P-Upgrade Review: What to Know Before Penile Filler Enhancement

Quick Answer: What Is the P-Upgrade?

P-Upgrade is The Re/ Clinic’s nonsurgical penile enhancement procedure using hyaluronic acid, or HA, filler to increase penile girth and create a fuller appearance.

HA is a gel-like substance commonly used in aesthetic medicine to add volume to soft tissue.

The goal of penile filler is primarily circumference enhancement, not permanent structural lengthening.

Published clinical studies have shown measurable increases in penile girth after HA filler injection, with improvements in appearance satisfaction reported by many participants. However, results vary by patient, filler amount, injection technique, and follow-up period.

The procedure is temporary, and maintenance treatment may eventually be needed.

Watch: P-Upgrade Explained at The Re/ Clinic

Original Video Language: Spanish

English Transcript

Patricia Dominguez:
A lot of people don’t like talking about this topic, but I’ve heard about men getting upgrades, like a “P-Upgrade” or enhancement, for their penis. How does that work?

Dr. John Dame:
There are several treatments that can be done, and one of the most popular is using what’s called a filler. It’s hyaluronic acid.

This helps increase the width, or girth, of the penis. It helps create a fuller, larger, but still natural-looking appearance, and it can also help a man feel more confident.

Patricia Dominguez:
Oh, I see. So it looks natural?

Dr. John Dame:
The purpose isn’t to completely change it, right? It’s to enhance it.

Patricia Dominguez:
And that’s something men are often very afraid of when it comes to that area of their body. They’re worried about doing anything there because they think something could go wrong and then say, “Oh no, it doesn’t work anymore.”

English translation lightly edited for clarity and natural phrasing while preserving the meaning of the original Spanish conversation.

1. What Is Hyaluronic Acid?

Hyaluronic acid is a substance naturally present throughout the human body, including in skin, joints, and connective tissue.

When manufactured as an injectable filler, HA is formulated into a gel that can create volume within soft tissue.

HA fillers are widely used in aesthetic medicine for areas such as:

Lips
Cheeks
Chin
Facial folds
Certain hand-volume indications

One feature that makes HA particularly useful as a temporary filler is that the body gradually breaks it down over time.

It can also generally be dissolved using an enzyme called hyaluronidase if medically necessary.

That combination of temporary volume and reversibility is one reason HA has been investigated for nonsurgical penile girth enhancement.

2. How Does Penile Filler Increase Girth?

Penile filler does not work by increasing the size of the erectile chambers themselves.

Instead, HA filler is placed within soft tissue around the penile shaft to add volume.

Think of it more like changing the outer contour rather than rebuilding the internal anatomy.

The primary goal is typically:

Increased circumference
Fuller appearance
Improved proportionality
Greater flaccid presence

The Re/ Clinic describes P-Upgrade primarily as a girth-enhancement procedure using hyaluronic acid filler.

3. Does P-Upgrade Look Natural?

That is one of the main goals of treatment.

As Dr. Dame explains in the video, P-Upgrade is intended to enhance rather than completely change a patient’s anatomy.

A natural-looking result depends on several factors, including:

Amount of filler used
Existing anatomy
Injection technique
Distribution of filler
Number of treatment sessions
Patient goals

More filler is not automatically better.

A staged approach may allow the provider and patient to evaluate the appearance before deciding whether additional volume is desired.

The Re/ Clinic’s existing P-Upgrade information describes the approach as gradual and customizable rather than attempting a dramatic transformation in one treatment.

4. How Much Size Increase Is Realistic?

Published studies have documented measurable increases in penile girth following HA filler injection, although the exact amount varies considerably.

A 2022 multicenter randomized trial involving 64 men found an average increase in penile girth of approximately 22.7 mm, or 2.27 cm, in the HA group at 24 weeks.

Another randomized study reported an average girth increase of approximately 1.7 cm at 48 weeks among men receiving HA filler.

A separate study of 38 patients found larger early increases that gradually decreased during the first year as the filler changed over time.

These are study averages, not guarantees.

Your result can depend on:

Starting anatomy
Amount of filler used
Specific filler product
Injection method
Desired appearance
How your body metabolizes HA

This is why a consultation is more useful than choosing a target number based on someone else’s before-and-after photo.

5. What Does the Research Show?

Penile HA filler has more published human research than many patients expect.

Randomized Multicenter Trial

A 2022 randomized multicenter trial compared hyaluronic acid filler with polylactic acid filler.

Both treatments produced statistically significant increases in penile girth.

Men in both groups also reported improvements in satisfaction with penile appearance and sexual life. No serious adverse events were reported during the study.

48-Week Randomized Trial

A separate multicenter randomized trial followed patients for 48 weeks.

Girth remained above baseline in both groups at the end of follow-up, with the HA group showing an average increase of approximately 16.95 mm.

