Penile filler lumps or unevenness: assessment and removal in Taichung
A hard lump, a bumpy surface, or filler that has moved to the wrong place can usually be treated. What can be done depends on the material that was injected or implanted.
This page explains, material by material, removal, what may remain, risks and recovery, wherever the filler was done.
Explained by Dr. Chao-An Chen, urologist, at 昭安泌尿科診所 (Morning Urology Clinic), West District, Taichung.
In short
- Hyaluronic acid lumps: under local anaesthesia, pressed out through a tiny hole made with a blade, or removed through a small opening. No dissolving enzyme is used here.
- Oily materials (petroleum jelly, paraffin, silicone oil): usually cut out with the affected tissue.
- Dermal grafts (sheet or powder type): removal or revision is decided after assessment.
- Afterwards: a dent, scar or unevenness may remain; the look may not return to how it was.
- Pain: anaesthesia first. After a small-opening removal or cutting out oily material, pain usually lasts 1–2 weeks.
- Cost: self-paid. Costs are explained at the consultation. You can also ask about costs on LINE before you come.
Go straight to a hospital emergency department. Do not send a message and wait for a reply.
1. Sudden severe pain after an injection, or the skin turns purple or white. This may be a sudden blockage of a blood vessel.
2. Sudden severe pain in the scrotum or testicle, or fever with back pain when you have a stone or a known blockage of the urinary tract (for example a swollen kidney or a double-J stent). When you can come straight here for scrotal pain: sudden testicle pain (Chinese).
What you may notice, and what is normal
A hard lump. Dermal powder or a dermal sheet feels firm for the first three months, while body tissue replaces the material. This is normal if the firmness is even, painless, without redness, and slowly softens. Come back if there is a single local lump, if it hurts or grows, or if there is redness, leaking fluid or fever. A hyaluronic acid lump is usually a nodule (small firm bump) from uneven spread or too much material in one spot. More: causes of a lump after a penile filler or implant.
A bumpy surface. This mostly comes from unevenly spread hyaluronic acid. Many people think they can only wait for it to be absorbed. In fact it can be treated under local anaesthesia.
Moved filler, or the two sides differ. Injected material can move. Hyaluronic acid in the wrong place can be treated in that section only. With uneven or misplaced dermal sheet or powder, the extent is assessed first, then the doctor decides between local revision and removal.
How each material is removed
Hyaluronic acid
Under local anaesthesia, the doctor makes a tiny hole with a blade and presses the material out, or removes it through a small cut and smooths the area. This suits nodules that are clear and in one place, or material already partly wrapped in fibrous tissue. If the material is unknown, the doctor first checks whether it may be oily. Suitability and which areas to treat are decided at the assessment. This clinic does not use a dissolving enzyme (see the questions below).
Petroleum jelly, paraffin, silicone and unknown injections
These cause a hard, scarring reaction in the tissue (sclerosing lipogranuloma, also called paraffinoma or siliconoma). The European Association of Urology (EAU) guideline clearly advises against putting silicone, paraffin or petroleum jelly into the penis. No enzyme works on them, and a small opening is not enough. The material is cut out in one piece with the affected soft tissue, often through a circular cut below the head of the penis or a cut along the shaft, down to the deep tissue layer (fascia). Missing skin may need a skin graft or flap. The material can also move into the scrotum.
The clinic assesses the extent first. If the area is large, needs a skin flap or staged reconstruction, or there is a deep abscess or dead skin, you are referred to a hospital that can admit you and do reconstruction.
In a series of 35 men plus a review of 68 articles, people sought care on average 7.8 years after injection (from 1 day to 20 years). Silicone (45.7%) and liquid paraffin (22.9%) were the most common. In the series, 91.4% needed surgery; 18 men had more than one operation and 8 had three or more. In the review, 78.8% had surgery, including 2 penile amputations.
Dermal grafts (sheet or powder)
Removal or revision can be assessed. The clinic first checks when it was implanted, the extent of the area, and any infection; the method is decided after that. Removal is a second operation with another recovery period, and the tissue may already be stuck together (adhesions).
