The Truth About Girth: What Women Really Want

Is it true that girth matters more than length? Or is it all in your head… and maybe hers too?
In this episode of Talk Sex with Annette, we’re pulling back the sheets on one of the most common questions men obsess over: Am I thick enough?

Joining me is Dr. Amy Pearlman, board-certified urologist and sexual health expert, here to break down the science behind penile girth, sexual satisfaction, and why so many men tie their self-worth to size.

We’re covering:
 🔥 What girth actually does during penetration
🧠 How penis size affects self-esteem and sexual performance
🩺 What partners really think about size (and what they crave instead)
💉 The truth about girth enhancement: risks, rewards, and what works
💡 Tips for better sex no matter your size

Whether you’re curious about procedures like PhalloFILL or just want to stop obsessing and start feeling confident in bed, this one’s for you.

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Chapters

• 0:00 Welcome to Talk Sex with Annette
• 4:22 Meet Dr. Amy Perlman: Sexual Health Expert
• 8:24 Length vs. Girth: What Actually Matters?
• 16:28 Average Girth and Size Expectations
• 27:49 Penis Filler: How Enhancement Works
• 40:26 Erections, Confidence, and Sexual Experience
• 57:34 Safety, Research, and Finding Help
• 1:07:10 Final Thoughts and Resources

Transcript

Speaker 1: 0:45

Do the sex?

Speaker 2: 0:47

I'm Annette Benedetti, host of the podcast formerly known as Locker Room Talkin' Shots. The show has a new name Talk Sex with Annette. But at its core, this is still your locker room. It's where we strip away shame, get curious and speak the unspoken about sex, kink, dating, pleasure and desire. Around here, nothing's off limits. Pleasure and desire Around here, nothing's off limits. These are the kinds of conversations we save for our boldest group chats, our most trusted friends and, of course, the women's locker room. Think, raw, honest and sometimes unapologetically raunchy. If you've been here from the beginning, thank you. And if you're new, welcome to my podcast, where desire meets disruption and pleasure becomes power. Now let's talk about sex Cheers.

Speaker 2: 1:38

Today's talk sex with Annette topic is does girth matter? The hard truth about size, satisfaction and insecurity. Truth about size, satisfaction and insecurity. So let's once again talk about penis size or, more specifically, girth. You know the thing guys worry about way more than they admit, the thing women rarely talk about directly unless they're bragging or complaining. And the thing no one wants to admit has emotional weight until they're alone, anxious and convinced. It's the reason they're not enough. Girth isn't just a stat on a measuring tape. It's tied to shame, status, ego and sex appeal. But does it actually matter? Does more girth equal more pleasure? Pleasure?

Speaker 2: 2:31

Today's guest is Dr Amy Perlman, a urologist, men's health expert and nationally known advocate for body image, sexual confidence and evidence-based enhancement options. She's been featured on everything from national medical conferences to trending sex education panels and today she's here to help us break down the truth about girth, where the pressure comes from. And today she's here to help us break down the truth about girth where the pressure comes from, how it affects men and their partners, and what we should actually be focusing on if we want to have better sex. But before we dive in, I want to remind y'all that I'm over on OnlyFans and that is where I'm able to share my sex and intimacy tips, how-tos, demonstrations and audio-guided self-pleasure meditations, all designed to help you have more pleasure, better sex.

Speaker 2: 3:13

Starting tonight, I'm also on Substack doing the same. You can find me there with my handle at TalkSexWithAnette. You can also scroll down to the notes under this episode and find links to all the places you'll want to find me below, so make sure to check them out. But for now, I would love Dr Amy to take a moment and tell us more about who she is.

Speaker 1: 3:38

Hi folks. Annette, it's so good to be with you here today. I'm a board certified urologist and I specialize in quality of life concerns that affect everyday men and women, specifically related to sexual health, hormone health and genitourinary health. I have the best job in the world. I mean, your job is pretty cool, but I have a wonderful job, and I honestly don't know why more people don't do what I do.

Speaker 2: 4:05

I love that you say that, because I also love what I do. It feels good to help people have a fulfilling, intimate life and feel good about themselves, right, and our bodies, especially our of all. This conversation isn't just about size. It's about quality of life. It's going to distill the truth about a lot of things I know you're curious about, because your questions all have gotten through to me. I've seen them and read them and by the end of this podcast you're going to know what's true, what's not true but, even more importantly, what to do if you are really on an unhappy, unsatisfied with your body, and you need help. We're going to get you that help. So stay to the end of this episode. It's not just about size. It's about self and image, sensation and the quiet insecurities that affect pleasure more than any penis ever could. So let's talk about sex, let's talk about size and let's get honest. I'm ready. Cheers here's to girth, here's the big question of the hour. Is girth, the new six pack?

Speaker 1: 5:24

Oh, that's a good question.

Speaker 2: 5:26

I thought it was.

Speaker 1: 5:29

And I think I want to preface this conversation. You know a lot of people ask me, as a urologist does size matter? And if you ask, I think most urologists, most urologists, are going to say your size, you're within normal limits, You're in the big part of that nice bell shaped curve and don't worry about it, and there aren't any safe options. And the reality is size and this is my perspective size matters to an extent and I think if we say size doesn't matter, I think we're ignoring our society and what culture says, and so I think we have to acknowledge that for many people, size matters.

Speaker 1: 6:11

I wish that everyone could accept their bodies as they are. I believe that body acceptance is such a beautiful thing. I also believe that if someone has a concern about a part of their body, including their genitals, and we have a safe solution for them, I believe they deserve the conversation to understand what those safe options are and that's what I hope today's conversation is really about is, if you have a concern, this is what you can do about it, right. It's not just about telling a person who's concerned about their size go see a sex therapist. Let's make sure you don't have body dysmorphia.

