Alex Tatem, MD, discusses safety and risks of hyaluronic acid injections

In this interview, Alex Tatem, MD, a urologist with Urology of Indiana, discusses the medical realities behind penile hyaluronic acid augmentation and addresses speculation about whether such procedures could influence athletic performance, particularly in ski jumping.

From a theoretical standpoint, he explains that medically performed hyaluronic acid injections can safely increase penile circumference, and research in ski jumping shows that slightly larger suit dimensions can improve aerodynamic performance. Because suit measurements are strictly regulated, the unresolved question is whether subtle anatomical changes could meaningfully affect how suits fit or are measured. Although the concept is biologically plausible, he emphasizes that the connection remains speculative and unproven.

Tatem contrasts medically supervised treatments with rumored unsupervised or clandestine procedures. In clinical settings, injections involve carefully selected products, standardized dosing, sterile technique, and structured follow-up care. Data from his practice, including a retrospective review of 471 patients over 3 years, showed a strong safety profile, with only a few manageable complications such as minor infections and temporary inflammatory reactions. He notes that complications previously associated with older protocols have been eliminated through updated methods.

By contrast, unsupervised injections pose serious medical risks. Patients treated outside professional care may receive permanent fillers, silicone, or even household substances, often leading to devastating outcomes requiring reconstructive surgery. Tatem highlights infection as the most immediate danger, including the possibility of Fournier gangrene, a severe tissue-destroying condition. Other risks include lymphatic obstruction causing chronic swelling, neurovascular injury, erectile dysfunction, fibrosis, and deformity resembling Peyronie disease.

Ultimately, Tatem stresses a clear takeaway: when performed properly, cosmetic or reconstructive injections can be safe, but unsupervised procedures carry unpredictable and potentially life-altering consequences.