- Matt, a contractor in his 40s, spent $16,000 to get Penuma, a silicone penis-enlargement implant.
- He's one of nine men who told Insider the implant caused damage or swelling in their penises.
- The implant's inventor says most patients are happy, citing studies that show high satisfaction.
Matt first discovered Penuma, a silicone penile implant that's surgically inserted just under the skin of the penis shaft, via an online search. The implant increases both flaccid length and flaccid and erect girth, and helps straighten out penises with mild to moderate curvature.
The latter issue was Matt's concern. He didn't like the curve in his penis, and he worried it might be hurting his girlfriend during sex, he previously told Insider.
In September 2019, Matt flew to Los Angeles to have Penuma implanted by its inventor, urologist Dr. James Elist. Since the device received its first FDA approval in 2004, nearly 5,000 men have gotten it, and Elist has trained 17 other urologists to implant it. The FDA has since cleared it twice more, most recently in 2022, when it clarified that Penuma is intended for penile augmentation.
The outpatient procedure is brief, typically lasting 45 to 60 minutes. It costs between $16,000 and $18,000, depending on the doctor, and isn't covered by insurance.
In the weeks following the surgery, Matt, a contractor in his forties who lives in the western US, began to experience excruciating pain and swelling, followed by a seroma — fluid collecting under the skin.
His penis ultimately ended up curved even worse than before, "like an orange peel in the sun," said Matt, who requested anonymity given both the sensitive nature of the surgery and his concerns about possible legal action from Elist. "I had to push it into the toilet to go pee."
Matt shared his experience with Insider for a larger story about the implant and its effects, which is based on interviews with 13 other Penuma patients.
Matt says he cared for his penis meticulously, but complications still arose
Matt previously told Insider that after the surgery, he followed Elist's strict orders: No sex, no masturbation, and using a compression wrap that fit snugly around the penis. His girlfriend, a registered nurse, confirmed to Insider that she double-checked his work.
He had been asked to stay in touch with Elist's office for eight weeks. Around week four, the complications began.
"When I get random erections at night, the blood flow combined with the additional fluid swelling is overwhelmingly painful," Matt told Elist via email. (A spokesperson for Elist declined to comment on Matt's specific case, citing patient confidentiality.)
The painful swelling did not go away, Matt said. Five months later, in February 2020, he returned to Elist's office to have him remove the implant. But new complications arose.
At the time, Elist was using a Covidien polyester mesh to hold the implant in place. (The newest generation of Penuma no longer requires it, he said.)
As a result of the mesh, Matt said, scar tissue had formed over his penis, constricting blood flow and preventing it from stretching and expanding. He ultimately chose to seek care from other urologists, and has since had seven pricey correctional procedures.
Insider interviewed other patients who said Matt's experience was not unique
Nine of the 14 patients interviewed for Insider's story said they experienced significant side effects, including excruciating pain in their penises, swelling, seromas and erectile dysfunction. The device is billed as removable, but two of the men told Insider that doing so caused them to lose penile length and sensation.
Elist contends that most Penuma patients are satisfied with the device, citing his own 2018 study, which found that 81% of subjects had "high" or "very high" levels of satisfaction two to six years post-operation.
"There is no procedure without any complications," he told Insider. An Insider reporter also spoke to five men who had positive experiences with Penuma; many said it significantly improved their confidence.
But Matt says he's seen a darker side of the story. Through PhalloBoards, a kind of Yelp for penis-enlargement procedures, he's connected with numerous men who have experienced painful side effects.
Two urologists interviewed by Insider for the story said they've seen disastrous effects of the implant firsthand.
"I've seen this thing erode through the skin, I've seen it fragment, I've seen it curl," said Dr. Mark P. Solomon, a board-certified plastic surgeon in Philadelphia and Beverly Hills. Solomon, who's published and lectured on complications from penis enhancement surgery, estimates he's removed between 50 and 100 Penuma devices.
Matt is one of nine patients who've filed a complaint against Elist with the California Medical Board. In the complaint, they accuse Elist of misdiagnosing them with penile dysmorphic disorder or low self-esteem without proper psychological evaluations; minimizing their post-surgical complaints of swelling, pain, curvature and loss of sensation; and maintaining inaccurate records, among other concerns.
"The accusations are false," a representative for Elist told Insider. "We are confident the matter will be resolved favorably with the California Medical Board."
As for Matt's penis, it now looks "OK" after multiple correctional procedures.
"It looks like it's finally back to normal and it works great now," he said. "But it took a fortune and years of despair to get here."