Monophasic or biphasic hyaluronic acid: which one for a penoplasty?

Not all hyaluronic acid gels behave the same way once injected. Behind a single name lie two families of product — monophasic and biphasic — of which only one is suited to penoplasty. This choice, invisible to the patient, nonetheless determines how even the result will be.

Two families of gel

The distinction lies in the structure of the gel itself. A monophasic hyaluronic acid forms a single, continuous and homogeneous phase. A biphasic one combines particles of cross-linked gel suspended in a carrier fluid: two distinct phases, hence the name.

This difference in structure is far from incidental. It determines how the product distributes through the tissues at the time of injection, and then how it behaves there in the months that follow.

Why monophasic gel is the choice in penoplasty

For a penoplasty, monophasic gels must be used. There are three reasons for this.

First, they distribute better. The continuity of the gel allows even diffusion within the injection plane, with no areas more heavily loaded than others.

Second, their fluidity is superior. This allows precise placement and gradual integration, without forcing the tissue.

Finally, and this is probably the most important point, their resorption is far more even. The product fades uniformly, leaving no localised residue. The result ages as a whole.

What a poor choice causes

I have seen several patients treated abroad with biphasic gels. The reason for consulting was the same each time: lumps of product away from the injection site. The gel had not distributed as expected, and had gathered somewhere other than where it had been placed.

This is not a trivial matter. Once formed, these lumps resorb no faster than the rest of the product, and correcting them requires specific management — where an appropriate initial choice would simply have avoided the problem.

Not advised here, not a poor product

One point must be made clear: biphasic gels are good-quality products. They have their own indications and are used appropriately in other areas of aesthetic medicine.

But they are not advised in the indication of penoplasty. This is not a question of product quality, but of the match between the structure of a gel and the area being treated. An excellent product in the wrong place remains a poor choice.

This is also why the choice of practitioner matters as much as the choice of product: knowing this distinction, and applying it, is part of what separates a well-conducted penoplasty from one that needs correcting.