Speaker 1: 6:48

It's very clear when I sit down with patients and I talk to them about their penile size at least the patients that come to see me. They don't have body dysmorphia. They know their penises are normal. They just want it to be bigger and they want to know about the safe solution. So, in some ways, to answer your question, is a girthier penis the next six pack? Well, a lot of people want a six pack and a lot of people want a girthier penis. So in many ways I think the answer is yes.

Speaker 2: 7:18

Yeah, yeah. It's interesting because I have published several videos on penis size. Usually, that conversation tends to lean towards length, and the most common question I have gotten from men is well, how does girth play into this, right? How important is it? So I'm going to ask you what your opinion is on length versus girth. Let's talk length versus girth. You can say what you're going to say, and then I'll, of course, always add in my two cents. It's the age-old question, it is. Let's talk about it.

Speaker 1: 8:04

No, you know, it's so variable and the reason why I say that is in my clinical practice, the majority of men who see me are coming in for girth enhancement because that's what I offer. They see that on my website. They see me do videos talking about girth enhancement, so they're primarily not coming in with length concerns. However, for any guy that comes in to see me, including the guys who come in for something like erectile dysfunction, I do bring up size, even for what seems to be an unrelated issue, and my goal is not to put the thought in the back of someone's mind that they might not have a large enough penis. In fact, we're having this, this discussion, before I do an exam. I think that's really important, right, it's to kind of bring up this discussion, not while I'm examining the person to see if they have any concerns about their size, but I'll simply ask my patients do you have any length or girth concerns?

Speaker 1: 8:58

And most of the guys that I see say they do have some length concerns. They just didn't know there was anything they could do about it, so they're not bringing it up in conversation. So a lot of guys that I see are concerned actually about length and girth. But then the question becomes what is more important when it comes to sexual satisfaction? And when you look at the research, the research would suggest that a lot of women are saying that girth is going to be more important. Right, and the way that I look at it, from both my personal and professional views here right is that you need enough length to be able to be in certain positions and not to fall out of the vagina. Right. But once you have enough length where you're not coming out, right Then too much length. Obviously you're hitting the cervix. It can be uncomfortable.

Speaker 2: 9:58

Some ladies like that shit. I am not one of them, I know, I know.

Speaker 1: 10:02

So I think the easy answer is it depends, but I think both in length and girth you need enough of each one for the partner to feel it. But if you think about it, you've done videos before on teaching people how to finger right. I mean you could get a woman off with my finger. That is way smaller and shorter than a penis.

Speaker 2: 10:22

I do it all the time.

Speaker 1: 10:24

I do it all the time, so technique also obviously matters. I do it all the time, so technique also obviously matters. I don't have any research to prove what I'm about to say, but this is my gestalt is that with a smaller object whether it's a finger, a penis, a toy when you're trying to use that smaller object to pleasure a woman, you have to be more precise. So if you think about a vibrator, right, if you're using a bullet vibrator and you put it on the clitoris, it has to be like on the exact spot for that to feel good, Otherwise it just feels like vibration and doesn't feel arousing, Whereas if you use a bigger vibrator like, let's say, a magic wand that has more coverage, you don't have to be as precise with that. And I'm guessing this is totally from a non-scientific perspective that with a larger object in the vagina maybe a larger penis compared to a smaller one maybe you don't have to be as precise with the technique for the woman to feel it. I'd love to get your thoughts on that.

Speaker 2: 11:27

So I think one thing because our sex education is not pleasure based, people just don't know how to have sex with each other. Now, for women, the bonus is getting a guy off is relatively easy. He enters you, he enjoys that friction. I'm not saying it's good sex, I mean maybe he thinks it is because he comes, but then should she have more techniques and know how to have this erotic experience, he would be like oh now that's really good sex, right, but with women we aren't set up that simple, right. You can't just stick a dick in it. Well, there are very few. There are some women, but very few women that you can just stick the cock in, thrust away and she's going to have an orgasm. That percentage is minuscule, right, it is a process for us. And because guys don't know technique most, all of them I mean they're learning, they're catching up now know technique most all of them, I mean they're learning, they're catching up now.

Speaker 2: 12:31

Pleasure education is new. Yes, I think that probably why we get size queens I am not one of them, but there are that having and I'm going to say girthier, because I still think the number of women who really get off and having their cervix pounded are pretty small. There is the A spot, also up in our vaginal canal. That can be really erotic that a smaller penis may not reach as well. But if you've got a girthy cock and it's short and it comes in, it's going to hit your A spot. The guy doesn't really have to know what to do other than thrust and hit it right, and with a girthier cock or a slightly longer cock then he's going to be more likely to hit it. So, yes, I could see how a bigger one might serve for that.

Speaker 2: 13:23

Now I have had a conversation on here about the truth about small penises and if you are someone who really knows how to do sex beyond the thrusting right you can like, if you're working with a micro penis and you and I will definitely talk about that you can use, you know, grinding the micro penis against the clit as a way to get her to orgasm. Again, you can use your fingers if she really wants to feel full Lesbians, queer women like me, do it all of the time. So I think that is. I think if you are small and on top of it you don't have pleasure education, you are not going to be as good of a lover as someone with a big penis who can at least just thrust away and hit the spots. I think that's fair to say, don't you?

Speaker 1: 14:43

I think it's fair to say yeah.

Speaker 2: 14:45

Mm-hmm. All right, this question has come across my desk a lot. What is the average girth?

Speaker 1: 14:55

Okay, so the average girth and this is based on research that is published when you look at the flaccid so that's the non-erect penile circumference the average is going to be about 9.3 centimeters and the average erect circumference is about 11.6 centimeters.

Speaker 2: 15:15

Okay, all right. Well, I hope, guys, that answers your question and means something to you. It doesn't really mean anything to me.

