events reported (e.g., infection in 3% of cases and seroma or fluid build-up in 5% of cases), often due to patient non-compliance with post-operative care instructions. Closely adhering to the post-operative protocol can reduce the likelihood of any complications.
Please watch the following video, which discusses realistic expectations and potential risks, benefits, and complications of the procedure:
Your physician will thoroughly discuss all possible risks, complications, benefits, and alternatives (including no procedure) with you in advance of any procedure.
Comparing Penuma to Other Male Enhancement Procedures
Penis enlargement surgery or male enhancement procedure is a procedure with the goal of enhancing the size of the penis.
There are several methods used to enhance the size of the penis; however, not all are safe or effective.
Here are some of the known operations offered across the US.
The following table offers a comparative analysis of some of these procedures.
|Procedure||Cost||Procedure Type||FDA Cleared For Penis Use?|
|Penuma® Implant||$16,000 to $25,000||Surgical Implant||Yes|
|Division of Suspensory Ligament||$15,000 to $25,000||Surgical||No|
|AlloDerm/ BellaDerm||$10,000 to $15,000 (Based on 3 Treatments)||Surgical Graft||No|
|Dermal Filler/Fat Graft (Including Hyaluronic Acid)||$25,000 to $30,000 (Based on 3 Treatments)||Injections||No|
|Fat Injections||$14,000 to $30,000 (Based on 3 Treatments)||Injections (After Surgical Liposuction)||No|
The suspensory ligament joins the pubic bone to the base of the penis. The idea behind a suspensory ligament division is that cutting the ligament can cause the internal parts of the penis to move forward and outside of the pubic area, giving the visualization of a longer penis.
Unfortunately, this procedure is risky and ineffective. The division does not actually increase the length of the penis, and may in fact retract the penis and lead to a loss of length if scar tissue forms. As such, the American Urological Association does not consider suspensory ligament division “safe or efficacious.”
Acellular dermal matrix, or AlloDerm, is a regenerative compound made up of natural biological components that promote cell growth. AlloDerm is normally used to repair damaged sections in hernia and breast reconstruction surgeries.
AlloDerm is most successfully applied in procedures that require regenerative properties. As such, a chemical like this may lead to unexpected results when used in a non-regenerative area like the penis.
AlloDerm penoplasty complications may include asymmetrical appearance of the penis, moderate to severe skin adhesion that can result in necrosis, and severe infections caused by the AlloDerm material.
Penile enhancement fillers include gel injections, PMMA injections, hyaluronic acid injections, and fat grafts. While some of these materials may be approved for use elsewhere on the body, none of them are approved for penile use.
Because filler materials are reabsorbed by the body, they can potentially lead to severe deformities, asymmetrical penile appearance, and permanent skin damage. They do not impact the length and can only temporarily increase girth.
For a penile fat injection, the surgeon will cut fat tissue from a fatty portion of the patient’s body, then inject them into the penis through a series of small incisions on the organ itself.
Fat injections are risky. As with fillers, the body absorbs the material over time, leading to lumps and other deformities. Even without side effects, any size gains are temporary, meaning the procedure needs to be repeated regularly.
Subcutaneous fat injections are not recommended by the American Urological Association.
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Penuma® has been covered by Vice, GQ, Cosmopolitan, BuzzFeed, and more.
There’s also been an IRB-approved, 5-year clinical analysis of over 400 Penuma® patients published in the peer-reviewed Journal of Sexual Medicine. The result was that 81% of patients reported “high” or “very high” satisfaction levels. For more information, patients can read more in our Men’s Health article or the Clinical Research page.
Each patient’s circumstances will determine the cost of the implant. The average cost of the procedure ranges from $16,000 to $18,000 based on the clinic; additional costs may include circumcision for uncircumcised patients, lipectomy for overweight patients, travel for remote patients, etc.
If paying for the procedure is an issue, many of our clinics offer financing plans, including zero-interest options for a period of time. You can also learn more about the costs of getting a Penuma® implant here.
To get a Penuma® implant, you have to be over 21 and circumcised. If you are not circumcised, the Penuma® physicians can provide a circumcision procedure in advance of a Penuma® procedure.
There are other criteria that your patient consultant will discuss with you. If we decline a candidate, it’s most often because they’ve had a previous penis enhancement procedure.
It is critical that you refrain from all forms of sexual activity (including oral, vaginal, anal, and masturbation) after the procedure until given clearance by the Penuma® surgeon and staff.
This clearance typically takes place six (6) to eight (8) weeks after the procedure, but individual circumstances may vary. After clearance for sexual activity, please use a condom and wash with antibacterial soap and water after engaging in sexual activity for the first six (6) to eight (8) weeks of sexual activity.
Observe the penis for the first few months and report any unusual findings (redness, soreness, swelling, inflammation, etc.) to your Penuma® surgeon and staff immediately. Do not engage in any risky or strenuous sexual activity.
