The Truth About Girth: What Women Really Want

do the

sex. Today's talk sex with Annette topic

is does girth matter? The hard 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? Today's guest is

Dr. Amy Pearlman, 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, 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 Only Fans, and that is where I'm

able to share my sex and intimacy tips,

how-tos, demonstrations, and audioguided

self-pleasure meditations, all designed

to help you have more pleasure, better

sex starting tonight. I'm also on

Substack doing the same. And you can

find me there with my handle, talk sex

with Annette. 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. 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 genital urinary

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. I love that you say

that cuz 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 sexual organs, play into

that in a big way. I want y'all to stay

to the end, and I'm going to tell you

why, like I always do. So, first 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 un unhappy,

unsatisfied with your body, um, 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-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 is to girth. Cheers.

Here's the big question of the hour. Is

girth the new six-pack?

Oh, that's a good question. Uhuh. I

thought it was. Yeah. 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 I this is my perspective, size

matters to an extent. Okay? And I think

if we say size doesn't matter, I think

we're ignoring our society and what

culture, you know, what culture says.

And so I think we have to acknowledge

that for many people size matters. 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 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. 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. 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 you can say what you're

going to say and then I'll of course

always add in my two cents. It's the

ageel question. It is. Let's talk about

it. So, 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? 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?" 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 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.

Some ladies like that [ __ ] I am not one

of them. I know it's so but it's 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 and

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. I do it all the time. Also, yeah,

do it all the time. So technique also

obviously matters. I don't have any

research to um 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.

So I think one thing because our sex

education is not

pleasurebased, 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.

Well, there are very few there are some

women, but very few women that you can

just stick the [ __ ] 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

pleasure education is new uh yes I think

that probably why we get size queens um

I am not one of them but there are that

having uh 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 uh really

erotic that a smaller penis may not uh

reach as well. But if you've got a

girthy [ __ ] 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 [ __ ] or a slightly

longer [ __ ] then he's going to be more

likely to hit it. So, yes, I could see

how a bigger one might um serve for

that. Now, I have had a conversation on

here about the truth about 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.

Uh, you can use, you know, grinding the

micro penis against the [ __ ] 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.

Um, 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? I think it's fair to say. Yeah.

Mhm. All

right. This question has come across my

desk a lot. What

is the average girth? 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

penal circumference the average is going

to be about 9.3 cm and the average erect

circumference is about 11.6 cm.

Okay. All right. Well, I hope guys that

answers your question and means

something to you. It doesn't really mean

anything to me, 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 averagesized

penises and they know it, right? So,

we're not talking about someone who has

a micro penis, 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 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. I 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 um these demos right

here, which are different um girths. For

my audio listeners, if you want to see

the demos, you're going to need to go to

my um YouTube channel, talk sex with

anette. Otherwise, we will try to uh

describe them to you. Will you hold

those up again? Um do you and are those

sized out? So, these demos are are just

tubes that are showing size and girth. H

interesting. I even look and go, I

prefer this one or that one. All these

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 maybe around

here." That's a fatty. That's a fatty.

Looks like a fatty to me. You know, I

have this one right here, which is the

largest one on my set. This one That's

big. Seven inches. That Wait. And that's

seven inches long or no around

circumference. Around. Okay. Okay. by

grip. If I were to grip it, that would

be like a a Yeah. Your fingers don't

even come together. Yeah. So, yeah.

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 4 in, 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. I 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. 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? 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 [ __ ] 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. 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 followup 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." And I'm like,

"Okay, well, that speaks volumes, you

know." Yeah. 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 it 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. 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 um who enjoy that full

feeling. Even when you know when it's a

woman towoman and you're fingering like

adding fingers and even fisting feels

really good to them, the the vagina can

really expand. But I also imagine seeing

your partner feel really

confident while having sex with you is a

turnon. There's something about that.

The increased confidence

uh is sexy in a partner and there

there's no way that can't play into it

improving sex overall.

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. 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.

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 the 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? in with men,

how much does body dysmorphia play into

their insecurity about their dick

size? 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 fowl, 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 penal

augmentation or penal 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 penal

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 and um so if I were to do

a questionnaire for body dysmorphia

which I didn't do in either of those

cases um 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. 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 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 just

thought 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. 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?

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 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

broaden 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

would 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, what I'll

talk to patients about those options and

I might have them use a penis pump for 3

months before I bring them back for

girth enhancement to see if they can

restore size that may have been lost.

Um, 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. Now, not that I can't

do girth enhancement when they come in.

I just want to see, hey, um, you know,

in some ways I try to save my patients

money, right? I mean, I'm a bad

salesperson. Um, 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 bearing 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. So let's talk about the

filler. You you've been talking about

filler. is one treatment for adding

girth.

Correct. What is this treatment 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. 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

Fallill because just like, you know, a

lay person, right? 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 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,

"Alice, Jonathan, what do you think

about the fowl procedure?" And they

said, "We love it and you should do it,

too." So I reached out to the company

Falafil because they're training

urologists like me around the country to

do this procedure because Annette 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 penal 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 um

I learned how to do this procedure. 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 nasol labial folds or in

the cheeks. So Annette, not all filler

is created equal. I'm injecting

hyaluronic acid. Hyaluronic acid is

normally present in our body. So it's

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 more

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-l like material on the side of

the penis. So the type of filler that

you put in matters, 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 [ __ ] Yeah, it feels

natural at least from what I can see

over uh video. 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 3 and 1/2 in

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 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 neurovvascular 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. Now, that

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

fallophil is that we use the phallow

sleeve. We put a sleeve on which is a

soft silicone sleeve, 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, talk sex with because you can

see that the what a sleeve looks like.