Speaker 1: 15:25

You know, and it's interesting because when guys see me in the clinic I never quote the average girth. You know, because I can just look at a penis of a patient coming into my clinic and pretty much all the guys who see me, minus a couple of outliers, they all have average size penises and they know it right. So we're not talking about someone who has a micropenis, which is really less than 1% of the population of men, right? These are the average dudes walking down the street. They know they have average penises, they just want it to be bigger, they have very realistic expectations and they just won't want a safe option. And, honestly, it's funny because when they come to see me, you would think they would know exactly what their measurements are.

Speaker 1: 16:16

I think the perception of like guys who see someone like me. They come in and I and they say I'm exactly this when I'm flaccid, I'm exactly this, you know circumference when I'm hard and this is exactly what I want to be. I want to be 5.5,. You know inches when I'm erect. That's not the conversation at all, believe it or not, it's. I sit down with someone and I ask them what size do you think you currently are? And most of the guys, don't know, they'll estimate. I'll have them walk over and they'll look at these demos right here which are different girths For my audio listeners.

Speaker 2: 16:53

if you want to see the demos, you're going to need to go to my YouTube channel at TalkSexWithAnette, otherwise we will try to describe them to you. Will you hold those up again, and are those sized out? So these demos are just tubes that are showing size and girth. Oh, interesting. I even look and go. I prefer this one or that one.

Speaker 1: 17:16

Always here and it has all the different sizes. So I literally just have them walk over to a corner of my office and I say point to where you think you are currently when you're flaccid, and they'll kind of look around and what they'll do is they'll grab one, They'll hold it in their hand like they're holding their penis to see how it feels and how their fingers touch or don't touch, and that's how they sort of estimate what their baseline size is. And then I ask okay, where do you think you want to be? What are your girth goals? And again, they're not saying I want to be exactly this amount. A lot of guys say I'm not really sure. Or they'll look at my demos and say, well, maybe around here.

Speaker 2: 17:58

That's a fatty. That's a fatty.

Speaker 1: 18:00

Looks like a fatty to me, you know I have this one right here, which is the largest one on my set.

Speaker 2: 18:05

All right, that's big. Seven inches that way, and that's seven inches long or no around circumference Okay. Okay, by grip. If I were to grip it, that would be like a yeah, your fingers don't even come together.

Speaker 1: 18:20

Yeah. So a lot of people will look at that and say, oh my God, that's huge. And I think again, a lot of people would think that all the guys that come in to see me in a clinic like mine would go would say I think I'm the smallest one, but I want to be the largest. Those are not my patients. My patients are the ones that say I think I'm around 3.5 or four inches and I think I'd like to get an additional inch right. It's very rare that I have someone say they want to be big like this.

Speaker 1: 18:51

I have two patients, okay, that have gotten a ton of girth enhancement and we'll talk more about the details of girth enhancement in a bit but they didn't want to start from the beginning being something like this. But as they've gotten more filler and as they realize how amazing it feels during sex with their wives, they know their penis does not look like it would in the natural habitat. Like you can tell, they've had some work done because their girth is so large, but because it feels so good during sex, they don't care and they just like how it feels.

Speaker 2: 19:26

Yes, Does it feel so good to them or to their wives when you get girth enhancement, and we will talk about how that happens. Does that enhancement increase their pleasure as well as their wives?

Speaker 1: 19:43

That's a really good question and I wish more of my patients brought their partners in. I've actually had some of my patients bring their partners in during the procedure and we just all kind of shoot the shit in the back room. And you know what? I love that, annette, because I think it really normalizes the conversation. Rather than someone coming in and they're very embarrassed or ashamed about wanting to have a bigger penis because you feel like they're coming in from a place of deficiency. When they come in with their partners, it feels like they're coming in from a place of abundancy, where they have a normal penis but they just want it to be better for them and their partner. So I love when they come in with their partners. That would give me more of an opportunity for me to ask their partners.

Speaker 1: 20:27

Right now I'm relying by secondhand. I'm asking my patients what their partners think For those two guys that I was referencing that have very large girth enhancement, like I've increased their penis by like two to three inches in girth. One of them I recently saw him for follow-up and I said um, so what is your wife saying? And he's like well, we don't really talk about it. And I was like okay, well, do you think she likes it? And he said, well, she never used to squirt when we were having sex, and now she squirts all the time.

Speaker 1: 21:01

And I'm like, okay, well, that speaks volumes you know, and then another guy said that his wife just her eyes roll to the back of her head when they're having sex. So I would love to talk to the women directly and for my patients who have male partners, I would love to talk to their male partners to understand the experience. But right now I'm kind of getting secondhand from my patients.

Speaker 2: 22:29

Yeah, and I wonder if there's two aspects of improving sex that I imagine that after a girth enhancement there are two things that add to increased pleasure and you can tell me if I'm on the right track. Number one, perhaps feeling more full feels really good to the woman. I know there are a lot of women who enjoy that full feeling. Even when it's a woman to woman and you're fingering, like adding fingers, and even fisting, feels really good to them. The vagina can really expand. But I also imagine seeing your partner feel really confident while having sex with you is a turn on. There's something about that. The increased confidence is sexy in a partner and there's no way that can't play into it improving sex overall.

Speaker 1: 23:36

Absolutely. That plays a big role. I mean, ultimately, our brain is our largest sex organ and the way that we feel about ourselves plays a huge role, and I hear that routinely from my patients. You think about what happens for a man. One of the first things that he does when he wakes up from sleeping he goes to use the restroom and probably on his way to peeing in the toilet he sees his penis in the mirror right, and the way that he feels about his penis for many men will dictate how he goes about the rest of his day and how he holds his head on top of his neck right. And so I hear from my patients that because they feel more confident in their bodies, it just helps with the sexual experience.

