Question 1

What is a Himplant?

Accepted Answer

The Himplant by Penuma is the first FDA-cleared penile implant designed to increase flaccid penis size. Made of medical-grade silicone that’s similar to implants used in other cosmetic enhancements, it fits like a sheath over the shaft, just under the skin.

Unlike other options, the Himplant is not inflatable. It’s also not specifically designed to treat erectile dysfunction (ED), the inability to get and keep an erection firm enough for penetrative sex.

Penile implant surgery is a 45-minute procedure, performed under general anesthesia in a surgery center.

According to the manufacturer, patients typically see an increase in flaccid penile girth of 1 to 2 inches. Increases in flaccid length have also been reported.

The Himplant comes in various sizes, and the shape and contour is customized for each patient. “Some sizes may not be able to ‘fit’ inside certain penises due to the physical limitations of their skin,” cautions Dr. Tim Neavin, a plastic surgeon in Beverly Hills, California.

Question 2

Who makes a good candidate for the Himplant?

Accepted Answer

This penile enhancement procedure can be a good one for men who:

Patients must be circumcised, since the post-procedure girth enhancement can prevent retraction of the foreskin, even when the penis is flaccid.

Dr. James Elist, an urologist in Beverly Hills, California who developed the Himplant, noted that patient selection and realistic expectations are key to successful outcomes. Providers have to follow a rigorous patient selection process that considers their health status, physical factors (including previous penis enhancement surgery), and psychological state.

According to Dr. Elist, the patient selection process, “from initial evaluation to a final decision by both the clinic and the patient, can take weeks, and even months.”

Question 3

Himplant pros and cons

Accepted Answer

Pros

A Himplant procedure can increase flaccid penis size—both girth and length.
This male enhancement option can enhance self-confidence and sexual satisfaction.
The tiny scrotum incision (to insert the implant) leaves inconspicuous scars. No incisions are made on the penis itself.
The implant contains no gel or liquid; it’s made of a malleable material designed to look and feel natural. According to the manufacturer, patients report that the implant is undetectable to sexual partners who haven’t seen them before the surgery.
Recovery time is minimal.
Results are permanent.
It’s available in multiple sizes and customized to your anatomy.

Cons

The Himplant costs $18,000, on average. Because it’s an elective cosmetic procedure, it’s not covered by insurance.
Though the Himplant is designed to be natural-looking and -feeling in both flaccid and erect states, “many men don’t like the idea of having a silicone implant placed in their penis because [they worry] it may feel unnatural to their partner,” says Dr. Neavin.
You’ll need to abstain from sexual activity and masturbation for six weeks after the surgery, until you’re entirely healed.
The penis will be swollen for a few weeks post-procedure.
Some patients experience pain with erections and partial loss of sensation in the penis. These side effects are usually temporary but can become chronic, especially if a patient has a complication like an infection. “If it becomes infected, it will often need to be removed, and fibrosis from the infection can shorten the penis,” says Dr. Neavin.
The procedure doesn’t treat ED.
The implant can also break or erode over time.
It requires that the patient be circumcised, which can be an additional expense.

RealSelf Tip: The Himplant is not yet widely available, but providers who offer it are based across the U.S., including in Atlanta; Austin, Texas; Beverly Hills, California; Boston; Chicago; Miami; New York City; Phoenix; San Francisco; Shreveport, Louisiana; and Washington D.C.

Question 4

How a Himplant procedure works

Accepted Answer

Here’s what happens during this type of penis enlargement surgery.

First, you’ll be given general anesthesia, so you’ll be completely asleep.
Then, your surgeon will make a small incision on the side of the scrotum. This leaves little to no visible scarring or textural changes.
Then they’ll insert the implant just beneath the skin of the shaft, above the corpus cavernosa (the spongy bodies at the top of the shaft that help create an erection) and secure it with small stitches.
The implant stretches the skin and tissue in the area, which makes your penis look and feel thicker and longer.
The surgeon will place a thin drain that exits at the scrotal incision site, to remove fluid and blood, prevent build-up, and improve healing. The drain is typically removed three days post-op.
After your procedure, you’ll be groggy from the anesthesia. Make sure you have someone you trust there to drive you home.

