In a New Jersey procedure room, the patient lies still on the operating table, staring steadily at the ceiling above him.
Dressed in a gown with his fingers folded across his chest, he appears calm but intent from my vantage point — more like someone preparing for a therapy session than a cosmetic operation.
But Tom, a 35-year-old who requested anonymity, has not come to discuss his state of mind. He is undergoing a penis enlargement procedure.
Urologist Dr Stuart Diamond moves into position and carefully opens Tom’s gown to reveal the area being treated. Leaning closer, he inserts a half-inch needle into the side of the penis, injecting a small amount of fat intended to increase its size.
The process is repeated several times. From where I am watching, it seems to continue for an uncomfortably long stretch — I count at least a dozen injections in all. Yet Tom shows no sign of pain, prompting me to ask whether he is all right.
‘I can’t feel a thing,’ he replies, his gaze still fixed overhead.
Within 10 to 15 minutes, the injections are complete, and the surgeon begins gently massaging and shaping the area to help spread the fat evenly.
Roughly 45 minutes after it began, the procedure is finished. The tiny beads of blood at the injection sites are wiped away, and Tom gets to his feet, finally allowing himself to look down.
Dr Stuart Diamond and his wife Noelle are pictured above. Dr DIamond is administering the aloeClae injections to Tom’s penis
The above picture shows the alloClae fat injections being prepared
Dr Diamond is shown above holding the filler injection. He is in a side room away from the main room where the injections into the penis are carried out
‘I’m thrilled!’ he declares. ‘It looks great!’
Tom is one of a reportedly increasing number of men in the US opting for cosmetic procedures to increase the size of their penis.
Such treatments have been around for decades. One of the most common techniques involves using dermal filler – a gel, usually made from hyaluronic acid, the same substance widely used to plump lips and smooth wrinkles.
Injected beneath the skin of the penis, the gel adds volume, increasing its girth rather than making it significantly longer.
But what Tom has just had injected is very different.
He is one of just three men in the country to have undergone an experimental new procedure using donor fat – tissue harvested from the bodies of deceased people – to enlarge the penis.
I was the first journalist invited to watch the technique being performed.
The treatment uses a product called alloClae, which takes donated fat, extensively processes and purifies it, then packages it as an off-the-shelf product that can be shipped to cosmetic clinics and injected beneath the skin to add volume.
It may sound macabre, but donated human tissue has long been used in medicine. Bone, skin and tendons, for instance, are routinely transplanted or used in reconstructive procedures.
Now the same principle is making its way into cosmetic medicine.
Fat is attractive as a filler because it can provide soft, natural-feeling volume and, unlike conventional fillers, can become incorporated into the body’s own tissue.
Traditionally, however, using fat for cosmetic enhancement has meant undergoing liposuction to harvest it from another part of your own body. AlloClae is designed to get around that problem: it provides processed donor fat ready to inject, without the patient needing a second procedure to supply it.
The penis-enlarging procedure costs between $8,000 and $12,000.
There is no medical need for it – it is entirely cosmetic, designed to increase girth rather than improve sexual function.
Yet doctors say demand for cosmetic penis enlargement has grown in recent years, no doubt fueled by an insecurity that is remarkably common.
Surveys suggest about half of men worry about their penis size, although doctors say virtually all have no medical reason to do so.
Tom is one of just three men in the country to have undergone an experimental new procedure using donor fat – tissue harvested from the bodies of deceased people – to enlarge the penis
Dr Diamond is shown above injecting filler into Tom’s penis during the procedure. His wife Noelle is shown preparing the filler for injections in the background
While dermal fillers are FDA-approved for adding volume to areas including the lips, cheeks and chin, they are not approved for injection into the penis.
And there are significant potential complications including injury, scarring, infection and angled erections. With injectable fillers, there is also a risk that the material can migrate or collect unevenly, leaving the penis looking lumpy or misshapen.
For Tom, however, the potential risks were worth taking. His penis functioned normally and no partner had ever commented negatively on its size, he said, but it had worried him for virtually his entire life.
He simply no longer wanted to feel insecure or anxious about it, he told me.
Before the procedure, his penis measured four inches when stretched while flaccid. Doctors use this measurement, rather than erect length, because it provides a more consistent way of assessing penis size in the clinic and is the standard method used to diagnose conditions such as micropenis.
Tom’s measurement was below the average stretched length of 5.2 inches but remained just above the threshold for a micropenis – the medical term for an abnormally small but otherwise normally formed penis.
This is generally defined in an adult as a stretched flaccid length of less than 3.7 inches.
After the injections, Tom’s stretched flaccid length had increased by half an inch, to 4.5 inches.
But the far more significant change was in girth – the circumference of the penis, and the principal target of injectable enlargement procedures.
Afterward, this increased from 3.5 inches, which is around average, to 5 inches.
For Tom, he said he first became worried about the size of his penis in his teenage years.
‘It was in the baseball changing rooms when I first looked and thought, hey, mine’s shorter than everyone else’s,’ he says.
‘No one ever commented, but it made me feel weird to take my pants off. Normally, I would rush to put them back on quickly.
‘When I joined the military, no one said anything again, but still, in the changing rooms, I saw mine was not as big as the others.’
Tom has been married to his childhood sweetheart for 16 years, who has also never said anything about his penis size, and the pair have three children together, now aged 14, 12 and six years old.
Deciding their family was complete, a few years ago he chose to undergo a vasectomy. But penis size remained a concern.
He had never tried anything to treat it. But this year, while scrolling, he came across a Daily Mail news article that reported on the experimental treatment in New Jersey.
‘After seeing that article, I said screw it, why not?,’ he said. ‘I only live a few hours away from the clinic.’
The treatment is being offered by Dr Diamond at NDA Medical Spa, about a 10-minute drive outside Philadelphia, which he co-founded with his dietitian wife, Noelle.
Tom initially had a consultation with Dr Diamond, where the pair went over the potential risks and benefits of the procedure. They also discussed what changes Tom hoped to see – primarily a thicker penis, rather than a significant increase in length.
At the start of the procedure, an antiseptic solution was rubbed over Tom’s penis to clear away any bacteria, before Dr Diamond drew two purple lines along the top to guide the injections.
Several injections of the local anesthetic lidocaine followed to ensure he wouldn’t feel the procedure.
‘I felt a bit of pressure to start off, but then there was nothing,’ Tom told me later. ‘When I got a tattoo, the pain was much worse.’
He gestured towards a tattoo covering the front of his right leg.
Throughout the procedure, Dr Diamond repeatedly moved around the table to look at Tom’s penis from the same perspective as his patient.
‘It’s important for me to look at the penis from the patient’s view,’ he said. ‘I need to know where any asymmetries may be.’
Tom remained conscious throughout and was able to hold a conversation.
Afterwards, he was told he would need to wait two weeks before having sex again – the time needed to allow the filler to settle.
Dr Diamond and wife Noelle offer their treatment just outside of Philadelphia
He was also sent home with a bag of creams and ointments to apply to his penis daily for the first two weeks to reduce the risk of infection.
No one knows for certain how long alloClae will last when injected into the penis, as the technique is so new.
Studies of similar donor-fat products used elsewhere on the body have shown they can retain volume for at least six months, while one patient was reported to still have results eight years later. However, long-term data remain extremely limited.
Dr Diamond suggests the effects in the penis will last for at least a year.
Walking out of the clinic, Tom said he was excited by the results.
‘I’m sure my wife will be thrilled too,’ he said. ‘My phone’s already buzzing – she’s asking how it went.’
He’s now looking forward to a family vacation to Florida next month, where he says he will proudly be wearing his swim shorts.
