The Men Using Lip Filler to Increase Girth

It’s a warm Tuesday in early May, and I’m a block from the historic New York Public Library building in midtown staring at a penis. It’s semi-erect and bleeding slightly, but there’s gauze on hand to soak things up. Bobbing in and out from under the skin at the shaft is an inch-long needle (technically a cannula since it’s not sharp and is going into a small hole already created by a needle) attached to a syringe that contains hyaluronic acid. This same type of filler that’s been injected into countless lips is now being used to pursue a plumper, thicker look — except in this case, it’s one most people won’t see.

Dressed in all black, wearing purple medical gloves, and displaying the no-nonsense demeanor of someone who’s lost track of how many penises he’s seen in his career is Chris Bustamante, 32, known to many online as Injector Chris. We’re at Lushful Aesthetics, the clinic he runs as a licensed nurse practitioner and where this procedure, penile-girth enhancement (also known as penis filler), has quickly become the bulk of his working life.

As Bustamante injects five vials first into the sides of the shaft, then six more around the glans (if you’re picturing a mushroom as the head of a penis, that’s the glans, and he is injecting around the base rim of the dome), he sweeps the needle slightly from side to side, then uses his thumbs to massage out any filler lumps, sculpting through what he calls “transitional zones” like a potter smoothing an edge of clay.

“It goes beyond just filling up a penis,” Bustamante says. “I really do think that there is an artistry to it, to making it look good: aesthetically pleasing, no lumps, smooth, consistent, looks natural, feels natural — all those things.”

“What I do for the face as an artist is really what I’m doing down there as well. And I think it just takes knowing what a nice penis looks like.”

This morning’s penis belongs to a 26-year-old gay man who works in marketing and who’s asked to be referred to in this story by a fake name he’s picked out, Tommy, given the sensitive nature of me reporting on his sensitive area. In the past two and a half years, he’s had this procedure done twice, forking over roughly $25,000 for a total of 36 syringes of Revanesse Versa mixed with a little Radiesse, which have increased his girth by about an inch and a half. Today, he’s also having eight syringes of filler injected into his scrotum to add even more heft to his Speedo bulge this summer. Once everything settles, Tommy is unlikely to experience any decreased sensation during sex (indeed, studies show his sexual satisfaction will likely increase for the next 18 months), but Tommy says his boyfriend will also be enjoying the increased size.

“It’s an immediate confidence booster both in the bedroom and outside the bedroom — even if I’m just walking around,” Tommy tells me as he sits in a reclining medical chair, naked from the waist down, save for a paper sheet through which his penis is staring up at me. “It feels nice. It feels more full.” (Bustamante comped Tommy for the procedures I witnessed in exchange for him agreeing to talk to a reporter.)

Tommy is among a growing number of men turning to fillers to expand their girth. Improving on the clunky and dangerous silicone injections of yore, the procedure has become increasingly common in the past few years. Although there’s no central database on the number of these penile-filler enhancements (an American Society of Plastic Surgeons spokesperson told me, they don’t yet track the data), they have been a topic of increasing discussion at recent American Urological Association conferences, Florida urologist and association member Justin Dubin told me. And just this month, the Sexual Medicine Society of North America published its first-ever position statement on them, noting what they said was the shift of such procedures from the “niche areas of sexual medicine” where they had been “historically … relegated” to their more recent status as topics being “increasingly discussed within academic congresses.” While men throughout history have long been obsessed with the size of their penis, much of that attention has traditionally been on length, rather than width. But in a year where a man who calls himself the Girthmaster can make tens of thousands of dollars each month on OnlyFans, it’s clear that circumference matters.

For Bustamante, client demand for girth-enhancement procedures has, well, expanded to a truly staggering level. The first day we met at his office in late April, he had just finished two penis filler appointments, with two more set for that afternoon, as well as some follow-up visits from patients who had previously had the procedure done. Currently, half of all the revenue Bustamante’s practice brings in (a total of $2.2 million in just his second year open) is from this one procedure. Girth is quite literally paying the bills. “I like the fact that I’ve honed in on a market that I can do well, and people are super happy,” Bustamante says.

He is far from the only provider offering penis-girth enhancement — some plastic surgeons have even tried branding their procedures with names like SWAG or Z-ROC Hard — but his growing clinic is somewhat unique in that 95 percent of all the clients he sees for any procedure are men. About half also come from out of town to see him, some from as far as the U.K. or Dubai. His Instagram features a grid of handsome, mostly queer men (some of whom might be recognizable to OnlyFans subscribers) smiling for the camera as they demonstrate the effects of Botox, lip filler, or laser-hair removal. On X, he reposts videos from gay adult creators with massive followings whom have received discounts or free procedures in exchange for sharing clips of them undergoing penis enhancement or laser-hair removal on their butts and scrotums. “Loving the GIRTH, I feel in my hands, and in between some cheeks…or mouth,” one such performer told his 150,000 followers. “Check out @InjectorChris for penis filler! 🍆”

Bustamante estimates that about 85 percent of his facial-aesthetic patients are gay men, but when it comes to girth procedures, it’s about 50/50 gay and straight. Do gay and straight men think about their penises differently? He thinks his straight clients tend to just want things to be bigger at any cost, while gay men are thinking more about the look of their penis — not that any client is turning up to an appointment with inspiration photos like at some sort of penis salon. “I just felt kind of insecure, not necessarily in terms of my sexual capabilities but it was more my sexual aesthetic,” says Tommy, which is to say that he wants his dick to look impressive in a Grindr photo, not just when he meets partners IRL.