Question 5

How long recovery takes

Accepted Answer

Most patients are able to return to work about three days after surgery, though you’ll want to take more time if your job is physically demanding.

During these first three days, you’ll have follow-up visits with your provider to ensure that you’re healing properly.
Bruising and swelling will take a few weeks to resolve.
Mild to moderate pain can last up to four weeks, according to Dr. Elist. Pain medication can help manage discomfort. Icing the area (not the penis itself) and elevating the scrotum by putting a rolled-up towel in between your legs can also help.

Pain with erections and some loss of penis sensation may occur during the first few weeks. Both are usually temporary.

Your surgeon will provide instructions for post-op care, which includes refraining from sex for at least six weeks. Be sure to follow them. According to Dr. Elist, most side effects or complications are due to people not following surgical aftercare instructions.

Question 6

Is the Himplant permanent?

Accepted Answer

Himplant results last as long as the implant is in place. They are intended to be a permanent solution.

If you have a complication or decide you don’t like the results, the implant can be removed.

In a 2018 retrospective analysis (which reported only the experience of Dr. Elist, the developer of the implant), 60% of 400 patients remained improved 2–6 years after a Himplant procedure and 81% of them reported high or very high levels of patient satisfaction.

Question 7

Possible risks and side effects

Accepted Answer

Penile implant surgery with the Himplant is generally considered safe, but complications can happen and may require the implant to be removed. If it is removed, it’s not always possible that it can be replaced.

In the previously mentioned clinical study, the most frequently reported complications were:

seroma, or fluid accumulation (4.8%)
scar formation (4.5%)
infection (3.3%) 5 to 12 months post-op, usually associated with poor wound healing or implant breakage or extrusion

No participants reported any changes in sexual function, erections, or ejaculation, though 3% experienced adverse events that required implant removal.

In some cases, penile implants or their removal can leave the penis deformed or affect its sensation, Dr. Neavin reports. (One 2021 case report on a patient who had to undergo removal after a severe infection is a particularly vivid example).

Potential complications and side effects of implant removal include:

penile shortening
curvature deformity
erectile dysfunction

Question 8

Alternatives to the Himplant

Accepted Answer

If you’re on the fence about getting an implant, talk with an experienced provider who offers a range of penile augmentation options. They may recommend one of these.

Fat injections involve extracting excess fat from one area of the body via liposuction and transferring it into the penis.

This option has a strong safety profile and permanent results. “You can expect about 25% of the fat to remain viable permanently,” says Dr. Neavin. He calls his method S.T.I.F. (super-concentrated thrombocyte injection with fat). “S.T.I.F. is a form of fat transfer that incorporates platelet-rich plasma and soft casting for a week to reduce the migration issues and nodule formation, which have previously been the major drawbacks of penis fat-transfer procedures,” Dr. Neavin explains.
As with the Himplant, this option enhances girth more than length.
Fat has two big advantages over silicone implants, says Dr. Neavin: It tends to feel more like a natural erection and generally costs a fraction of the price of implant-based penis enlargement.

Temporary injectable fillers for penis enlargement are also growing in popularity.

The most common fillers include hyaluronic acid (HA) products like Juvéderm and Restylane. “Commonly, physicians offer these injections in the office under a trademarked procedure name, so it’s important to ask exactly what product is being injected since some hyaluronic acid products with larger particle size should be avoided in the penis due to risk of biofilm generation,” advises Dr. Neavin.
Fillers don't require a donor site and have little post-procedure swelling.
They’re also reversible if you don’t like the results.
A major disadvantage to fillers is that they’re temporary and tend to clump up in the penis, forming visible irregularities.
Other reported complications include bleeding, nodules, and infections. As with any filler injection, vascular occlusion is also a risk and can lead to skin death. (Be aware that there are also reports of silicone injections into the penis, a dangerous, potentially disfiguring practice that should be avoided.)

Ligament release severs the ligament that keeps the penis close to the body, improving penile length in the flaccid state.

This option doesn’t necessarily improve performance.
“The largest complaint patients have is that the penis is too wobbly, making intercourse awkward or penetration difficult, and the gains aren’t significant in the erect state,” says Dr. Neavin.

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Karyn Repinski

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Karyn Repinski

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