Do not engage in any heavy lifting or strenuous activity until you receive clearance from your Penuma® surgeon or the medical staff (typically 6 to 8 weeks after the procedure).
Light upper body exercises can resume upon clearance by the Penuma® surgeon and staff. This typically takes place four (4) weeks after the procedure, but individual circumstances may vary.
Light lower body exercises can resume upon clearance by the Penuma® surgeon and staff. This typically takes place four (4) to six (6) weeks after the procedure, but individual circumstances may vary.
Regular exercise routines can resume upon clearance by the Penuma® surgeon and staff. This typically takes place six (6) to eight (8) weeks after the procedure, but individual circumstances may vary. We recommend that you continue to wear the UroWrap during any strenuous activity and for up to 6 months.
The implant has been in use since 2004. The implant is made of soft, medical-grade silicone. It does not contain a gel core or any form of liquid. The implant may need to be removed (e.g., if complications arise).
The procedure is designed to maintain the natural state of the penis during the insertion process. Your surgeon will take all necessary measures to ensure that the integrity of the penis remains intact so that the implant can be removed if need be. Based on a study that was conducted in 2021, removal of the implant for adverse events and personal preference (i.e., dissatisfaction) occurred in less than 10% of cases.
It’s important to know that there is a rehabilitation process required to ensure optimal healing after the removal of the implant. There can be an initial retraction of the penis after removal of the Penuma®, and this rehabilitation process is critical to help regain any possible lost length. To learn more about the removal procedure, please see this article from the International Journal of Impotence Research.
Based on a clinical review of 400 patients over 5 years, there were no cases of changes to penile function, ability to get or sustain an erection, or ejaculation during sex. There may be a change in sensation. Some patients have reported both increased and decreased sensitivity. This is generally temporary and typically resolves over time as the skin expands. Individual results may vary.
The Penuma® procedure can only be performed by Penuma®-trained providers within our nationwide network. See the Penuma® Clinics page for a full directory of available locations and doctors.
As of August 2022, the procedure is offered in:
If traveling, please bear in mind that you will need to stay in the area for three days after the procedure for post-operative follow-up visits.
It’s unlikely that you can safely receive the Penuma® implant, as it is common to have scar tissue or other adhesions to the area after the treatments of Peyronie’s. This, in turn, makes placement of the implant difficult, increasing the likelihood of complications.
Final consultation will be determined by photo evaluation by our medical team, and, if necessary, consultation with your Penuma® provider. Since patient safety is our number one priority, if your Penuma® provider does not feel that the procedure is safe for you, they will not clear you for the procedure.
There may be a change in the size of the penis after the insertion. The penis may look shorter after the procedure due to the fact the girth has increased, and the perception of the length has changed. However, in some cases, there may be a slight retraction due to the limitation of the skin at the time of the surgery and during the capsule formation process. This generally resolves once the tissue softens and skin stretches. Full recovery may take up to a year.
The Penuma® implant is designed not to interfere with the erectile body of the penis. Generally, any time there is a surgical operation in the genital area, ED is a risk. However, a 5-year, 400-patient clinical review of Penuma® did not show evidence of erectile dysfunction due to the Penuma® implant in the past.
Increased size as a result of the implant can cause phimosis, a condition wherein the foreskin is unable to properly retract over the glans (head) of the penis.
Uncircumcised men may also face a higher likelihood of complications due to the increased difficulty of keeping the area clean after the procedure.
Due to these safety concerns, uncircumcised men must undergo circumcision prior to the Penuma® procedure. The Penuma® surgery can be performed usually 10-12 weeks after the circumcision, or upon complete healing of the skin.
We highly recommend that you get the circumcision completed with your Penuma® surgeon. If not possible, you can have it done with your local physician.
After insertion of any medical implant, forming a "capsule" or tissue is a typical body response during the healing process. The body tends to react to the presence of any foreign object it detects within it and attempts to isolate the foreign object by creating a barrier of tissue around it. In the case of the Penuma® implant, this is usually a very good thing.
The capsule can add additional girth that provides a protective layer over the sutures, which can help with the durability of the implant and help create a more natural feel to the touch.
This process generally takes 4-8 months to materialize fully. It is important to note that the size of the capsule is different for every individual. Wearing the compression sleeve, UroWrap, can help this process. The formation of the capsule can help the aesthetic result of the procedure.
Consumption of alcohol is generally not recommended during the recovery period following a medical procedure. Most importantly, alcohol can decrease the efficacy of the medications prescribed to achieve optimal recovery and may cause further complications.
We ask you to be cautious of your diet during the recovery period and try to achieve a healthy and nutritious diet for the best results.
The Penuma® implant is not for everyone. Patients must meet the age requirement and must be circumcised before receiving the implant.
Patients who have undergone other methods of penile enhancement are usually not eligible since their skin has been damaged by foreign materials. Even if the other procedure was done several years ago, the penis does not fully return to normal; there will always be remnants present and attached to the interior lining of the penile tissue.