Speaker 1: 24:21

What is another common concern for men because we think only women have these insecurities, but men obviously and it's obvious from your conversations on your podcast that men have a lot of insecurities themselves is a lot of men are concerned about retraction, so once their penis is erect, they're fine with that. They say I'm a grower, not a shower. But what they can be very self-conscious about is when they're first getting excited. Or they get out of a shower right, or they're nervous or it's cold, their penis is retracted and it looks very small. And so we've also found although we haven't studied this in a scientific way, we've just heard it from our patients is that when you put filler in the penis a lot of guys have said, my penis doesn't retract as much, and so that also plays into the self-confidence.

Speaker 2: 25:12

Interesting. I found it interesting that you said that the way a man feels about his penis can affect how he basically walks throughout the day, and so I want my listeners to take note that, again, one of my arguments about why sex is so important for us to be talking about openly is because it doesn't just affect us in the sexual realm, which a lot of us compartmentalize, we're like, oh, this only happens at night or whatever in bed. That it affects how we move through the world and how we interact with other people, right, and our overall mental health, and I think that you're speaking to this here, right, this is affecting how this person feels about themselves and everything they do, from the time they wake up and see themselves in the mirror and forward which is also true, I mean women we feel the same way, right, and with men, how much does body dysmorphia play into their insecurity about their dick size?

Speaker 1: 26:23

In my clinical practice I actually don't see a lot of men who have body dysmorphia, and I think part of it is because the guys that I see in my clinic are coming in for falafel, which is a temporary solution. So I just see I have just guys coming in who have very realistic expectations. Two guys stand out, though, in my clinical practice that I would be concerned have body dysmorphia, and those two guys were actually coming in because they wanted a permanent solution for penile augmentation or penile enlargement, and in meeting with those guys they were willing to take on more risk than my other patients. They both had already undergone several procedures for penile enlargement, both of them had issues with their prior procedures and both of them wanted to take on more risk to get a larger penis penis, and so if I were to do a questionnaire for body dysmorphia which I didn't do in either of those cases I have no doubt they would have both screened in. I feel like it's just you can tell when you're meeting with them.

Speaker 1: 27:30

In my clinic, when someone comes in for a procedure, I'm sitting down with them for like 90 minutes before I actually do a procedure on them, so while in a lot of clinics they might give a body dysmorphia questionnaire. That might save them time because I can talk with patients for literally 60 to 90 minutes. I'm able to tease out by simple conversation whether or not they have expectations or real issues that I will not be able to solve, that they might need to see a therapist. For when you look at the research, there is some research looking at body dysmorphia and how common it is. So in one study that looked at guys who were coming in, they were seeking penile girth augmentation, they found that about 11 to 14% of these men met the diagnostic criteria for having body dysmorphia. But I think it depends this is my gestalt is. I think it depends on the clinic that a healthcare provider like me is running and the types of procedures that we're offering.

Speaker 2: 28:31

Right, right. So what are conditions that men could have that would keep you from being able to, or willing to, treat them for girth?

Speaker 1: 28:45

So I would say two come to mind. One is if someone has, let's say, had erectile dysfunction for several years and they've noticed that they've lost length and girth, so it's which is a little bit different from someone coming in who has had a smaller penis than they would have liked their entire adult life. Right, there's a difference there between restoring size that may have been lost and just always being a certain size in their adult life. So if someone has lost size and they're coming in for girth enhancement, I actually brought in that discussion about penile rehabilitation strategies to see if we can use different devices like a vacuum erection device or a penis pump, like traction therapy. The Restorex device is a really great device for penile lengthening, so I actually might have someone do restorative therapies to see if they can get the size back that they may have lost before I put filler in. And the reason why I bring up that conversation is because once I put filler in they may no longer be a candidate for using a vacuum erection device or a penis pump. We don't have research that tells us what a penis pump will do to filler and it's possible that it could get the filler to move or go away sooner. So I'll talk to patients about those options and I might have them use a penis pump for three months before I bring them back for girth enhancement to see if they can restore size that may have been lost. So that's one population of guys and I've had that happen for a few patients where they will try other strategies before coming in have been lost. So that's one population of guys and I've had that happen for a few patients where they will try other strategies before coming in.

Speaker 1: 30:23

Now, not that I can't do girth enhancement when they come in, I just want to see. Hey, you know, in some ways I try to save my patients money, right, I mean, I'm a bad salesperson. The other scenario is if someone has a buried penis where they're overweight and they have a lot of fat on top of their pubic bone that's burying a lot of their penis, I can sit someone back in my procedural chair and I can really expose their penis and I can put filler in the penis and it can look amazing when they're laying back. But, annette, what happens when I get them out of the chair and they stand up? The penis will retract and that can cause the filler to move. So if someone has a very retractile penis or they're overweight and they're burying their penis. That's where we would have a really comprehensive discussion on ways to lose weight, get in better shape before I put filler in to optimize their outcomes.

Speaker 2: 31:18

So let's talk about the filler. You've been talking about filler. This is one treatment for adding girth, correct? What is this treatment?

Speaker 1: 31:30

to be clear for my listeners, yeah, so let's get into the details of filler. I am a urologist, as I mentioned. As a urologist, most of our training is in urinary tract infections, prostate health, kidney health and urinary symptoms. It's actually the minority of urologists who are actually passionate when it comes to sexual health. Okay, so that's a minority of us to begin with, and most of us, even those who are passionate about sexual health, actually do not get training in cosmetic procedures for the penis. So for much of my career and my training, I was having a similar conversation as many of my colleagues do with patients. When they would ask is there any way to get a longer or girthier penis, we would tell them there are no safe options. But, annette, that is no longer the case. More technology is now available.

