Kenny, a firefighter from Texas, got filler injected into his penis eight years ago.

His wife still has no idea.

It's his not-so-little secret.

Back then, as a single guy, Kenny had struggled for years with erectile dysfunction and he was getting frustrated with local urology clinics offering to write him a Viagra prescription and rush him out the door.

He wasn't interested in medication. He wanted to address the root cause of his issues.

So he traveled to Morganstern Urology in Atlanta – the 'longest running men's sexual health clinic' in America – to find a permanent cure.

'It was a miracle,' Kenny told DailyMail.com of the various treatments he received, including some which manually manipulated his blood flow. 'I was getting erections naturally within a week.'

That's part of the reason he jumped at the chance when his doctors up-sold him.

For a total of $3,000 plus the costs covered by his health insurance, Kenny was told he could not only treat his E.D., but add to his girth.

The treatment would involve the injection of off-label filler, hyaluronic acid, that is injected under the skin on the shaft of the penis. Kenny agreed.

Hyaluronic acid is naturally occurring in the body, and lubricates and cushions our joints. It is most commonly used to plump up cheeks and lips. The U.S. Food & Drug Administration has not yet cleared it for below-the-waist therapies.

The treatment involved the injection of an off-label filler, hyaluronic acid, that is injected under the skin on the shaft of the penis. (Picutred: Adult film actor Boomer Banks)

The treatment involved the injection of an off-label filler, hyaluronic acid, that is injected under the skin on the shaft of the penis. (Picutred: Adult film actor Boomer Banks)

Dr. David Shafer, 50, a double board-certified plastic surgeon in New York City, and inventor of the SWAG procedure (Shafer Width and Girth) said that penis filler procedures make up 50 percent of all the work he now does

Dr. David Shafer, 50, a double board-certified plastic surgeon in New York City, and inventor of the SWAG procedure (Shafer Width and Girth) said that penis filler procedures make up 50 percent of all the work he now does

'It was a lot fuller, just thicker,' Kenny said. 'Like crazy thick, like six and a half inches around.'

After a few days of down time during which he was advised not to have intercourse, he immediately started getting rave reviews.

'Women's eyes were bugging out of their heads,' he said. 'I never got those reactions before. A couple of girls I dated were just like, "Wow".'

'It helped my confidence. I had this feeling like I couldn't go wrong,' he said, adding that the pump gave him an 'extra arsenal' in the bedroom.

Kenny (whose name has been changed to protect his anonymity) met his wife six years later but chose not to tell her about his procedure.

'I would have told her from the start but now it's been too long. I feel bad keeping a secret, but I'm not ashamed,' he said.

More and more men like Kenny are now discovering this growing cosmetic trend – and that's translating into big business for boutique clinics on the cutting edge of male enhancement.

Dr. David Shafer, 50, a double board-certified plastic surgeon in New York City, and inventor of the SWAG procedure (Shafer Width and Girth) said that filler procedures make up 50 percent of all the work he now does.

'When I first started doing it in 2017, I was maybe seeing one or two patients a week,' he said. 'Now we have four or five a day.'

New York nurse practitioner, Chris Bustamante, 32, said he treats so many men that he's lost track of how many patients he's seen.

Better known as 'InjectorChris' to his 21,000 Instagram followers, Bustamante said that since opening his medical spa 'Lushful Aesthetics' two years ago, revenues have more than doubled to $2.2 million.

Half of his business comes from patients seeking girth enhancement. But that's not all he offers.

The full menu of intimate procedures includes Botox injections to the penis or the scrotum to make the treated areas hang lower.

A 'P-Shot' delivers platelet-rich plasma via injection directly into the tissue to stimulate harder erections.

Better known as 'InjectorChris' to his 21,000 followers on Instagram, Bustamante said that since opening his medical spa, Lushful Aesthetics, two years ago, revenues have more than doubled to $2.2 million.

Better known as 'InjectorChris' to his 21,000 followers on Instagram, Bustamante said that since opening his medical spa, Lushful Aesthetics, two years ago, revenues have more than doubled to $2.2 million.

And 'Shockwave Therapy' – a non-invasive treatment that emits powerful acoustic pulses through the penis – amplifies blood flow and sexual performance.

But, by far, penis filler is the preferred procedure.

Bustamante estimates that half his clientele are gay men, with a noticeable number being in the adult entertainment industry.

Boomer Banks – a gay porn star – tweeted out his endorsement of Bustamante's handy work just last month, writing 'The bigger the better… Thanks to InjectorChris.'

