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Previous studies suggest that a flaccid, rather than erect, penile girth is more likely to cause distress in men complaining of a small penis [22,23,24]. Contrary to the results comparing the augmentative effects between the fillers, the increases in satisfaction levels were smaller in the PMA group than in the other groups at 24 weeks. In our study, satisfaction levels increased after filler injections and were adequately maintained in all filler groups, even when the augmentative effects gradually decreased. Penile Girth Enhancement Case 3 Dallas, TX I'm John Hanger, President at Zen Hanger, and I've dedicated years to researching and developing safe, effective methods for natural penis improvement. However, consistency and proper technique are crucial for both safety and effectiveness. A penis is only considered medically small (micropenis) if it measures less than 3 inches when erect, affecting less than 0.6% of men. 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