Speaker 1: 32:25

So about three years ago, when I started my practice in Miami Florida my own practice with my twin sister I reached out to two of my colleagues who were doing girth enhancement through a company called Falafel Because, just like a lay person, they're not just going to go to any provider and give them a few thousand dollars and trust that they're going to do the right thing. It's actually the same thing for healthcare providers. I selectively reach out to colleagues to ask them for advice. Because if you reach out to someone and they have, you know they're injecting whatever they want into the penis. They're not going to give me real advice on actually what to do in my clinic. So I'm always, for me as a healthcare provider, reaching out to people like Trust in the Field who are not going to oversell something. So I reached out to two of my colleagues who were doing girth enhancement and I said Alex, jonathan, what do you think about the Falafel procedure? And they said we love it and you should do it too. So I reached out to the company Falafel, because they're training urologists like me around the country to do this procedure, because in that we have no other way of learning how to do it. The only time really in most urology practices where we have exposure to men who have undergone penile augmentation procedures is when it goes bad. We see the complications. So we get this perception in our mind that all penile augmentation is bad, because if someone is happy, they're not going to come to us and say how happy they were with the procedure they had done elsewhere. So we get a very skewed version of what's actually happening in this space. So I learned how to do this procedure.

Speaker 1: 33:57

It's we have no FDA approved products when it comes to filler in the penis, so that's very important. We use products off label in the penis that are approved for certain facial indications. So it's the same filler that we might put in the lips or in the nasolabial folds or in the cheeks. So, annette, not all filler is created equal.

Speaker 1: 34:19

I'm injecting hyaluronic acid. Hyaluronic acid is normally present in our body, so for our bodies it's not like an abnormal molecule, it's a hydrating molecule, it's a sugar molecule okay, that we already have. And these are two different blocks of hyaluronic acid because they have different consistencies. So the one here that I'm squeezing is a lot softer to squeeze. And then in my other hand this is harder to squeeze the consistency of the filler that I put in the penis is a little bit softer. So when you're squeezing the side of the penis that has filler in, you can feel like tissue there, but it just feels like tissue on the side of the penis. It doesn't feel like I injected concrete or cement-like material on the side of the penis. So the type of filler that you put in matters.

Speaker 2: 35:13

Right, and so the one that you were squeezing, that was the softer one that you put in. It looks like it would be the same consistency of what it would feel like if I were squeezing any cock. Yeah, it feels natural. It looks like it feels natural, at least from what I can see over video.

Speaker 1: 35:32

Yeah, and a lot of guys, when they come in because I think a lot of guys are wondering what's the average person that you see that comes into a clinic Like, what are they saying, estimating their size of their penis to be in terms of girth, and a lot of guys will point to a three and a half inch circumference. So that's what this one looks like right here, and a lot of guys are interested in getting an additional inch, which would be 4.5. So you can just see the difference here that even an inch increase is a huge increase in size. Okay, now, in terms of where we inject the filler, a penis in its natural state doesn't have an actual space to accommodate the filler. We have to create that space, all right. So it's important to understand the anatomy of the penis for this discussion.

Speaker 1: 36:23

When it comes to the technique, and if you just look at this cylinder block right here on the top of the penis is where you have the neurovascular bundle, lots of nerves, lots of blood vessels, okay, so we typically don't inject on the top part of the penis, although sometimes I will inject on the top. On the bottom part of the penis is the urethra, that's the tube that men urinate out of. So when you think about anatomy, where we're typically focusing, the filler is actually on the sides of the penis. Okay, which makes sense, because when you look down at a penis, it just looks thicker when you're looking down, right, so you get the sides there.

Speaker 1: 37:03

Now some people will ask will that make my penis look flat if you're only injecting the sides? Well, the answer is no, and that's for a couple of reasons. One is if we go back to anatomy and we see that the urethra is on the bottom, that urethral tissue is very vascular and when a man gets a full erection, you can see the outline of the urethra on the bottom and so that engorges and creates more of a cylinder of the penis. The other very key point here, which is specific for fallow fill, is that we use the fallow sleeve. We put a sleeve on which is a soft silicone sleeve.

Speaker 2: 37:44

Okay, it's not like a hard she is holding holding one up for my listeners. I just want you to know again if this is really interesting to you or something you want to know more about. Please go to the YouTube channel at TalkSexWithAnette because you can see that what a sleeve looks like she's holding it up. It's cylinder, you know, like you could put it over your dick.

Speaker 1: 38:05

That's a great way of describing it.

Speaker 1: 38:08

So we fit the sleeve depending on the length and girth to the penis and we just put it over the penis here once we put the filler in.

Speaker 1: 38:17

Okay, and this helps round everything out, and so the guys will wear this consistently for three weeks after each injection procedure. It helps minimize bruising, helps minimize swelling, helps round out the tissue or the filler that we put in, and because as soon as the guy walks out of my clinic, what happens to the penis? It expands, it retracts, it moves right and that can move the filler, and so what happens is the glands or the tip of the penis will actually sit outside of this ridge, right here on the sleeve, and it helps minimize the penis from retracting. So the other key part about this sleeve is it minimizes retraction to help keep the filler in place. And that's why you know again, not like, as I mentioned, not all filler is created equal and not all filler procedures and post procedures are created equal. One of the reasons why we have such great cosmetic outcomes after our protocol is because we're putting a lot of time, effort and resources into what happens after you put the filler in.

Speaker 2: 39:22

Right? Well, I will say this that is one thing we've never gone over on this podcast is sort of the full procedure, what it looks like, and then the aftercare, which is important, and I do think there's a lot of information out there about fillers that make them sound scary, whether you're someone getting them injected into your face or your cock, and so that makes sense. You've got sort of that safety net in place. And also I'd like you to verify my understanding with this kind of filler is you can also, if it's injected and the person doesn't like it or wants less, you can go in and dissolve it, correct?

Speaker 1: 40:06

Yeah. So the biggest concern that my patients have when they see me they don't want to regret their decision having seen me Because again they're coming in. They don't have a disease, they have a normal penis that they want to enhance, and the last thing they want to do is mess up their normal penis. That was a very elective procedure from the get-go, and so what they like about the falafel procedure and using hyaluronic acid is that it is completely reversible.