Tommy isn’t alone in his insecurities. One 2022 study of men seeking penile-girth procedures found their most common reason for doing so was to improve self-confidence. And such an outcome is likely, according to a 2019 study that showed a high-satisfaction rate among girth patients, as well as increased sexual confidence and increased self-confidence, particularly in places where their penises might be on display, such as a locker room (the procedure increases the girth when the penis is both flaccid and erect).

Yet this lack of confidence may also be mostly in these men’s heads; other research has shown that most men seeking penile-enhancement surgery have perfectly normal-size penises but just view them as small due to forms of body dysmorphia perhaps exacerbated from seeing large penises in pornography. Thanks a lot, Girthmaster.

Dubin, from the American Urological Association, advised anyone considering the procedure to speak first with a urologist. The visit may end up allaying concerns; Dubin said he has often reassured patients that their penises are of a normal size. (For what it’s worth, a 2014 international study of more than 15,000 penises found an average erect length of 5.16 inches and girth of 4.6 inches; when flaccid, the average penis was 3.6 inches long and 3.7 inches wide.) Still, he is among a new generation of his urologists who have slowly become more comfortable in advising patients seeking girth enhancements. “Women can get their breasts done cosmetically; we’ve always thought that was a way for women to feel better about themselves and have self-improvement,” Dubin said. “Why can’t men have that same kind of ability to do that with their penises?”

The Food and Drug Administration has approved the use of hyaluronic acid but not for the penis specifically, so this is technically an off-label application. Yet Dubin said he viewed the procedure as “reasonably safe,” especially compared with other past methods of penis augmentation that are mostly concerned with length, not girth, and that can leave people disfigured. Although the American Urological Association has not yet put out a statement on penile-girth enhancement, Dubin suspects that will soon change. “People are going to do this with or without urologists, and if we can find a safer, better way to do it, we should,” Dubin said. “As urologists, we’re like the stewards of the penis, and we should be the ones doing this.”

Of course, there are risks associated, especially for those who undergo the procedure at medspas or other clinics not run by board-certified professionals where infections may develop. (Similar risks exist for men who inject themselves.) Other studies have reported pain, itching, and inflammation at injection sites as well as under-skin bleeding, among small numbers of men, although these symptoms largely healed on their own. One study also found that 2.2 percent of patients developed nodules, or lumps, where the hyaluronic acid had accumulated in certain spots or had not been distributed evenly. To try to prevent this, Bustamante injects his filler slowly and asks patients to massage their penises on their own for around 15 minutes per day, either while flaccid or erect, before returning for a follow-up appointment in two weeks. Bustamante also said the risk of filler migrating is rare if injected properly, although many medical professionals advise against sex or exercise for at least two weeks after the procedure to prevent this.

On RealSelf, a popular cosmetic-procedure advisory website and online marketplace, 90 percent of the 40 users who left reviews about their own penis-filler experience recommended the procedure. The few who didn’t complained of lumps (one complained of their injector turning their penis “into Frankenstein”) or weren’t happy with the speed with which their filler dissolved (filler will usually begin to slowly dissolve after six to eight months but can last for up to three years in the shaft).

Bustamante says he doesn’t view his job as about making guys conform to a certain standard of jawline or penis but instead helping them feel the best they can for the short time they’re on this planet. It’s why he wanted to get into this line of work to begin with. Growing up Latino in the mostly white town of Huntington on Long Island, he never liked the way he looked until he came out as gay and started experimenting with makeup. Suddenly, he felt empowered. Prior to obtaining his doctorate of nursing at Columbia University, he worked in cosmetics stores because he wanted others to feel confident in their appearance. “The same thing kind of applied to [getting into] injectables,” he says, “but in a more substantial, impactful way that goes beyond something you can wash off at night.”

As he finishes up on Tommy’s penis, Bustamante injects a little extra filler into the left side to help correct its slight curve. And he makes sure not to put any filler on the top of the penis, only the sides, so as to ensure it doesn’t end up resembling a “sausage” when erect. He also wants to avoid “the baseball-bat effect,” so he tries to work toward a thicker base that tapers slightly up, rather than the reverse. If anyone isn’t happy with the result, Bustamante can inject Hylenex to dissolve the filler, but he says he’s never had to do this on penises he’s worked on, just ones on which other providers haven’t done their best work.

Before he leaves, Tommy also has some injections of Botox into his anus (“Holetox”), which can make bottoming easier by relaxing the anal sphincter muscles, but which for Tommy, a top, is more to help with anal fissures. It’s just one of a number of below-the-belt services that Bustamante offers, including chemical peels to clear up skin on the butt, an “instant” Brazilian butt lift that makes use of fillers, Botox for the penis to make it look larger when flaccid, Botox for the scrotum to help it hang lower and prevent sweating, and shockwave therapy to help with erections.

Tommy’s procedures take about an hour, including the consultation period, the insertion of Trimix to stimulate an artificial erection, the injection of nerve blockers, and the application of numbing cream — the latter two of which are to prevent any pain to the penis during the procedure (Tommy also opted to receive nitrous oxide, or laughing gas). He leaves with his penis wrapped in a bandage, but he can take that off tonight.

“I haven’t had any complaints, Tommy says. “It looks natural. No one’s ever detected anything. No one’s ever asked me, ‘Did you do this? Did you do that?’ It’s like I had the dick I always wanted.”