Sheet type (placed by surgery) is designed to let your own small blood vessels and cells grow into it. The better it joins the tissue, the more must be separated to take it out. In a study of 78 men with a donor dermal sheet, about 72% had complications, most often discomfort during erection (about 60%, mostly pulling); 7 men (about 9%) had it removed. Its material was specific, so the numbers cannot be applied directly. In 69 cases with a pig-derived sheet, 13% developed graft scarring (fibrosis), and in these men the penis became about 0.5 cm shorter on average: the tissue can change before any removal. Long-term studies are still limited, and important complications have been reported.
Powder type (injected): there are no published studies of similar scale and no removal data. The sheet numbers do not apply, and you cannot assume the injected type is easier to treat.
For both types, once infection sets in, the material usually has to be removed to control it; antibiotics alone are usually not enough.
Your own fat
There is no enzyme for fat. It can be suctioned out again, or the uneven, dead (necrotic) or hardened (calcified) areas can be cut away. Both work in the thin tissue layer under the skin of the penis, so the treated area may be left with a dent, unevenness or a scar. Reported long-term problems include thickening, deformity, fat shrinkage, scars and contracture (tightening); in one published case, painful inflamed nodules three months after injection needed surgical removal. Absorption varies widely and reliable long-term data are lacking, so no absorption figures are given.
Timing: does waiting change anything?
| Material | How time affects it | The real turning point |
|---|---|---|
| Hyaluronic acid | No fixed deadline; still treatable years later. | What it has become. A lump in one place: usually local anaesthesia. A delayed inflamed nodule or foreign-body granuloma: a larger treatment area. |
| Dermal graft | The opposite: the longer and more fully it has joined the tissue, the more must be separated. | Infection or clear scarring (fibrosis) brings the timing forward. |
| Your own fat | Once dead fat, calcification or scarring forms, it does not go away by itself. | A painful hard lump or repeated inflammation should be assessed. |
| Silicone, paraffin | Time only makes the area larger. | On average 7.8 years before seeking care; many needed more than one operation. |
The simple rule: a new hard lump, a change in appearance, or repeated redness is the time to come back for assessment. Do not wait for it to go away by itself.
The assessment visit
The doctor checks three facts: what material (product information, product name, record of the amount), when (how long ago, how many times), and what is happening now (you dislike how it looks, or there is a hard lump, pain, redness or thinning skin).
If the material is unknown, it cannot be known in advance whether it can be broken down, so the plan must be able to change. The visit can include examination, feeling the area, and ultrasound to locate the material when needed. Deep abscess, dead skin, or a need for large reconstruction means referral.
At the first visit, the doctor explains the method, the anaesthesia and the costs; treatment is booked for a separate time if needed. If you need wound care or infection treatment, the doctor checks the wound first and then treats it. You do not have to decide on the spot, and no deposit is taken. Bring the material name, the date of the injection or operation, and the consent form if you have them.
Wound care or infection after a procedure elsewhere
After surgery in another city, or a dermal sheet at another clinic in Taichung, you can come here during consulting hours for wound care or antibiotic treatment of an infection (self-paid). Bring your operation record, medicines and aftercare instructions.
A shallow wound infection is mostly treated with wound care and antibiotics. If the infection is linked to an implanted material such as a dermal sheet, drainage or removal of the material is often needed to control it. An infection linked to hyaluronic acid is first controlled with antibiotics; the doctor explains after the assessment.
Anaesthesia, recovery and risks
- Anaesthesia. Pressing out hyaluronic acid through a tiny hole, and removal through a small opening, are done under local anaesthesia. For dermal sheet or powder, the type of anaesthesia is explained after the assessment.
- Pain. After removal through a small opening, or cutting out oily material, pain usually lasts 1–2 weeks, worst in the first few days. You get pain tablets; a pain injection can be added (self-paid).
- Sex and masturbation restart after the wound has healed. The number of days depends on the material and the treated area; the doctor explains it at the first visit.
- What may remain: dents, scars, unevenness or colour differences. The penis may not return to how it looked before. The doctor explains this before treatment.
