Himplant Before and After: A Look at the Results

Published case series show that the Himplant produces measurable increases in both penile length and girth, with studies reporting mean gains of roughly 3.5 to 4.4 centimeters in flaccid dorsal length and 2 to 3.6 centimeters in midshaft girth depending on the patient population. Those numbers, drawn from small surgical studies rather than large randomized trials, paint a picture that is encouraging but still incomplete. The device is relatively new to the peer-reviewed literature, and the “before and after” story involves more than measurements alone.

What the Himplant Actually Is

The Himplant, previously marketed as Penuma, is a solid silicone sleeve that a surgeon places beneath the skin of the penile shaft through an incision near the top of the scrotum. It is not an inflatable erectile device and does not pump up or down. Instead, it sits around the shaft permanently, adding bulk the way a shell surrounds a cylinder. The wall thickness varies along its length from about 1.5 to 2.5 centimeters, and it comes in three sizes: 14, 16, and 18 centimeters long. It holds four separate 510(k) clearances from the U.S. Food and Drug Administration, with approved uses that include cosmetic correction of soft tissue deformities and cosmetic enhancement of the penis.¹

That distinction matters. The Himplant is not designed to treat erectile dysfunction in the way inflatable penile prostheses are. It does not create an erection. Some patients with partial erections may find that the added rigidity from the sleeve helps during intercourse, but the device’s primary purpose is changing the physical dimensions and appearance of the penis, not restoring hydraulic function.

Measured Size Changes Across Studies

The most commonly asked question about any “before and after” outcome is simple: how much bigger? The answer varies by study and patient population, but the direction is consistent across the published case series.

In a series of four men who received the Himplant after radical prostatectomy for prostate cancer, the mean increase in flaccid dorsal length was about 4.4 centimeters and the mean increase in flaccid midshaft girth was roughly 3.6 centimeters. Both changes were statistically significant, though the study’s authors noted that the statistical power was low given the small sample.¹ Erect measurements were not recorded in that study, which is a gap worth flagging. Many men care more about what happens during an erection than in a flaccid state, and the published data simply does not address that dimension yet.

A separate pilot study looked at men with adult-acquired buried penis, a condition where the shaft retracts into surrounding tissue. Those patients saw a mean increase of about 3.5 centimeters in flaccid dorsal length and roughly 2.8 centimeters in midshaft girth.² A third case series, focused on men with residual penile deformity after prior Peyronie’s disease treatment, found smaller gains: about 1.5 centimeters of additional flaccid length and 2.0 centimeters of girth on average.³

The range across these studies, roughly 1.5 to 4.4 centimeters in length and 2.0 to 3.6 centimeters in girth, reflects differences in starting anatomy, the reason for surgery, and the specific patient group. Men whose anatomy had been significantly altered by cancer surgery or a buried penis saw larger absolute gains, while those with post-Peyronie’s scarring saw more modest changes. This is not surprising. A device that physically wraps around the shaft will produce different visible results depending on how much tissue was already present and how much skin laxity allowed the implant to add apparent length.

Complication Rates From a Larger Cohort

Small case series are useful for understanding what the implant does, but complication data requires bigger numbers. The largest published dataset to date followed 299 men who received the silicone sleeve implant across multiple surgical centers. The average patient was around 42 years old with a body mass index of about 28.5, and the group had relatively few health problems going in: about 5 percent had high cholesterol, 2 percent were smokers, 2 percent had cardiovascular disease, and 1 percent had diabetes.⁴

Complication rates from that cohort were as follows:

• New erectile dysfunction: 0 percent. No patient developed new-onset ED after the procedure.
• Infection: 1.3 percent.
• Seroma: 2.0 percent. A seroma is a pocket of fluid that collects near the surgical site.
• Erosion: 5.0 percent. This is the most common complication, where the implant pushes through the overlying skin.

Erosion at 5 percent is the number that jumps out. When an implant erodes through tissue, it typically requires surgical revision or removal. The 299-patient study established that the device does not appear to cause erectile dysfunction on its own, which is reassuring, but the erosion rate means roughly one in twenty men faced a second procedure. Whether that rate will hold, improve, or worsen as more data accumulates from longer follow-up is still unknown.⁴

The buried penis pilot study reported an even lower complication profile: no infections, no erosions, and no cases requiring implant removal over a median follow-up of about 16.5 months.² That is encouraging, but seven patients followed for just over a year does not overwrite a 299-patient dataset. Both numbers should be held loosely until longer-term and larger studies become available.

How Results Compare to Injectable Alternatives

The Himplant is not the only option for penile girth enhancement. Dermal fillers, primarily hyaluronic acid and polylactic acid, are injected into the penile skin to increase circumference without a solid implant. These injectables are popular because they avoid a surgical implant, but the results differ in meaningful ways.

A systematic review and meta-analysis pooling data from multiple studies found that hyaluronic acid injections increased penile diameter more than polylactic acid injections, with both approaches considered safe in the short term. Neither material showed a significant increase in pain or inflammation compared to the other.⁵ A separate randomized trial of hyaluronic acid filler found mean girth increases of about 2.3 centimeters in the treatment group, and both groups in that trial showed improved satisfaction scores and self-estimated sexual performance afterward.⁶

The key trade-off is durability versus invasiveness. Fillers are absorbed by the body over time, meaning their effects gradually diminish and repeat injections are needed to maintain girth. The Himplant, as a solid silicone device, provides a permanent structural change but requires an actual surgical procedure and carries the risks associated with any implanted foreign body, including the erosion rates described above. Fillers also add girth without much effect on apparent length, whereas the Himplant’s sleeve design can change both dimensions.

Satisfaction and Self-Confidence After Surgery

Measurements on a ruler are one thing. Whether a patient actually feels better about himself is another, and arguably the more important outcome. The buried penis pilot study included a follow-up questionnaire and found that about 86 percent of respondents reported improved self-confidence in both daily life and sexual activity.² The questionnaire used in that study was not a validated psychological instrument, which limits how much weight you can put on the exact percentage, but the general direction is consistent with broader penile prosthesis research.

A larger study of inflatable penile prostheses (a different device category, used primarily for erectile dysfunction) found that at one year or more after surgery, about 83 percent of patients and 85 percent of their partners reported satisfaction. Satisfaction dropped when complications occurred, when patients perceived postoperative length shortening, or when they experienced pain.⁷ A separate study of penile prosthesis recipients and their partners found significant recovery in arousal, orgasm capacity, and satisfaction scores in both patients and partners after the procedure, with no meaningful difference in satisfaction between the two groups.⁸

These partner and patient satisfaction studies were conducted on inflatable prostheses for ED, not the Himplant specifically, so they cannot be directly mapped onto cosmetic penile implant outcomes. But they offer a useful frame of reference: penile prostheses in general tend to produce high satisfaction rates, and partner satisfaction tends to track closely with patient satisfaction. Whether complication-related dissatisfaction will prove equally important for Himplant recipients is a question that needs its own long-term data.

Who Seeks Penile Augmentation and Why It Matters for Expectations

Understanding the typical patient considering a Himplant matters because expectations going in heavily influence satisfaction coming out. Research on men seeking penile girth augmentation has found that the most commonly reported motivation is improving self-confidence, followed by wanting to change penile size or appearance, improving sexual function, and addressing feelings of insecurity. Compared to men who were not seeking surgery, those pursuing augmentation scored higher on measures of penile dysmorphic concerns, lower on self-esteem, and lower on body image quality of life. About 11 to 14 percent of men in one study met diagnostic criteria for body dysmorphic disorder.⁹

That last finding is clinically important. Body dysmorphic disorder, or BDD, involves a preoccupation with perceived physical flaws that others do not notice or consider minor. People with BDD frequently remain dissatisfied after cosmetic procedures because the problem is perceptual, not physical. Surgeons who perform penile augmentation are increasingly encouraged to screen for BDD before operating, because a patient whose dissatisfaction is rooted in distorted self-perception is unlikely to be happy with any measurable outcome.

Qualitative research has also explored what shapes men’s perceptions of their own size. Interviews with men seeking augmentation identified three recurring themes: the influence of pornography, comparison with peers (usually in locker rooms), and indirect exposure to jokes about small penises in mainstream media. All participants had compared themselves unfavorably to others, and none had actually received direct negative comments about their size.⁹¹⁰ This gap between perceived inadequacy and actual feedback from partners or peers is worth sitting with. A procedure that adds two to four centimeters of girth will not recalibrate a man’s relationship to pornography or locker room comparison.

Age-Related Differences in Motivation

Not all men arrive at the decision for the same reasons. A cross-sectional study of Chinese men seeking penile girth enhancement found sharp differences between younger and older patients. Younger men scored significantly higher on measures of social comparison, masculinity-related appearance stress, and psychological distress. Psychological distress in particular was an independent predictor of surgical intent in younger men, meaning the more distressed a young man felt, the more likely he was to pursue surgery.¹¹

Older men, by contrast, tended to be driven more by straightforward dissatisfaction with appearance or functional concerns, with lower levels of the social comparison and distress that characterized younger patients. This split suggests that “before and after” means something different depending on where a patient is in life. For a younger man whose primary driver is psychological distress and peer comparison, the “after” he is hoping for may not be fully addressed by a physical change. For an older man with a concrete cosmetic or functional complaint, the results described in the published case series may align more closely with what he was looking for.

What the Evidence Does Not Yet Show

The honest picture of Himplant before and after includes acknowledging what the published research has not yet established. Every study cited here involves small patient numbers, short follow-up periods, or both. The largest dataset, 299 patients, is a reasonable surgical cohort but still not the kind of evidence base that would settle questions about long-term safety. No study has followed Himplant recipients for five or ten years to track late complications, implant integrity, or evolving satisfaction.

Erect measurements have not been published. For a device whose central promise involves changing how the penis looks and feels, the absence of erect-state data is a significant blind spot. Partners’ perspectives on the Himplant specifically, rather than on penile prostheses in general, have not been formally studied. And no head-to-head trial has compared the Himplant directly against injectable fillers, fat transfer, or other augmentation approaches, so any comparison between these methods relies on indirect evidence from separate studies with different patient populations and outcome measures.

Litigation data from the broader penile prosthesis field offers a cautionary footnote. A legal database review of penile prosthesis lawsuits found that the most common alleged breach of duty was error in surgical decision-making, present in nearly half of cases. Issues with informed consent appeared in about a third of filings.¹² That study covered penile prostheses generally, not the Himplant in particular, but it underscores how important thorough preoperative counseling is. A patient who understands the realistic range of outcomes, the possibility of complications requiring reoperation, and the limits of what a physical change can do for psychological well-being is far less likely to feel misled after surgery.

The Screening Question Most Surgeons Should Be Asking

Given that roughly one in ten men seeking penile augmentation may meet criteria for body dysmorphic disorder, and that younger men in particular tend to be driven by psychological distress and social comparison rather than purely cosmetic goals, the most impactful part of the “before and after” journey may happen before anyone enters an operating room. A growing body of research suggests that validated screening tools for BDD and psychological distress should be part of the preoperative workup for any cosmetic genital procedure.⁹ A surgeon who adds three centimeters of girth but does not address the underlying distress has treated the symptom, not the problem. For the right patient, the published data on the Himplant shows a device that delivers measurable physical change with a manageable complication profile. For the wrong patient, no amount of silicone will produce the “after” he was imagining.