Treatment-related adverse events in that study were described as mild and temporary.

18-Month Follow-Up

An earlier prospective study followed patients receiving HA penile filler for up to 18 months.

Researchers found that increased girth was maintained during follow-up, although this study used a particular filler and relatively large injection volumes that may not reflect every modern clinical protocol.

Systematic Review and Meta-Analysis

A systematic review and meta-analysis evaluating HA and polylactic acid filler found that both were associated with increased penile girth.

HA showed an advantage in penile diameter and some measures of sexual satisfaction compared with PLA in the included studies.

What Does This Mean?

There is legitimate clinical evidence showing that HA filler can temporarily increase penile circumference.

However:

Studies remain relatively small
Techniques differ
Filler products differ
Injection volumes vary
Long-term evidence is more limited
Results should not be assumed to be permanent

6. Does Penile Filler Affect Erectile Function?

This is an important distinction.

P-Upgrade is primarily a size and appearance procedure, not an established treatment for erectile dysfunction.

The filler is adding volume around penile tissue. It is not intended to replace the physiological mechanism responsible for an erection.

A patient can therefore want penile enhancement while having completely normal erectile function.

If a patient is primarily concerned about:

Difficulty getting an erection
Difficulty maintaining an erection
Reduced rigidity
Other changes in sexual function

those concerns deserve their own evaluation.

The Re/ Clinic offers separate sexual-wellness treatments, including P-Shot, shockwave therapy, P-Tox, and hormone evaluation, depending on the patient’s individual concerns.

7. What Happens During a P-Upgrade?

The exact protocol depends on the patient’s goals and anatomy.

At The Re/ Clinic, the process typically starts with a confidential consultation.

Consultation

You can discuss:

Desired increase in girth
Current anatomy
Expectations
Medical history
Sexual function
Previous procedures
Questions or concerns

This is also the time to discuss what a natural-looking result means to you.

Numbing

A numbing medication is used to reduce discomfort.

The clinic’s current service page notes that topical numbing is applied before treatment.

Filler Placement

HA filler is carefully injected into the targeted tissue.

The amount used depends on the patient’s anatomy and desired outcome.

Shaping

The provider distributes and shapes the filler to create an even contour.

Aftercare

You receive instructions about:

Swelling
Bruising
Activity
Hygiene
Sexual activity
When to contact the clinic

The entire appointment is typically relatively short compared with surgical penile enhancement.

The Re/ Clinic currently estimates approximately 30 to 45 minutes, depending on the individual treatment.

8. Does P-Upgrade Hurt?

Numbing is used before treatment to make the procedure more comfortable.

Patients may still experience sensations such as:

Pressure
Pinching
Temporary tenderness
Swelling
Bruising

Experience varies from person to person.

The Re/ Clinic currently describes the procedure as minimally uncomfortable with topical numbing used beforehand.

9. What Is Recovery Like?

P-Upgrade is minimally invasive compared with surgical enhancement, but that does not mean the tissue has experienced nothing.

Temporary effects may include:

Swelling
Bruising
Tenderness
Temporary unevenness while swelling settles

The Re/ Clinic notes that patients generally return to routine daily activity quickly.

Your provider should give you specific instructions about strenuous activity and sexual activity based on your treatment.

Following those instructions is important while the tissue settles and the filler integrates.

10. How Long Does P-Upgrade Last?

HA filler is temporary.

The Re/ Clinic currently estimates P-Upgrade results at approximately 12 to 18 months, although individual duration varies.

Published studies have demonstrated persistent girth increases at:

24 weeks
48 weeks
12 months
18 months

depending on the study and filler used.

How quickly filler is metabolized can vary based on:

Product
Injection volume
Individual metabolism
Tissue characteristics
Time

Some patients may eventually choose maintenance treatment.

11. Is P-Upgrade Reversible?

One advantage of hyaluronic acid filler is that it can generally be dissolved using an enzyme called hyaluronidase.

This can be useful if there is:

An unwanted aesthetic result
Excess product
Asymmetry
A complication requiring filler dissolution

However, the ability to dissolve HA should not be interpreted as meaning the procedure is completely risk-free.

Hyaluronidase itself is a medication, and management of complications should be performed by a qualified medical provider.

12. What Are the Risks of Penile Filler?

This is the question hinted at at the end of Patricia and Dr. Dame’s conversation.

Men may understandably worry:

Could something go wrong? Could this affect function?

Published penile-filler trials have generally reported favorable safety outcomes in the relatively small groups studied, but no injectable procedure is risk-free.

