The Penuma implant is an FDA-cleared silicone device designed to permanently enhance penile size while maintaining a natural look and feel.

It can add an average of 2.5 to 5 cm in girth in both flaccid and erect states, along with a noticeable increase in flaccid length. The implant comes in different sizes (Large, Extra Large, and Extra Extra Large) that are selected by the surgeon to perfectly match each patient’s anatomy, ensuring proportional and natural results.

Originally developed in the United States by urologist Dr. James Elist, Penuma was the first penile enlargement implant to receive clearance from the U.S. Food and Drug Administration (FDA).

Over the years, its popularity has grown rapidly, and it is now available in select countries outside the U.S., including advanced medical centers in Turkey, where patients can benefit from high-quality care at more affordable costs compared to the American market.

There is also a similar device called the Peniflex implant, designed by Dr. Ivan Aguilar in Mexico. Like the Penuma implant, it is made from soft silicone to enhance girth, but with greater flexibility for improved comfort during erection.

Patient Selection for Penuma Surgery:

Choosing the right patient is one of the most important steps for a safe and successful Penuma procedure. According to a 2020 study published in IJIR: Your Sexual Medicine Journal, the evaluation process combines both physical and psychological screening before a patient can be approved for surgery.

From a physical standpoint, certain conditions make the surgery safer and help ensure good results.

For example, if a patient has already undergone other penile enlargement procedures, such as injections with PMMA, hyaluronic acid, fat transfer, or skin grafts, we might need to some more work before putting the implant.

These past procedures often leave behind scar tissue and reduce skin quality, which can slow recovery and increase the risk of infection.

Circumcision might also be required in some cases. This is because Penuma increases the girth of the penis, and in uncircumcised men, the foreskin might not retract properly even in the flaccid state.

If a man is not circumcised, a physical consultation with the surgeon urologist will be necessary to determine the best to be done.

In addition to these key points, doctors will check for other medical issues such as uncontrolled diabetes, active infections, or medications that may interfere with healing. In some cases, surgery may be delayed until these issues are resolved.

Who Can Get a Penuma Implant?

Penuma is not designed to treat erectile dysfunction like inflatable penile implants. It is for men seeking a permanent increase in penis size for cosmetic, functional, or psychological reasons.

Ideal candidates are men who:

• Are in good overall health with no conditions that could increase surgical risks, such as uncontrolled diabetes, heart disease, untreated mental health issues, or active infections.
• Are at least 21 years old.
• Feel unhappy with their penis size and want to improve self-confidence and sexual satisfaction.
• Have a buried penis or hidden penis syndrome.
• Do not suffer from erectile dysfunction to achieve the best possible results. In cases of mild erectile dysfunction, we recommend combining the procedure with stem cell therapy for erectile function restoration alongside the Penuma implant surgery.
• Former patients who previously had erectile dysfunction and received a malleable penile implant, but later experienced penile shrinkage and are dissatisfied with their size, may be good candidates for Penuma implantation. However, if these patients are unhappy with both their erection quality and size, an inflatable penile implant may be recommended instead, as it can improve erectile function while also increasing size in cases of moderate to severe erectile dysfunction.
  

Patient Story: Enhancing Girth After a Malleable Implant

One of our patients, a 64-year-old man, had previously received a malleable penile implant in another country to treat severe erectile dysfunction.

While the implant restored his ability to have intercourse, he was unhappy with the reduced thickness of his penis, which he felt affected his confidence.

After consulting with our surgical team in Istanbul, we determined that he was a good candidate for Penuma implantation to enhance girth without affecting the function of his existing implant.

In some cases, like his, careful planning is crucial to ensure a safe procedure and a natural result. Three months after the surgery, he reported a noticeable increase in thickness, better self-confidence, and greater satisfaction in intimacy, while still maintaining the erectile support provided by his original implant.

Circumcision and Penuma Implant: What You Should Know

For many men, being circumcised can help achieve a smoother and more comfortable result after Penuma surgery. During your pre-operative evaluation, our surgeons will check whether circumcision is needed in your case.

In some patients, the implant can be placed without circumcision, but for others, removing the foreskin can improve the final shape and reduce possible discomfort in the long term.

If circumcision is recommended, you can choose between three approaches:

1- Both Procedures in the Same Surgery

Although we can perform circumcision at the same time as Penuma placement, we usually prefer not to. Combining them slightly raises the risk of infection or implant shift to around 4%. That said, strict adherence to recovery guidelines can keep risks low.

2- Penuma First, Circumcision Later

With this option, we insert the Penuma implant first, let the area heal, and then perform circumcision about three months later. You may also have the circumcision done in your home country.

3- Circumcision Before Penuma

Some patients choose to be circumcised first, wait three months for full healing, and then have the Penuma procedure. This sequence offers the lowest infection risk and allows for ideal surgical conditions.

At Istanbul Urology Clinic, we guide each patient toward the safest plan for their health and goals, making sure both the procedure and the recovery go as smoothly as possible.

How Is the Penuma Implant Surgery Done?

The Penuma implant procedure is performed under general or spinal anesthesia, depending on the patient’s case and preference. On average, the surgery takes about 45 minutes and follows these precise steps: