Before injection: 2 layers of anaesthetic
The first layer is a numbing cream applied for 20–30 minutes to reduce sensation at the skin. The second is an injected anaesthetic at the base to block the nerves supplying the whole shaft. The needle is very fine and goes in at just 2 points. It feels like an ant bite for 2–3 seconds, then the whole shaft goes numb within 5–10 minutes. This is the most painful point of the entire process, and most men rate it 2–3 out of 10.
During injection: tightness, not pain
Once you are numb, the doctor opens 1–2 small entry points with a needle, then inserts a blunt-tipped cannula to spread the gel. What you feel is pressure and tightness as the gel goes in, not sharp pain. Some men describe it as ticklish or strange rather than painful. It takes 20–40 minutes. You can talk to the doctor throughout, and pause if you need to.
The first 24 hours after injection
The anaesthetic wears off in 2–4 hours. After that it feels dull, swollen and tight, like a bruise. Paracetamol is enough. Most men do not need anything stronger. You can sleep normally. Morning erections may feel tight and uncomfortable in the first few days, which is normal.
Days 2–7
The tightness eases every day. Any bruising changes colour and fades in 5–7 days. Urination does not hurt, because the filler does not involve the urethra. You can walk, work and drive normally from the next day. The most bothersome part is the feeling that something unfamiliar is there, which goes away once the gel settles.
What the doctor does to keep pain to a minimum
She always applies numbing cream first and never skips it. She injects the anaesthetic slowly, with the finest needle. She uses a cannula rather than a needle, so there is no need to pierce several points. She warms the gel to near body temperature, injects slowly so the tissue has time to expand, and applies a cold compress straight afterwards.
When pain is not normal
Pain that increases instead of easing after day 3, severe pain in one spot together with pale or dark skin, fever, or localised swelling that is red and hot. Contact the doctor immediately. Do not wait for your appointment. These signs are rare but need to be seen quickly.
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