Penuma Implant 2026: Cost, Results, Risks and Removal Rates

Penuma is a crescent-shaped sleeve made of medical-grade silicone, shaped to sit under the penile skin along the shaft. It is sized to the individual during surgery and is intended as a permanent device, though it can be surgically removed.

The single most important distinction, and the one most often blurred in marketing: Penuma is a cosmetic implant, not a functional one. It is entirely different from an inflatable penile prosthesis used to treat erectile dysfunction. It does not create erections, does not improve erectile quality, and is intended for men who already have normal erectile function.

Published and reported averages place gains at roughly 1.5 to 2 inches in girth and 0.5 to 1 inch in flaccid length. Individual results vary considerably with baseline anatomy, skin elasticity, and implant size.

What matters more than the averages is understanding where the change is and is not visible:

• Flaccid state: this is where the visual difference is greatest and most consistent.
• Girth: the most reliable measurable gain.
• Erect length: minimally affected. The implant does not lengthen the erect penis in any meaningful way.
• Sensation and function: the goal is no change. Any change is a complication, not a benefit.
• Timeline: early swelling exaggerates the result. The settled outcome is only visible at around 3 to 6 months.

Men whose primary concern is erect length are generally poor candidates and should be counselled accordingly rather than sold a procedure that cannot deliver what they want. If your interest is in non-surgical or alternative approaches, see our guide on girth enhancement options.

The Penuma implant costs between $16,000 and $18,500 in the United States, typically requiring an upfront deposit of around $5,000, with surgeon fees, anesthesia, and facility fees making up the balance. Prices in Turkey, Mexico and Thailand are meaningfully lower, though the comparison is only fair when the full package is compared rather than the headline number.

Prices are estimates based on published 2026 ranges and vary by surgeon, facility, and case complexity.

What a Quote Should Itemize

• Surgeon fee, anesthesia fee, and facility fee, listed separately
• The implant device itself
• Circumcision if it is required as part of the procedure
• All post-operative follow-up visits
• Policy on revision and removal: who pays if the device has to come out

That last item is the one most patients forget to ask about, and it is the most financially consequential. Reviewing treatment packages tends to make inclusions clearer than comparing bare surgical fees.

This is the most important paragraph in this article. Clinical studies report overall device removal, or explant, rates ranging from 3% to as high as 21%, varying substantially by surgeon experience, patient selection, and length of follow-up. In other words, somewhere between roughly 1 in 33 and 1 in 5 implants ends up being taken out.

That range is wide, and the width itself is informative. It tells you that outcomes depend heavily on who performs the surgery and on how carefully patients are selected, far more than on the device. It also tells you that a clinic quoting you a single reassuring figure without naming its own series and follow-up period is not giving you usable information.

Questions worth asking any surgeon directly:

1. How many Penuma procedures have you personally performed?
2. What is your own explant rate, and over what follow-up period?
3. What is your revision rate, separate from removal?
4. What happens, clinically and financially, if my implant has to be removed?
5. What does the penis look and function like after removal?

Clinic marketing leans heavily on regulatory language, and most patients read it as a safety guarantee. It is not one, and the distinction is worth understanding before you sign anything.

Clearance and approval are not the same thing. Most implantable cosmetic devices reach the US market through a clearance pathway that asks the manufacturer to demonstrate the device is substantially equivalent to something already on the market. That pathway does not require the large randomised trials that the stricter approval pathway demands. A cleared device is legally marketable. It has not necessarily been proven superior, nor studied over decades.

Two practical implications:

• A device being cleared tells you little about your personal risk of needing it removed. The 3% to 21% explant range exists within a regulated market, not outside it.
• Regulatory status differs by country, and a device marketed in one jurisdiction may sit under different rules elsewhere. If you are travelling for surgery, ask the clinic directly which regulatory status applies where you are being treated, and verify it rather than taking a website badge at face value.

Returning to sexual activity before clearance is one of the more avoidable causes of complications. The 6 to 8 week window is a minimum, not a target.

Given that removal is a realistic possibility rather than a remote one, it deserves a straight answer rather than a footnote. Removal is itself a surgical procedure, usually shorter than the original, and it is not simply an undo button.

Read the removal clause in your consent paperwork before surgery, not after. It is the single document that determines what a bad outcome costs you.

• Men seeking treatment for erectile dysfunction — this is the wrong device entirely
• Men whose main goal is erect length
• Active infection anywhere, or poorly controlled diabetes
• Significant Peyronie's disease or substantial penile curvature
• Prior penile surgery with extensive scarring, assessed case by case
• Smokers who will not stop before and after surgery
• Body dysmorphic concerns, or expectations that no anatomical change can satisfy — surgery reliably fails here and psychological assessment serves the patient better

A surgeon who declines to operate on any of these grounds is protecting you, not losing your business. You can review surgeon profiles and accredited facilities before committing to a consultation.

The last row deserves more attention than it usually gets. In men carrying significant suprapubic fat, a meaningful portion of the shaft is buried, and weight loss alone can produce visible change with no surgical risk at all. It is the first thing an ethical surgeon raises, and the last thing a sales-driven clinic mentions.

1. Verify the surgeon is a licensed urologist with specific, documented Penuma training and volume.
2. Ask for their own outcome data, not manufacturer averages.
3. Insist on a written quote that itemizes revision and removal policy.
4. Be sceptical of before-and-after galleries — lighting, angle, and timing after surgery all change the apparent result dramatically.
5. Treat pressure tactics as a red flag. Limited-time pricing on elective genital surgery is a sales technique, not a clinical one.
6. Confirm the aftercare plan if you are travelling, including who manages a complication once you are home.

The Penuma implant delivers a real, measurable cosmetic change to flaccid girth and length for appropriately selected men with normal erectile function. It costs $16,000 to $18,500 in the United States, requires 6 to 8 weeks before resuming sexual activity, and carries a published device removal rate somewhere between 3% and 21% depending on surgeon and follow-up. It does nothing for erectile function and little for erect length. Anyone presenting this as a low-risk cosmetic tweak is not describing the same procedure the published data describes.

This content is informational and does not constitute medical advice or a treatment recommendation. Only a qualified surgeon can assess your suitability.

To discuss your options with a medical team and receive a detailed written estimate, book a free consultation with Livist Medical, or browse our available procedures.