Aesthetic medicine and dermatology physician, Dr Mobola Savage, has cautioned that non-surgical penis enlargement procedures involving injectable fillers can carry serious medical risks.
Savage issued the warning while reacting to the death of Nigerian-British businessman and social media influencer, Igho Ubiribo, who died after undergoing a penis enlargement procedure in Thailand.
In an X post shared with Online on Tuesday, Savage stressed that penile filler procedures should not be regarded as a completely safe alternative to surgery.
“And perhaps the biggest lesson from this tragedy is that non-surgical does not mean risk-free. Penile filler is still an invasive medical procedure involving highly vascular anatomy,” she said.
Ubiribo, 43, died in March while on holiday in Bangkok after undergoing the cosmetic procedure.
Reports from an inquest at the Inner West London Coroners’ Court indicated that 40 millilitres of hyaluronic acid and lidocaine were injected into his penis at an unnamed clinic in Thailand.
A UK coroner later ruled that the cosmetic treatment resulted in a fatal pulmonary embolism. A postmortem examination reportedly found material in Ubiribo’s lungs consistent with the hyaluronic acid used during the procedure.
Savage explained that the treatment Ubiribo received was not conventional penile enlargement surgery but a non-surgical augmentation procedure using hyaluronic acid filler.
“From what has been reported, this wasn’t penile enlargement surgery in the conventional sense. It was non-surgical penile augmentation using Hyaluronic acid filler, a treatment primarily intended to increase girth, not true penile length,” she said.
The physician also expressed concern about the reported quantity of filler administered during a single session.
“What immediately stood out to me was the reported 40ml administered in one treatment. Now, penile augmentation does require considerably larger filler volumes than facial aesthetics, but I think this raises an important conversation about how we approach volume,” she said.
She argued that achieving a greater degree of augmentation did not necessarily require administering a large quantity of filler at once, noting that treatment should be tailored to each patient.
“A more measured approach is to individualize treatment according to patient’s anatomy, tissue capacity and desired outcome, with further augmentation performed progressively where appropriate,” she said.
Savage further warned against using the quantity of filler injected as an indication of the quality or effectiveness of a procedure.
“This is particularly important because there is a tendency for patients seeking penile enhancements to focus on ‘How many mLs am I getting?’, as though more filler automatically means a better result. It doesn’t work that way,” she said.
According to the physician, the appropriate amount should instead be determined by factors such as the patient’s anatomy, tissue capacity, desired result, characteristics of the product and the clinician’s professional judgement.
“The number of milliliters should never become the objective of the treatment. Appropriate volume depends on anatomy, tissue capacity, the desired outcome, product characteristics and clinical judgement,” she said.
Savage also discussed the presence of lidocaine, a local anaesthetic found in some hyaluronic acid fillers, and its relevance in high-volume procedures.
“Many HA fillers already contain lidocaine, although not all do. With high-volume filler treatments, the lidocaine contained within the product contributes to the patient’s total exposure,” she said.
However, she cautioned against concluding that lidocaine toxicity contributed to Ubiribo’s death in the absence of sufficient evidence.
“We do not have enough information to say that lidocaine toxicity played any role in this particular death, and it would be wrong to assume that it did.
“But it is another consideration when planning large-volume injectable procedures,” Savage said.
The doctor also identified medical tourism as another factor that could influence how such procedures are performed, particularly when patients travel abroad and seek to complete extensive treatments in a single visit.
“When someone has travelled internationally for treatment, there can be pressure to achieve the entire desired result in one visit because returning for staged treatment may be difficult.
“But travel schedules, convenience and even patient demand should never override clinical judgement,” she said.
Savage said several factors determine the safety of penile filler procedures, including appropriate patient selection, anatomy, product choice, injection technique, treatment volume and the ability to identify and manage complications.
“Patient selection, anatomy, product choice, injection plane and technique, appropriate volume, total local-anaesthetic exposure and the ability to recognise and manage complications all matter. More is not always better. And faster is not always safer,” she said.
Ubiribo, who was also known by the nicknames “Tiny”, “Denisi” and “Ego”, reportedly travelled to Thailand with his wife, Danielle Simba Allen.
After undergoing the procedure, the couple returned to their Marriott hotel before going for a massage.
During the massage, Ubiribo complained of chest pain and reportedly passed out twice. He was subsequently taken by ambulance to Sukhumvit Hospital, where he was initially responsive to medical staff.
Evidence presented during the inquest indicated that his wife informed doctors about the recent penile filler injections.
Doctors suspected that Ubiribo had suffered a pulmonary embolism and recommended a CT scan. However, he reportedly lost consciousness before the examination could take place.
He was later transferred to an intensive care unit, where medical personnel carried out cardiopulmonary resuscitation for more than 100 minutes in an effort to revive him. He died in the early hours of March 6.
A postmortem examination carried out in the UK subsequently found material in his lungs that was consistent with the hyaluronic acid used in the filler.
Pathologist John du Parcq reportedly told the inquest that the material discovered in Ubiribo’s lungs matched the substance used during the cosmetic procedure and was consistent with a pulmonary embolism.
A pulmonary embolism occurs when a blood vessel supplying the lungs becomes blocked, potentially reducing blood flow and placing significant strain on the heart.
Ubiribo had reportedly undergone previous joint surgery and had been described as pre-diabetic and suffering from gout. His primary care doctor, however, reportedly said he had no other significant medical conditions.
Penile fillers containing hyaluronic acid are used as a non-surgical option for increasing penis girth. Although the procedure is less invasive than conventional surgery, it still involves injections into tissue and carries potential medical risks.
Savage’s warning has renewed attention on the safety of cosmetic procedures involving injectable fillers, particularly treatments carried out abroad.
Her comments also underscore the importance of patients understanding that a procedure being described as “non-surgical” does not mean it is free from potentially serious complications.