- A larger cut means a second operation and another recovery period. With oily materials, skin grafts, flaps or more than one operation may be needed.
- Referral for a large area, a skin flap or staged reconstruction, a deep abscess or dead skin.
- Planning. The anaesthesia and number of visits decide how many days off you need and whether you need a place to stay or someone with you. This is explained at the assessment.
If you have pain, a hard lump, thinning skin or repeated redness now, see a doctor. Do not treat it yourself, and do not go to anyone who is not medically trained. For other implanted objects, see removal of penile beads and implanted objects.
Other sudden problems: LINE first or the emergency department?
Done at this clinic, or removed or revised here: for redness that spreads, a wound that leaks fluid, or bleeding, tell us on LINE first at any hour (a photo helps). The doctor replies and arranges care. For bleeding, keep pressing with clean gauze. Go to the nearest emergency department only if LINE does not reply and the bleeding will not stop or the redness keeps spreading.
Done elsewhere, not yet removed or revised here: during consulting hours, you can ask on LINE first, and the clinic will assess and treat you. Outside consulting hours, go straight to an emergency department.
Frequently asked questions
Can injected hyaluronic acid be dissolved?
In theory, yes: an enzyme, hyaluronidase, cuts it into small pieces. This clinic does not use it. Its limits: It works only on hyaluronic acid, not on fat, dermal grafts, silicone or paraffin. It also acts on the body’s own hyaluronic acid, so dose and site matter. It has no drug licence in Taiwan: it is a special import under the Pharmaceutical Affairs Act, handled by the Taiwanese Dermatological Association for the Ministry of Health and Welfare, in principle at most once a year. Using it on cosmetic fillers is off-label (also in the United States and the United Kingdom), and needs signed consent and a record in the medical chart. Within one production technology, more cross-linked products resist it more; in a laboratory study, the time needed differed by more than 12 times between products. It is not used during an active infection, because it may help the infection spread, and works less well once a granuloma has formed. Allergy is reported in about 0.05%–0.69%. Most data come from the face; for the penis there are only case series, so no success rate is given.
I had a dermal sheet done somewhere else. Can you treat it?
You can come for an assessment first (self-paid), whether it feels uneven or you want it revised or removed. Whether to revise or remove, and how, is decided after the assessment. Wound care or infection treatment after surgery can also be done here during consulting hours (self-paid). Tell us on LINE when it was done and how it is now, and bring your operation record.
Appointments and access
Consultations are conducted in Mandarin, and can also be conducted in English.
On LINE, tell us what material was used, when it was done, and what the problem is now: a hard lump, unevenness, moved filler, or a need for wound care or infection treatment. We arrange the visit time together. Removal, revision and wound care are done by Dr. Chao-An Chen (board-certified in urology and in surgery) or Dr. Kai-Wu Yang. You can choose your doctor.
You do not need to explain why you are here in the waiting area; the clinic has private consulting rooms.
昭安泌尿科診所 (Morning Urology Clinic)
No. 98, Boguan 2nd St., West District, Taichung City 403, Taiwan（403 臺中市西區博館二街98號）
Consulting hours: Monday to Saturday (closed Sunday). Online booking is open 24 hours.
This page was produced by 昭安泌尿科診所 (Morning Urology Clinic). Medical content last updated: October 2026 (same as the Traditional Chinese version). English version published: 5 November 2026. Medically reviewed by Dr. Chao-An Chen, urologist.
Sources: Xu T, et al. J Sex Med. 2019;16(12):2011–2017. DOI: 10.1016/j.jsxm.2019.09.010 / Transl Androl Urol. 2025 (review) / Faivre J, et al. Aesthet Surg J. 2024;44(6):NP402–NP410 / Moon DG, et al. Int J Impot Res. 2026 (case series) / EAU Guidelines on Sexual and Reproductive Health / Taiwanese Dermatological Association (special import of hyaluronidase) / Taiwan Food and Drug Administration (approved uses follow the approved product information).
This page provides general medical information and does not replace an individual diagnosis or treatment plan.