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BDE comes with a price.

We're talking upwards of $15,000 if you want to enlarge your package. Because while many celebrities have recently spoken out about dissolving their facial fillers, including Blac Chyna, Courteney Cox and Simon Cowell, there's a rising demand for penis fillers.

"I'll have a patient say they've always wished there was something that they could do," double board-certified plastic surgeon Dr. David Shafer told E! News in an exclusive interview. "Now, they have something to enhance their penis, and it gives them confidence."

Dr. Shafer, who specializes in this treatment, said the idea originated about six years ago when a patient's friend suggested injecting his member.

"A light went off in my head and I said, 'Why not?'" Dr. Shafer recalled, "'If you want to be the guinea pig, we'll do it.' I had him come back a couple of days later and we did it. He called a week later, 'Doc, this stuff is amazing but I want to have more of it.' One thing led to another and I've refined the procedure over the years."

According to the plastic surgeon, the experimental nature of the subject ended up being a huge reason he became popular with this procedure.

"The guy I was injecting started going on these penis chat rooms," Dr. Shafer revealed, "and people eventually came across our website and ended up making the appointment. People come in for all different reasons. When I first start doing it, I thought it was going to be people smaller on the spectrum, but it's not. I get a lot of porn actors, teachers, prison guards, actors, executives, financial people, people in the tech world."

At this time, Dr. Shafer is the lead on the only FDA-approved study on off-label use of fillers for penis enlargement.

"We're doing a multi-year study, looking at safety, percentage of complications," he said. "Safety is my number one thing. Just how the original breast implants were made out of very low-quality silicone and bad, structural integrity, those have evolved over the years. And I've done thousands of penis fillers now, about 20-25 a week. It's a very popular procedure for me."

He added, "I have doctors reaching out, wanting me to teach them how to do it. So, there's a growing demand out there."

But before you decide to book an appointment, let's dive into everything you need to know about the cosmetic treatment, including where it's injected, if it impacts your sex life and the ups and downs that come with enhancement.

What is penis filler?

As the name suggests, penis filler is filler injected into the penis. But before going into the details of where exactly it's placed, let's first break down which type of filler is most commonly used. According to Dr. Shafer, hyaluronic acid-based fillers are the preferred injectable, and if it sounds familiar that's because it's what's used to plump the lips, add volume to the cheeks and enhance the face overall.

"The hyaluronic acid-based fillers are the most popular because it is a natural-occurring molecule," Dr. Shafer explained. "So, the chance of incompatibility of the skin or tissue reaction is very low. If you inject a permanent filler like silicone, I always say permanent fillers lead to permanent problems."

There's also an added benefit to using hyaluronic acid-based fillers—such as Voluma (which Dr. Shafer said he typically uses) Juvéderm, Restylane, Perlane and Belotero—because it's dissolvable. "Let's say you have a lump, asymmetry, you don't like the results or there's a complication, then you can use that enzyme," Dr. Shafer said, referring to hyaluronidase, which breaks down hyaluronic acid. "There's always a backup plan."

What does a penis filler procedure involve?

A huge factor to keep in mind ahead of your appointment: You'll want to hold off on scheduling any other procedures, Dr. Shafer said, "where you'd have a risk of bacteria in the bloodstream," such as dental work or a colonoscopy for at least two weeks.

Now, onto the meat of where penis filler is injected and what you can expect. 

You'll be happy to know that the procedure itself isn't as painful as it sounds. You likely won't feel anything at all. "We inject a numbing shot right at the base of the penis," Dr. Shafer explained. "Once it's numb, we prep it, just like we're doing a surgery, with the same sterile techniques, and they're laying on the procedure table."

According to the New York City-based plastic surgeon, he recently improved the actual injection portion of the treatment by using a cannula—a thin tube that's inserted into the body cavity like the nose or veins. "With fillers before," he shared, "you had to inject with a short needle and you could get lumpiness. But now, we use a cannula to inject long threads of the filler underneath the skin of the penis."

Not only does this involve fewer entry points, but Dr. Shafer said it often leads to a smoother finish for the patient. "As soon as we're done with the procedure," he added, "everybody gets off of the table and says it's not as bad as they ever imagined."

Does penis filler impact your sex life?

Although you might be excited with the results of penis filler, you'll want to avoid penetrating sex for at least two weeks after the treatment. "What can happen is if you're pushing it into a tighter hole," Dr. Shafer shared, "you're going to push that further towards the base of the penis. You want to give it time to settle in." 

Masturbation, on the other hand, is OK but "you can't have your hand in the same position," Dr. Shafer added. "Some guys come in a week later with three fingerprints from wrapping their fingers around the same position. I've also had people use a penis pump right after and then at the base, where the penis pump is making a seal, you can see the outline."

Again, those are all fine to do eventually, but patience is key.

After following the two-week abstinence recommendation, you can run wild with your new and improved package. "Universally," Dr. Shafer described of his clients, "there's an enhancement of the sexual experience because it's a tighter fit, and it enhances the experience for both the partner and the patient."

However, we also spoke to board-certified facial plastic surgeon Dr. Ben Talei, who pointed out that there's a possibility that repeat traumatization of the penis filler "can make how it reacts unpredictable, both with regard to its reabsorption and with any kind of nodule formation and movement." In other words, there's a slight chance it could become lumpy.

What are the pros and cons?

As expected, there are ups and downs to enlarging your bratwurst. Of course, the biggest pro is that the filler enhances the girth and weight of the penis. But when it comes to the actual size, well, that varies between patients. 

However, that's not to say if you have a goal in mind, it's not achievable. Dr. Shafer recommends patients book one to three sessions with three-week breaks in-between to gradually inject the filler until they reach their desired effect. 

"Now, when you're at your goal," he continued, "you come for annual maintenance. You might inject maybe half as much as you needed to reach your goal because some of the filler is still there—kind of like filling the gas tank in your car, and every time it's half-full, you fill it up again."

Sometimes, he said, people like the results so much that at their annual check-up, they end up wanting to boost it even more.

However, Dr. Talei doesn't think "the gain is very substantial" because there are various side effects that can arise. As he put it, "The issue you can have with it is getting various irregularities or bumps under the skin. And if you put the wrong kind of filler, you can get a whiteish discoloration because it's thin skin."

"If it were me," the Los Angeles-based plastic surgeon added, "I would never touch that area because I don't want to have irregularity, pain or any kind of weird issues that would need to be fixed there."

So, what are the takeaways?

Both Dr. Shafer and Dr. Talei can agree that safety is of the utmost importance when it comes to this procedure. "This isn't something where you want to go to a new injector," Dr. Shafer said. "You want somebody who has a lot of experience in this field."

As previously discussed, getting a hyaluronic acid-based filler is highly recommended "especially the first time you're having it done," Dr. Shafer continued. "The worst thing to do is have a procedure where you can't reverse it."

Dr. Talei also offered words of wisdom that transcends penis filler, sharing, "Never follow the immediate trend. Always wait a year to see how the trend plays out before you do anything that's new and popular."

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