02 · Compare
No single method is the right answer. Compare the trade-offs — goal, material, reversibility, recovery, and how mature the evidence is — rather than the maximum size gain.
| Attribute | Hyaluronic acid filler | Polylactic acid filler | Autologous fat transfer | Dermal graft and biological materials | Suspensory ligament release | Traction therapy | Revision and correction |
|---|---|---|---|---|---|---|---|
| Main goal | Girth (circumference) | Girth (circumference) | Girth (circumference) | Girth (structural) | Visible flaccid length | Modest length; post-op adjunct | Correct a previous result or complication |
| Procedure type | Non-surgical injection | Non-surgical injection, often multi-session | Procedural: harvest + injection | Surgical | Surgery | Non-surgical device | Varies: dissolution, removal, surgery |
| Material | Cross-linked hyaluronic acid | Poly-L-lactic acid (biostimulatory) | Autologous fat (patient’s own) | Dermal graft or acellular biological matrix | None (ligament division ± spacer) | External traction device | Depends on the original material |
| Anaesthesia | Topical or local | Topical or local | Local, sometimes with sedation | Local or general | General, spinal or local | None | Varies |
| Reversibility | Often reversible (hyaluronidase) | Not readily reversible | Not reversible; partially reabsorbs | Not reversible; surgical | Not reversible | Non-surgical; can be stopped | Depends on original material |
| Expected recovery | Usually short | Usually short | Moderate; two sites | Longer; surgical wound | Surgical; weeks of care | None (ongoing use) | Varies |
| Evidence maturity | Mostly short- to mid-term | Limited; smaller studies and case series | Case series; variable graft survival | Limited; case series | Mixed; variable satisfaction | Randomized and cohort studies; modest effects | Limited; individualised |
| Long-term uncertainty | Long-term behaviour; repeat injections | Predictability of collagen response | How much volume persists long term | Graft take, thickness change, long-term contour | Retained gain, retraction, satisfaction | Real-world adherence and durability | Depends on prior material and tissue changes |
| Common concerns | Nodules, migration, asymmetry | Nodules, irregularity, delayed onset | Reabsorption, lumps, asymmetry, oil cysts | Contracture, irregularity, scarring, asymmetry | Scarring, unstable erection angle, loss of gain | Discomfort, skin effects, inconsistent results | Residual irregularity, scarring, incomplete correction |
| Possible revision | Dissolution or re-injection | Difficult; conservative or surgical | Repeat grafting or contour correction | Surgical revision | Limited; scar revision | Not applicable | This is the revision pathway |