Girth Maxx and Other Methods of Penile Augmentation: Clinical Outcomes and Complications: A Retrospective Descriptive Study with Published Implant Comparators

Abstract

Background: Penile augmentation methods differ in durability, reversibility and treatment burden. We described circumference change, satisfaction and complications after three injection protocols and placed these findings alongside published implant outcomes. Methods: Retrospective cohorts comprised hyaluronic acid (HA; 214 patients), an HA–poly-L-lactic acid combination (Girth Maxx; 183) and Powerfill (32). Published Peniflex (232) and Penogrande (23) cohorts provided surgical context. Crossovers accounted for 19 repeated group memberships. Injection outcomes included clinician-measured flaccid midshaft circumference and a patient-reported satisfaction composite. Results were analysed descriptively using visit-specific denominators and Wilson 95% confidence intervals (CIs). Results: After an initial 20-mL HA injection, mean circumference gains at 2, 6 and 12 months were 2.10, 1.76 and 0.21 cm. At 12 months, 67/102 HA respondents were satisfied (65.7%; 95% CI 56.1–74.2). Girth Maxx satisfaction was 159/165 at the designated two-month visit and 141/144 at 10–12 months (97.9%; 95% CI 94.1–99.3). Mean retained gains were 1.30 cm at approximately 12 months and 0.80 cm at 24 months in subsets assessed before full-volume retreatment. Powerfill gains were 2.54 cm at two months and 1.84 cm at one year; 22/27 respondents were satisfied at one year (81.5%; 95% CI 63.3–91.8). Recorded complications included HA irregularity and migration, 14 Girth Maxx contour complications and five marked inflammatory episodes after Powerfill. Implant results involved different measurement states and concomitant lengthening procedures. Conclusions: HA offered a straightforward, modifiable approach but limited persistence. Girth Maxx showed a favourable observed balance of satisfaction and contour outcomes. Powerfill complications warrant caution despite persistence. Implants offer a long-term surgical option. These observational findings require prospective confirmation.