Himplant / Penuma — Subcutaneous Silicone Penile Sleeve (Biomaterials Profile)
Himplant and Penuma® refer to the same device family — a silicone-elastomer subcutaneous penile sleeve placed in the dartos plane around the penile shaft for cosmetic girth and apparent-length augmentation. Himplant is the contemporary rebrand / next-generation iteration; Penuma is the original device that received FDA 510(k) clearance and on which the foundational and multicenter outcome series were performed.
Canonical page. For the full device deep-dive — design, FDA status, indications, surgical technique (infrapubic and concealed-scrotal), Elist 2018 / Siegal 2023 / Wilson 2022 outcomes, complications, removal-and-rehabilitation program, SMSNA 2024 position, and the comparison with HA / PLA / dermal grafts — see the canonical atlas page: Penuma & Himplant (Cosmetic Genital Surgery atlas).
Device (biomaterials view)
- Material — medical-grade cured silicone elastomer (the same family as breast implants, testicular prostheses, chin implants). Not liquid silicone — see Free Silicone Injection for the unrelated and dangerous injectable category.
- Form — preformed crescent-shaped (C-shaped) sleeve; ventral surface (urethral side) open to avoid urethral compression and preserve erectile function.
- Sizes — Penuma supplies L / XL / XXL; Himplant offers a refined size matrix marketed as more granular shaft-by-shaft fit.
- Plane — subcutaneous, between dartos and Buck's fascia. External to the tunica albuginea — does not enter the corpora cavernosa.
- Function — purely cosmetic / aesthetic enhancement of the flaccid penis. Does not treat erectile dysfunction.
- Regulatory — FDA 510(k) cleared (Class II, substantial-equivalence pathway). The only penile implant cleared specifically for aesthetic enhancement; intracorporeal penile prostheses occupy a separate regulatory and clinical category.
Why It's Included Here
These devices are cosmetic augmentation, not reconstruction — but patients with Penuma / Himplant in situ present to the reconstructive urologist with complications squarely within reconstructive practice:
- Device extrusion / erosion through the skin
- Infection and abscess
- Device migration or asymmetry
- Distal flaring producing a visible coronal ridge
- Vascular and sensory compromise of the shaft skin
- Sexually disabling penile deformity, severe shortening, scrotalization, sexual dysfunction at referral centers (Furr 2018)
- Dissatisfaction requiring removal
Removal
Explantation through an inguinoscrotal or coronal degloving incision is generally straightforward for clean, uninfected devices. Infected or eroded implants may require staged debridement, scar-tissue management, and subsequent cosmetic revision. A penile-rehabilitation program (Wilson 2022) is described to restore the pre-operative appearance after dissatisfaction-driven explant. See the canonical atlas page for technique detail.
Contrast With Corporal Implants and Foreign Bodies
| Feature | IPP | Penuma / Himplant | Free silicone (injected) | Penile pearls |
|---|---|---|---|---|
| Intent | Erectile function | Cosmetic girth | Cosmetic girth | Cosmetic / sexual stimulation |
| Material | Silicone elastomer (cured) | Silicone elastomer (cured) | Liquid silicone oil | Beads / balls (variable) |
| Location | Intracorporeal | Subcutaneous shaft | Subcutaneous (anywhere) | Subcutaneous shaft |
| FDA-cleared | Yes | Yes (510(k)) | No | No |
| Reversible | Yes (explant) | Yes (explant) | Very difficult | Surgical removal often required |
| Typical complications | Mechanical, infection | Extrusion, infection, distal flare, removal 3–10% | Granulomas, migration, sclerosing lipogranuloma | Erosion, ulceration, deformity |