Speaker 1: 40:39

And it's actually really interesting because when I think about all the different procedures that I offer as a urologist, that all of my colleagues offer as urologists, I cannot think of another procedure that is 100% reversible. Even you think about a vasectomy, which is a very common procedure that we do for someone who no longer wants to have children. I mean, true, you can reverse a vasectomy, but it's not going to be the same and you're not going to have the same outcomes in terms of fertility potential for someone who never had a vasectomy, whereas my patients love that I can dissolve this medication if I need to. I've never had someone want that, but I can if I need to, and that provides peace of mind for patients. There is no price you can put on peace of mind.

Speaker 2: 41:28

Right and this gives me a great opportunity to address a listener comment that I did not publish. One thing that has it's been said more than once, but usually not very politely, so you don't get published is what you know. All of this conversation about penis enhancement, so on and so forth, I had a listener say well, you don't hear people talking about doing that for women. Look, guys, this is a procedure that is in line with the procedures we've been doing and I would call them gender affirming procedures. These are gender affirming procedures If we want to talk about that we've been talking about with women for a long time. Breast enhancements those have been I mean, I don't know, I grew up with those booming, although different than this kind of procedure, but all of like the things women are doing with their faces, and now men too, although I would venture to guess it started with women, and women do them more. You know, putting filler in their face, in their lips.

Speaker 2: 43:59

This is just an option for men, who are all so unhappy with their physical appearance, and it happens to be the sexual organ that makes them feel manly or more like the more sexually virile version of themselves, just like women sometimes want bigger boobs, because it makes them feel more feminine and sexy in that way. Now there's an option for men, and that is what I've addressed here on the show. There are options for people who want to feel more like the person that they believe themselves to be right, or want to feel more confident in bed, and this is what the option gives them. So it is not always just about men In our society, women are doing this too, and we've talked about it a lot. This is now us giving men the information and kind of the affirmation that is look, if your sex life is being ruined by this, whether it's because of how you feel about yourself, it's your own stuff, or it's because it's really affecting your sex life and and you want to have a better sex life, there's an option for it.

Speaker 2: 45:17

I'm not pushing it here. I'm just giving you options. I'm learning about this along with you folks. I'm not a urologist, you know. I just know the things that are hurting people's sex life and ability to have pleasure. Yeah, so that's what we're talking about here. I would like to address are there specific conditions, like medical conditions, where girth enhancement is a solution? But beyond sort of the ego and confidence, do you use these fillers for certain medical conditions.

Speaker 1: 45:56

That's a really good question. First of all, I want to really I want to go back really quickly. I just I love how you just verbalize everything that you just said. I love how you spoke about this being gender affirming care. Like, as a men's health specialist, pretty much everything that I do is gender affirming care. It helps men feel more masculine in their bodies, and not in a toxic way, but in a let me celebrate myself as a man type of way, you know, and I think that's a really beautiful thing for a lot of men, and my goal is not to make every man feel like he needs a bigger penis, but obviously there are men that are concerned, and so we're just giving them the safe option. So I love that you said that and can.

Speaker 2: 46:38

I let me just chime in. I have been in relationships with men who are insecure about their penis size and sex with them was miserable. And I'm going to tell you why. I was fine with the penis. I probably wouldn't have even like considered the size. I was fine with the penis. I probably wouldn't have even considered the size. I was really into the person. Their size was fine. I hadn't noticed it, but what I started to notice was how much they brought it up.

Speaker 2: 47:11

And then every time we had sex, if I didn't have an orgasm, there was this like comments about size. I had to do all of this reassuring all the time and look, I'm all about reassuring, but it made it so suddenly I felt like, oh my God, even if I wasn't in a place where I could have an orgasm, I wanted to fake the orgasm because I didn't want to. You know I don't want to spend time after sex. You know that. You know, in this bad place I want it to be fun, I want sex to be fun, and of course it wasn't fun for them because they were worried the whole time. But it really like. I look back at some people who I was very like, at least one who I was definitely in love with, and I ended up just dreading sex with them because they were so insecure about their dick size.

Speaker 1: 47:59

You and I have both had that experience right when we're with someone who feels confident about their body, they are more fun to have sex with hands down, and I don't need a research study to tell me that's the case. We know from our personal experience.

Speaker 2: 48:13

Right, regardless of size, if you show up and you're confident in bed, you could have a small penis. But if you show up and you're just like really confident about what you bring to the bed, the gal is probably not going to notice nor care about the dick size. Even if she does notice it, she might be like I don't care, like this is good, right.

Speaker 1: 48:31

Yeah.

Speaker 1: 48:31

Confidence is sexy. Confidence is everything. Confidence is so sexy and so arousing, like, I think, more than anything else. So, to answer your question about other medical conditions, so there are actually a couple where filler can improve. I see guys who come in with premature ejaculation and so they might orgasm even before they penetrate their partner or within you know, 30 seconds or a minute of penetration. And you might wonder well, wouldn't putting filler in? That would then lead to more friction and increased sensitivity? Wouldn't that make premature ejaculation worse? And it's interesting because it doesn't seem to do that. We haven't studied this, but I ask all of my patients who are coming in and we talk about this, you know, as part of this comprehensive discussion before I do filler if they want to last longer, and what I've seen across the board is they're able to last longer. My guess is they're more confident, and so that confidence allows them to have more control over their body, and I don't know how else to explain it.

Speaker 1: 49:41

The other condition that I see is delayed ejaculation, and delayed ejaculation is one of the most complex conditions I treat, in part because we don't have a definition for it, because a lot of young guys would love to be able to last 30 minutes in bed. But then you take a guy who's 75 years old and lasting 30 minutes in bed is way too long because he doesn't have the stamina or the energy to last 30 minutes. So the definition is highly variable depending on who the person is and the stage of their life. But for a lot of people, as they get older, their genitals become less sensitive. We know that for women, you know, a lot of us need more stimulation, like a vibrator on the clitoris to climax, and the reality is a lot of men need that as well. We just and we haven't made it as socially acceptable for men to bring in other products into the bedroom to increase their stimulation, like we have for women.