Even after the removal of a foreign body, insertion of the implant cannot be done. The implant does not lay properly within the shaft, and the skin does not heal well around the implant. Consequently, those patients end up in a much higher risk category for complications and infection.
You must be in good general health to undergo anesthesia.
All patients must refrain from tobacco and illicit drugs for a minimum of 30 days prior to the procedure and for at least 3 months after the procedure.
You should have realistic expectations from Penuma® and what it can offer. This implant can help improve your confidence, but it is not a solution to other issues. You must agree to follow all pre and post-operative instructions.
To find out if you are a candidate, start with the eligibility questionnaire. After your initial evaluation, you can consult further with your Penuma® consultant and surgeon.
You can take a shower once cleared by your physician. Generally, once the Jackson-Pratt (JP) drain is removed, you are cleared to take a shower though individual instructions may vary.
Do not use a hot tub, Jacuzzi, sauna (wet or dry), or Whirlpool bath, or submerge yourself in any body of water until you have been cleared to do so by the medical staff (typically six (6) to eight (8) weeks after the procedure).
The Penuma® implant is designed to feel natural whether your penis is in a flaccid ("soft") or erect ("hard") state. We have used soft medical-grade silicone to achieve the most natural feel possible.
Additionally, the capsule formation around the implant will give the implant more of a natural feel to the touch. The entirety of this process will take anywhere between 6-12 months.
Patients often report that it's undetectable to sexual partners who have not seen their penises prior to the procedure. However, it is essential to note that the implant is a foreign object, and it may be detected.
We have observed that patients suffering from diabetes have a much higher complication rate and longer healing periods. This has to do with the change in the vascularity of the skin resulting from diabetes.
As such, we require patients to submit their most recent (within 3 months) blood work to ensure that A1C levels are at 6 or below. Patient safety is always our priority.
If your A1C level is above the accepted range or is uncontrolled, please work with your primary care physician to manage your blood sugar and consider changing your diet and habits. We will be happy to re-evaluate your eligibility at a later time.
The short answer is yes, fat above the pubic area can affect your eligibility. The longer answer is that suprapubic fat can apply pressure to the base of the implant, affecting its ability to sit properly, compromising the visual results of the procedure and increasing the likelihood of complications.
Some Penuma® providers offer lipectomy and some offer liposuctions.
However, our recommendation is to try to get to your goal weight with diet and exercise prior to the procedure. A useful tool for assessing eligibility is the BMI (Body Mass Index) calculator. Please note that BMI is not the sole determining factor, as individuals carry weight differently.
If needed, you can always submit photos to the Penuma® medical team, and they can help you with the best course of action.
This depends on the severity of the curvature. Our medical team will need to see photos of the penis to evaluate whether or not the patient is a candidate for the procedure.
Further evaluation might be required. We will assist you with scheduling a consultation with your Penuma®-trained physician, who will make the final determination of eligibility for the procedure.
It’s important to note that any deformity prior to the procedure may affect the cosmetic result of the surgery.
Nicotine products can decrease vascularity and therefore extend the recovery time. This results in a higher chance of complications.
All Penuma® patients must refrain from tobacco (nicotine gum, vapes, cigarettes, chewing tobacco) and illicit drugs for a minimum of 30 days prior to the procedure and for at least 3 months after the procedure.
Most likely not, as the medications used to treat or control autoimmune diseases will increase your chances of complications. Case-by-case evaluation can be done by the medical team or your Penuma® surgeon.
If you have undergone a PRP (Platelet-rich plasma) procedure, you are no longer a candidate for the Penuma® implant, as PRP injections can lead to fibrosis.
Please do not use any form of stretching or stretching exercises/external devices or vacuum pumps. This will damage your implant and may cause serious complications.
Excessive pressure on the implant can lead to a complication resulting in the removal of the implant.
A compression sleeve can help minimize post-surgical swelling and edema, thus likely reducing the length of the recovery period. At your first follow-up appointment, the wrapping around your penis will be replaced by a medical sleeve called UroWrap, which must be kept on your penis at all times until your drain removal.
Make sure to change your UroWrap and use a clean one every day. For the first week after the drain removal (or per the surgeon's instructions), please wear the UroWrap during the day and while sleeping. Remove the UroWrap every few hours if at home.
Please remove the UroWrap before you shower and keep the UroWrap off for an hour immediately after the shower in order to allow the penis to air dry. After the first week (or per the surgeon's instructions), please wear the UroWrap only during the day, and remove it at night. Continue to remove it whenever you shower or submerge yourself in water.
Are you considering getting a Penuma implant but unsure if you qualify? If you are older than 21 and want penile augmentation, the Penuma procedure could be a possibility for you. For people with buried penises, retractile penises, or mild to moderate penile curvature, Penuma may be a viable solution.
We want to make sure you have all the information you need to decide whether the Penuma penile enhancement surgery is the appropriate decision for you since we understand that every man’s situation is unique. Schedule your consultation today to learn if Penuma can help you live a life of confidence.