Potential issues can include:

Swelling
Bruising
Pain or tenderness
Asymmetry
Nodules or lumps
Uneven filler distribution
Infection
Filler migration
Inflammatory reaction
Unsatisfactory cosmetic result

A rare but serious complication of dermal fillers generally is vascular occlusion, which occurs when filler blocks or compresses a blood vessel and compromises blood supply to tissue. The FDA emphasizes that filler injections can carry serious risks and should be performed by licensed healthcare professionals with appropriate training and knowledge of anatomy and complication management.

This is why choosing an experienced medical provider matters.

13. Is Penile Filler FDA-Approved?

This needs a precise answer.

Hyaluronic acid fillers exist as FDA-approved medical devices for specific indications.

However, FDA approval applies to specific products, anatomical locations, and intended uses.

Current FDA-approved dermal filler indications include areas such as:

Lips
Cheeks
Chin
Facial wrinkles and folds
Certain under-eye areas
Jawline
Back of the hands

The FDA does not list penile augmentation as an approved dermal-filler indication.

Therefore, describing the penile procedure itself simply as “FDA-approved” would be misleading.

A more accurate statement is:

The procedure uses hyaluronic acid filler, a material used in FDA-approved filler products for specific aesthetic indications. Penile augmentation is an off-label use.

Patients should understand that distinction as part of informed consent.

14. Who Might Consider P-Upgrade?

P-Upgrade may appeal to adult men who are primarily interested in:

Increased penile girth
Fuller flaccid appearance
Improved proportionality
Nonsurgical enhancement
Temporary rather than permanent augmentation
A customizable or staged approach

It may not be appropriate for everyone.

A consultation should include discussion of:

Medical history
Current medications
Previous penile surgery or filler
Existing penile conditions
Infection
Skin conditions
Erectile function
Expectations

The goal should be realistic enhancement, not chasing an arbitrary measurement.

15. P-Upgrade vs P-Shot: What’s the Difference?

These two treatments are easy to confuse.

P-Upgrade

Primarily focuses on:

Penile girth
Fullness
Appearance
Proportion

It uses hyaluronic acid filler.

P-Shot

Primarily focuses on:

Erectile concerns
Sexual wellness
Regenerative treatment

The Re/ Clinic’s current P-Shot protocol uses platelet-rich plasma and may incorporate a human tissue allograft.

Someone may be interested in one treatment, both, or neither depending on his goals.

A consultation helps separate size concerns from function concerns.

Frequently Asked Questions

Does P-Upgrade actually make your penis bigger?

HA filler can increase penile circumference.

Randomized clinical studies have demonstrated measurable increases in penile girth following HA filler injection.

The exact increase varies by patient and treatment protocol.

Does P-Upgrade increase length?

P-Upgrade is primarily intended for girth enhancement, not true structural penile lengthening.

A fuller flaccid appearance may change how the penis looks, but patients should not confuse that with surgically lengthening the underlying anatomy.

Does penile filler look natural?

It can be designed to create a natural-looking enhancement.

Outcome depends on anatomy, filler volume, distribution, technique, and patient expectations.

Is penile filler permanent?

No.

HA filler is gradually metabolized by the body.

The Re/ Clinic currently estimates results lasting approximately 12 to 18 months, though duration varies.

Can P-Upgrade be reversed?

HA filler can generally be dissolved with hyaluronidase if necessary.

That is one reason some patients prefer HA over permanent materials.

Does P-Upgrade hurt?

Numbing is used before injection to reduce discomfort.

Some temporary tenderness, swelling, or bruising may occur afterward.

Is P-Upgrade surgery?

No.

It is an injectable, minimally invasive procedure and does not involve surgical implants or incisions.

How long does P-Upgrade take?

The Re/ Clinic currently estimates approximately 30 to 45 minutes, depending on the treatment.

How long until the final result is visible?

Volume changes are visible immediately, but swelling can temporarily affect appearance.

The Re/ Clinic notes that the appearance generally settles over the following days as swelling decreases.

Can penile filler cause erectile dysfunction?

Published studies have not established erectile dysfunction as an expected outcome of properly performed HA girth enhancement.

However, penile filler is still a medical procedure with potential complications.

Any new difficulty with erections, significant pain, discoloration, worsening swelling, or other concerning symptoms after treatment should be reported promptly to the treating provider.

Is penile filler FDA-approved?

HA filler products are FDA-approved for certain specific aesthetic indications, primarily involving facial tissue and the hands.

Penile augmentation itself is not an FDA-approved filler indication.

Is P-Upgrade the same as P-Shot?

No.

P-Upgrade uses HA filler primarily for girth enhancement.

P-Shot is a separate regenerative sexual-wellness treatment.

Thinking About Penile Enhancement? Start With a Private Conversation.

There is nothing unusual about wanting to ask questions before doing something to one of the most sensitive areas of your body.

In fact, you should ask a lot of them.

At The Re/ Clinic in Sandy, Utah, P-Upgrade consultations are designed to be confidential and straightforward.