Speaker 1: 50:43

So as men get older, what oftentimes happens to the penis? It gets smaller, he loses length, he loses girth. It could be due to Peroni's disease or scar tissue that forms in the penis. It could be due to erectile dysfunction that the tissue changes and the penis gets smaller. And what happens to the female if we're talking about a heterosexual relationship?

Speaker 1: 51:02

Well, look, if she's had children, the tissue can become more lax and the elephants in the room that so few people you know are talking about are like, if you can't feel your partner, if the woman can't feel the man and the man can't feel the woman, damn, it's going to be hard to orgasm, right, you know, and you don't want to say that to your partner, like I don't think anyone wants to say to their partner hey babe, are you in? I can't really feel you. But I don't know, I'm not going to speak for you. I've been in this scenario where, when a guy is losing an erection, you can't really feel it. Yeah, yeah, I think we've all been there, you know. And so sometimes you just need to increase the friction, and that's where, if you increase the size of the penis and then both people can feel it more, it doesn't take a rocket scientist to understand. Both people are then going to enjoy it more.

Speaker 2: 51:56

Right, yep, there you go, guys. The unsaid thing that a lot of women don't say is is it in yet, or is it still in?

Speaker 1: 52:06

But the interesting thing and gosh, you know, even as a sexual medicine specialist I've never had this conversation at like a scientific meeting with my colleagues. But obviously there are different positions that both men and women like more than others because they feel it more, and there are other positions where they just don't feel it as much.

Speaker 2: 52:25

What positions require girth? Like, if you don't have the girth, they aren't going to be as fun.

Speaker 1: 52:36

Oh gosh, that's a good question, you know, I don't. I don't know the answer to that question.

Speaker 2: 52:41

I was thinking that. Oh, I know one like if you are laying down like the spooning laying down there behind you, you got to have some length and and you got a little. Have a little fatty going on there, you know.

Speaker 1: 52:59

The thing is it depends for men and women. You know the positions that feel good for one may not feel good for the other. But I think the reason obviously why certain positions feel better is because, depending on the angle and the body, you know, you just have more friction on that more sensitive area of the genitals. Again, that's not rocket science, but when do we actually have those conversations with our partners of like, hey, in this position, do you feel anything? And it's not even like the question of like, does that feel amazing or does that feel great? It could be the difference of like I don't know if you're in versus that feels like neutral, like no one's talking about that part of it.

Speaker 2: 53:40

I mean, that's always awkward when, like I've definitely have you ever had this happen, when you're having sex with someone and you're like you know, you felt it like they were really hard and then maybe because, a penis will get harder and softer throughout sex, and then they're still pounding away or even speeding up and you're like, is it still in there?

Speaker 2: 54:04

They're pounding away faster and they seem frenzied, but I'm not sure what's going on. And I'm a small girly. Here's the thing. I know, I know it's not me. My problem is quite the opposite. Like I can't handle big. So when I start to not feel it, I'm like are they just, have they gone limp? And they don't want to say anything, so they're trying to get it going again. I do also know, and we do have a podcast on soft cocks, and soft cocks can come and feel pleasure, but have you ever experienced that?

Speaker 1: 54:42

Oh yeah, 100% yeah.

Speaker 2: 54:44

We never talk about that.

Speaker 1: 54:45

It has to do with the size, it has to do with the rigidity. You know a lot of guys. You know what I see in my practice. Obviously I see a ton of erectile dysfunction. And so, guys, you know, especially as they get older, they have like a limited period of time where they know they can maintain the erection. So why are they going super fast? Cause it's like if they lose the erection completely they're out of the game. And as they get older it becomes more difficult to get that erection back. And if they know once they lose the erection they're not getting it back Like they may have when they were 19 years old, they're really trying to get the job done right.

Speaker 1: 55:20

Even if they have, like a partially erect penis and yeah, so that could be completely separate from the size of the penis it's just not fully erect. So whenever these guys are coming in for penile enhancement, we are absolutely addressing erectile function, because if I make a penis bigger but he's not fully erect, I'm not really optimizing his sexual health. So we're definitely doing both at once and I want that penis erect as possible whenever he's having sex right, yeah, yeah, we all, we all do, buddy, we all do.

Speaker 1: 55:53

we want it as erect as possible when you're having sex and the good news for everything that we're talking about today is we have solutions for everything, and my job, my goal as a urologist, is not to create problems where they don't exist, right, you know, and so I'll bring up, oh, any concerns regarding getting or maintaining erections, and if someone says no, like we move on. But oftentimes it opens up the conversation where they may not have brought it up, because maybe it's not a problem all the time, but maybe one in 10 times it is a problem, but one in 10 times is still significant, right? All it takes is one in 10 to have a bad experience that will dictate how he interacts with his partner for the next 10 times they have sex, right? So my job is, if someone wants to talk about any of these sexual health issues whether it's getting erections, maintaining erections, length, girth, sensation of orgasm, ejaculation, volume of ejaculate like, we tackle everything, because now we actually have solutions for every one of those things.

Speaker 2: 56:52

There's so much shame shame that keeps people from asking for help or talking about or telling Like we were just sitting here, kind of joking about how we've been in sexual situations where someone's pounding away at us and we're just like what is happening and of course, it's hard to say in that moment to someone because we don't want to make them feel ashamed.

Speaker 2: 57:12

So anything that can. When it comes to your sexual health, I have to say and I'm sure you'll back up it's so important that you are able to talk to your provider about what's going on, and if shame is keeping you from doing that, it can keep you from finding out you could have a condition that is detrimental to your health and dangerous for your health. I have a whole podcast on like penises being this sort of. You know it can be an alarm for underlying health conditions that are severe and also we've talked about this in women. So it's important that shame is not keeping you from talking to specialists, your partner and getting the help you need. So we're out of time, but I want you to give my listeners just a quick, like the quick top tips. If they're feeling insecure about their penis and they want some help, what are some things they can start doing day tomorrow to figure out what's going to be the best solution for themselves.