She's holding it up. It's cylinder, you

know, like you could you could put it

over your dick.

That's a great way of describing it,

Annette. So, um, 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. Okay.

All right. And this helps round

everything out. And so, the guys will

wear this consistently for 3 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. 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 afterare, 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 [ __ ]

Um, and so that that makes sense. You've

got sort of that safety net in place.

And also I'd like you to verify. My

understanding

uh 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. Yeah. So

Annette, 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 fowl

procedure and using hyaluronic acid is

that it is completely reversible. 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 a 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, you know,

fertility potential for someone who

never had a vasectomy, right? 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, right?

And this gives me a great opportunity to

address a listener comment that I did

not publish. Uh, one thing that has it's

been said more than once, but usually

not very politely, so you don't get

published. Um, is what you know, all of

this conversation about penis

enhancement, so on and so forth. Uh, 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 different

than this kind of procedure. Uh, but all

of like the things women are doing with

their faces and now men too, although I

would I would venture to guess it

started with women and women do them

more uh, you know, putting filler in

their face, in their lips.

This is just an option for men who are

also unhappy with their physical

appearance and it happens to be the

sexual organ that makes them feel manly

or

more like the the more sexually viral

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 uh that is what I've addressed

here on this 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 it

gives them. So it it is not always just

about men in our society. women are

doing this too and 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 you are 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. 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. So, that's what we're talking

about here. I would like to address um

are there specific

conditions like medical conditions where

girth enhancement is a solution? So but

beyond sort of the ego and confidence

um do you use these fillers in for

certain medical conditions?

It's a really good question. Oh, 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 um 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 I

let me just chime in. Yeah. 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 really into

the person. Their size was fine. Um I

hadn't noticed it. But what I started to

notice was how much they brought it up.

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 I wasn't in a place where

I could have an orgasm, I wanted to fake

the orgasm cuz 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. 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, 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? Yeah.

Confidence.

I% confidence is everything. Confidence

is Confidence is so sexy and so

arousing. like I think more than

anything else. Um 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. 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. So, as men get older, what often

times happens to the penis? It gets

smaller. He loses length. He loses

girth. It could be due to peronis

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? Well, look,

if she's had children, the tissue can

become more lax. And the elephant 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, I are you in?

I can't really feel you." But I 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. It's in there.

We've all been 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. 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? Well, but the interesting

thing and 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. What

positions require girth? Like if you

don't have the

girth, eh, they aren't going to be as

fun. Oh gosh, that's a good question.

You know, I don't I don't know the

answer to that question. I was thinking

that Oh, I know one like if you are

laying down like the spooning laying

down, they're behind you.

You got to have some length and and you

got to let have a little fatty going on

there. You know,

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. I mean, that's always a

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 is it still in there?

like 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 get it going

again. Um I do also know and we do have

a podcast on soft [ __ ] and soft [ __ ]

can come and fill uh

pleasure but have you ever experienced

that? Oh yeah 100%. Yeah, we never talk

about that to do with the size. It has

to do with the rigidity, you know, but 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? Cuz 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? Even if they

have like a partially erect penis. And

yeah, so that could be completely um

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. We want it as

erect as possible when you're having

sex. 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 often

times 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, um sensation of orgasm,

ejaculation, volume of ejaculate. Like

we tackle everything because now we

actually have solutions for every one of

those things. 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. So

uh anything that can when it comes to

your sexual health I have to say and I'm

sure you'll back up. 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 is detrimental to your

health and dangerous for your health. I

have a whole podcast on like uh penises

being this sort

of you know it can be an alarm for

underlying health conditions that are

severe. Uh and also we've talked about

this in women. So it's important that

shame is not keeping you from talking to

specialist your partner and getting the

help you need. Uh, so I 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 today, tomorrow to figure

out what's going to be the best solution

for themselves?

So, 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. We did

a survey of over 400 of our fowl

patients and like 70 let's see 80% said

that their

self-confidence and overall well-being

after filler was better or much better

in 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. So to

answer this last question, I would tell

patients or people interested is one

stay curious. Go down the rabbit holes

online. Oftenimes as healthc care

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 chat

GBT 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 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

penal 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 got to take that with a grain

of salt. You're going to 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

health care providers get offended by

patients calling their offices and

doctor shopping. I encourage it. 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 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? 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 if on 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 phalophil 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 riskaverse 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 penal enhancement.

Well, there you go, guys. That's got you

set up to go. Go do your homework if

this this 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?

Yes. So, the best places to find me, my

clinical practice is called Prime

Institute. We're located in the Miami,

Florida area. I do 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. Um,

so that's primeinstitute. us 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

doc doocc amy urology. Those are the two

best places. 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

birthight

and you deserve to have access to

whatever care you need to claim it. 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

annatalksexwithanette.com. 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. uh so that all

of those questions cuz I get so many of

them uh 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. Cheers.

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