A lot of men spend months thinking about these procedures before they ever pick up the phone. Many do their research online first. Many even start with the practice chatbot, because it feels more private. By the time they sit down with Dr. Frank Agullo at Southwest Plastic Surgery, most already know the terminology. What they want is a straight answer from someone they trust.

Dr. Agullo says it plainly: these are actually very common procedures that most men already know about and have even researched for themselves. We just do not talk about them. This is the honest version of that conversation, and a look at how the practice handles men’s enhancement and wellness as a whole.

What Men Are Asking For

According to Dr. Agullo, men are asking for several different kinds of procedures, and the most common is size enhancement, usually done with fillers. The fillers that give the most volume are Voluma and VoluX. They increase girth and can add up to about half an inch of length, though length is not really the main objective or how it physically works.

Men who want to enhance sensation, or who have erectile dysfunction, often choose the P-Shot, which is essentially PRP, platelet-rich plasma from the patient’s own blood, injected into the cavernous bodies and the crown to increase sensation, libido, and erection strength.

A newer request is Bocox, botulinum toxin into the cavernous bodies, which creates vasodilation and a larger, stronger erection, usually adding half an inch to an inch. It is used for erectile dysfunction and for men who simply want a stronger result.

Some men want a descended testicle look, with smoother scrotal skin, and to avoid the shrinkage that comes with temperature changes. Those men are candidates for Scrotox, Botox into the dartos muscle and scrotal skin.

The Sterility Warning the Practice Leads With

Dr. Agullo is firm on one point. The muscles relaxed during Scrotox are the muscles the body uses for temperature control of the testicles and the spermatic cord. Relaxing them can cause sterility. A man who still wants to have a family is not a candidate, because the procedure can make a male sterile. At Southwest Plastic Surgery that conversation happens before anything is scheduled.

It is also important to understand that all of these treatments are off-label. The products are FDA-approved, but they are used in an off-label nature, with the patient’s consent and a clear understanding of the risks and complications.

What These Procedures Realistically Do

Dr. Agullo spends part of every consultation correcting the same misconceptions. The first is that these procedures considerably lengthen the penis. They do not. Half an inch at most, maybe an inch, with a lengthening effect at rest and mostly an increase in girth.

The second is that the results are permanent. Fillers last one to two years, and Botox usually lasts three to six months.

The third, and the one he pushes back on most, is that bigger is always better. It is not. Sometimes the quality of the erection is more important than the size.

Who Comes In

There is no typical patient. There is a wide range of ages and backgrounds. Many men assume most patients consider themselves small, but a lot are already well-endowed and simply want enhancement. The thirty-to-fifty range is the most common, and the practice sees patients who travel in from other states for this.

Safety Comes First

The risks are real, which is why the setting matters. Dr. Agullo stresses that these procedures belong with a board-certified physician, in a sterile environment, using FDA-approved botulinum toxin and fillers. This is not the place to shop for the cheapest provider.

With penile fillers, possible complications include contour deformities that can be touched up, palpable nodules that can be dissolved, and edema in uncircumcised men that can interfere with intercourse or voiding. The product must be placed in the correct plane. The most serious complication is infection, which is avoidable with proper sterile technique and aftercare. Southwest Plastic Surgery performs these in an accredited, sterile setting for exactly these reasons.

Recovery and the Bigger Wellness Picture

Recovery is straightforward. Patients are usually asked to refrain from sexual activity for forty-eight to seventy-two hours, with any mild discomfort managed by over-the-counter ibuprofen or Tylenol. Botulinum toxin treatments take about two weeks to work, and PRP takes two to four weeks and sometimes needs repeating.

Male enhancement fits into a broader men’s program at the practice. Southwest Plastic Surgery sees men for cosmetic procedures, hair restoration, hormone replacement, weight loss therapies, peptides, and wellness IV drips through ElixirMD. Men are getting more comfortable with all of it, and the deciding factor is almost always a provider they trust.

About Dr. Frank Agullo

Dr. Frank Agullo is the founder of Southwest Plastic Surgery in El Paso, Texas. He is double board-certified by the American Board of Plastic Surgery and the American Board of Surgery, a Fellow of the American College of Surgeons, and completed a plastic surgery fellowship at the Mayo Clinic. He is a Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center Paul L. Foster School of Medicine and an Affiliate Professor at the University of Texas at El Paso, and he has been named a Castle Connolly Top Doctor for thirteen consecutive years.

Ready to Talk?

If you have been curious but holding off, start with a private conversation. Read about the procedures on the site, message the practice, or come in and ask anything. Nothing is off the table and nothing is judged.

For the surgeon’s editorial take on the trend, see Dr. Agullo’s essay on drworldwide.com. For the clinical patient guide, see the companion post on agulloplasticsurgery.com.

Call (915) 590-7900, text 1-866-814-0038, or book online at swplasticsurgery.com. #StayBeautiful.

@RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.