Adult film star Ricky Roman was another satisfied customer. He tweeted last year: 'Loving the GIRTH'.

However, Bustamante said, the vast majority of his clients are ordinary guys.

'I see more of your Average Joes than I do porn stars,' he told DailyMail.com.

An appointment at Lushful Aesthetics usually lasts one hour. After a consultation, Bustamante injects his patient with nerve blockers, applies numbing cream for the pain and injects a dose of Trimax - a medication that induces an erection - to allow him to get a look at what he's working with.

'Having the patient "chubbed up" helps you as an artist to visualize the entire area,' he maintained. 'I find that a lot of the people who do this when the patient is completely flaccid end up with very awkward, weird results.'

The filler procedure involves the nurse guiding the syringe from side to side and using their thumb to rub out any unsightly lumps.

A typical penis filler treatment at Bustamante's clinic uses around 15 syringes of hyaluronic acid (a person having their lips plumped generally receives one syringe). That'll add at least a half-inch in circumference and set you back $10,500.

Injecting the filler only takes about ten minutes – and patients go home with their treated parts coated in Vaseline and wrapped gauze.

They can expect to be 'hyper swollen' for a few days and are instructed to avoid sex, hot tubs, pools, and saunas for 24 hours.

Bustamante also advises the newly enhanced to massage their penises for 15 minutes each day for two weeks. This helps with 'draining' the swelling to avoid the filler becoming dislodge and creating small irregularities.

In the event that a patient is unhappy with their results, 'Hylenex' injections can be used to dissolve the filler, though Bustamante claimed he's never had to do that.

Josh, a 35-year-old gay man living in New York City and working in Financial Technology Services, claims he was above-average size to begin with but wanted something with more 'shock factor.'

He's spent $18,000 for penis to be widened by a full inch.

Adult film star Ricky Roman was another satisfied customer. He tweeted, 'Loving the GIRTH'.

Adult film star Ricky Roman was another satisfied customer. He tweeted, 'Loving the GIRTH'.

'Partners have noticed the difference,' Josh bragged, but he says he appreciates 'the attention-grabbing aspect' of his new penis even more.

He took his enhancements a step further and shelled out for 15 syringes of hyaluronic acid to be injected into the subdermal layer of his scrotum as well.

Bustamante said 'ScroFill' is the 'best kept secret' for men who are looking to augment their overall package, as it makes everything look bigger under a pair of tiny shorts or speedos.

'ScroFill' only 'thickens' the skin, Bustamante explained. No filler goes inside the actual scrotum.

'I've had guys who start with 15 syringes in their scrotum and worked their way up to 45,' he said, 'It just looks like they have a huge ball sack.'

Josh told DailyMail.com that he plans to return to the clinic for a top-off before a beach vacation to Greece at the end of summer.

'When you're wearing swimsuits, you see it. It strikes the eye, it's like, "Oh hey!'''

Depending on individual metabolism and biochemistry, the treatments can last between 12 to 24 months – and are considered to be fairly safe.

A Chinese study in 2021 followed 230 penis filler patients and found that only 4 percent experienced mild complications such as subcutaneous bleeding, infection, tissue decay or unsightly bumps.

But that's not to say penile enhancement is completely without risk.

Going to an unlicensed clinic, Bustamante warned, is an obvious no-no.

In February 2020, a 32-year-old man in Germany died from septic shock after a restaurant worker posing as a doctor injected silicone oil, instead of hyaluronic acid, into his penis.

Bustamante also cautioned potential patients to be aware of feelings of body dysmorphia – a mental disorder characterized by an obsession over imaged physical imperfections.

He recalled declining to treat one patient who had a 'Frankenstein penis,' that was twisted and scarred from the overuse of penis pumps – devices that uses vacuum suction to stretch the penis.

Despite all this, Bustamante believes that the future of penile enhancement is bright and predicts that one day it'll be as common as female breast implant surgeries.

Kenny from Texas is not so sure.

Now, nearly a decade later, he admits the effects of his filler have faded.

'With the enlargement, you get one fun year,' he said. 'When my wife first saw it, she was like, "Oh my god, it's thick," and I was thinking to myself, "Well you should have seen it before!"'

Now, Kenny thinks the best money he ever spent was on his… hair transplants.

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Inside the Wild West of male genital enhancement: How 'average' guys are paying $20,000 for off-label fillers, Botox shots and 'shockwave' therapy... despite the terrifying risks