Speaker 1: 58:22

One thing I do want to mention because we do actually have data on this, and this addresses one of your earlier questions about self-confidence.

Speaker 1: 58:28

We did a survey of over 400 of our falafel patients and like 70, let's see 80% said that their self-confidence and overall wellbeing after filler was better or much better than 80% of men. We know that from a survey study. And then, in terms of how filler has impacted partner satisfaction during intimacy and again this is asking the person who had filler, not the partner themselves, is, let's see, over 70% said better or much better. So we do. It hasn't been published, but we do have some survey data that answers kind of both of those questions related to partner satisfaction and self-confidence.

Speaker 1: 59:10

So, to answer this last question, I would tell patients or people interested is one stay curious, go down the rabbit holes online. Oftentimes it's healthcare providers when our patients come in and they said okay, I apologize. I went on Dr Google and I looked this up. I had a patient earlier today that said I had some conversations with chat GPT and that's how I ultimately found you and I said I love that. I love when my patients have conversations with a chat GPT because it gives them a foundation of knowledge from which they can then come to my office and face-to-face, we can have a very meaningful conversation. It means they know the questions to ask. When patients come in which is rare in my current clinic and I ask them are there any questions? I can answer for you. Annette, I worry about the patients who say I don't have any questions. It means they don't understand what we're talking about, because everyone should have questions, because no one like me is amazing at explaining everything. That eliminates all questions. So I will ask my patients have you gone down a lot of rabbit holes online? Have you looked at Reddit, different forums, what questions do you have? It means they've done some research, especially when it comes to penile augmentation. I don't think any of these people should ever show up to a doctor's office not doing any of their research. So I encourage that and, honestly, where else are they going to learn about it? It's not often in textbooks, it's not on TV shows, like it is for women and cosmetic surgery. So really, the big way for people to learn about this is online, and I think that's okay. We should encourage people to learn from their peers. With that being said, you gotta take that with a grain of salt, you're gonna see the best and the worst cases. So you just have to understand the spectrum of what people are going to report online. That's one thing. Number two doctor shop. A lot of healthcare providers get offended by patients calling their offices and doctor shopping. A lot of healthcare providers get offended by patients calling their offices and doctor shopping. I encourage it.

Speaker 1: 1:01:23

I have patients calling my office all the time to ask about my accessibility, the procedures I offer, the price. That is transparency at its finest. I want my patients, when they schedule a visit, to know exactly what they're going to get when they show up to my clinic. I don't want to waste their time. I hope that all of my patients, when they schedule a visit, to know exactly what they're going to get when they show up to my clinic. I don't want to waste their time. I hope that all of my patients that see me have found a provider with whom they feel comfortable talking about such a taboo topic with. I understand that, annette, that a lot of men may not feel comfortable talking about this with a woman, and I take no personal offense if he would prefer to speak about these issues with a man, you know. So that's why I do a lot of stuff online, because I want people to see how I talk, what I look like, what my message is. So when they actually come and they visit with me, they know they've chosen the right person even before they schedule that visit Right.

Speaker 1: 1:02:15

And number three, I would say, is decide your risk aversity. Okay, I am very risk averse. So the way that I counsel my patients on interventions, for anything that I offer my patients is not based on its effectiveness. It's not based on a treatment's efficacy. It is based on its safety profile. If there is a very effective treatment but I can hurt my patient, and especially if I can't fix it, if the treatment hurts them, I cannot offer them that solution. But if I offer a treatment like falafel with the hyaluronic acid, that is not going to be a permanent solution, it's not going to last forever, but if I cannot hurt my patient and if it has an incredible safety profile, then I am going to offer that solution. So I know for myself I am very risk averse and patients need to understand that for themselves too is how much risk are they willing to take for a particular procedure, especially when it comes to penile enhancement?

Speaker 2: 1:03:21

Well, there you go, guys. That's got you set up to go Go do your homework. If this particular topic has been on your mind, as I know it has been for so many of my listeners Now can you tell everybody where they can find you?

Speaker 1: 1:03:36

Yes, so the best places to find me. My clinical practice is called Prime Institute. We're located in the Miami Florida area, if you have a bunch of people that fly in, so I'm very close, about 20 minutes away from Miami International Airport. People can fly in and out the same day if they decide. So that's primeinstituteus, and you can just submit an inquiry online if you want to schedule an appointment, and then I have a lot of content on my YouTube channel and you can find me at at doc, doc Amy urology. Those are the two best places.

Speaker 2: 1:04:07

Fantastic. Thank you so much. So, folks, everyone deserves to love their bodies. Everyone deserves to have a pleasure-filled life with their partner and feel good about their role in that. Now I want, like Dr Amy does, everybody to love their body as it is. But we know the reality in this society. Sometimes it's a little bit hard. So if you are struggling, there are options. I hope that you know that now and you can do your research and then decide how you want to move forward. But the bottom line is pleasure is your birthright. Loving yourself and self-love is your birthright and you deserve to have access to whatever care you need to claim it.

Speaker 2: 1:04:59

So if you have questions for me or for the doctor, you know, go to YouTube. You can scroll down and leave a comment below. I will do my best to get your comments or questions addressed. You can email me at Annette at TalkSexWithAnnettecom. You can scroll down to the comment section below or the description below. You're going to find my speak pipe there. You can send me a voicemail. I am actually going to be launching a regular series where I just answer your questions in little shorty audios and videos so that all of those questions because I get so many of them, I can get at least some of them answered for you. So go ahead, send me your questions. I'm going to get you the answers to the best of my ability. I'm looking forward to them. So until next time, listeners. I will see you in the locker room and thank you again, dr Amy Cheers.