Male Insecurity Over Penis Size Is a Booming Business

Bill Moore is what you might call a televangelist for big dicks.At AdvancedYou, an anti-aging aesthetic clinic specializing in “biohacking and wellness treatments” that he runs out of a Dallas strip mall, Moore offers men a unique form of personal salvation through PhalloFill. It’s a penis enlargement procedure that, while not able to add inches in length, involves injecting hydrocyanic acid dermal filler for increased girth.In Daniel Lombroso’s new documentary Manhood, in theaters this week, the director tracks this desperate quest for sexual adequacy among men who find themselves struggling with self-worth and the crisis of modern masculinity.As headlines about the male loneliness epidemic were making the rounds a few years ago, which Lombroso felt were “sort of thin and maybe navel-gazy,” he decided he wanted to tell a more “propulsive story” about what was going on with men in America. Around that time, he also started hearing more about penile enhancement and began talking to some of the practitioners offering it as well as the men getting it, including Moore, who invited him to Texas.Moore fancies himself something of a cosmetic revolutionary. He was among the first wellness professionals in Dallas to use platelet-rich-plasma for hair replacement. In Manhood, his goals remain unwavering: to make his patented penis enlargement technique as commonplace as Botox.You could say Lombroso, a former editorial producer for The Atlantic and The New Yorker, has a metaphorical hard-on for subcultural deep dives. His first documentary, White Noise, followed white-nationalist groups for three years from Donald Trump’s 2016 win until the end of his first term.With Manhood, Lombroso wanted to understand what was driving men to get on the operating table. During visits to Moore’s clinic, he met men with unique stories: a megachurch pastor; border patrol agents; a man suffering from brain cancer. David, a 24-year-old gay OnlyFans star shunned by his religious mother, who visits AdvancedYou following a botched procedure, and Ruben, an out-of-work father of five who moonlights as a stand-up comedian and listens to the Joe Rogan podcast, are cast as the central figures in the film, along with Moore.“I was just like, this is fucking crazy that these guys are really eager to tell Bill, and were really eager to tell me, what was going on in their life,” Lombroso says. To his surprise, an overwhelming majority—he estimates around 75 percent—of the men undergoing the procedure were straight. “People for some reason make the assumption that it wouldn't be that division, but it's mostly straight men,” whom he notes were “conservative-leaning.”Lombroso is careful not to reduce the men seeking penis enlargement to one type but says they all carried a similar trait: “this deep feeling of shame and social isolation.”Penis size is an unusually intimate subject shaped by cultural ideas about masculinity and self-worth—though not everyone buys into the belief that the size of your penis determines your well-being. In one scene, Ruben talks with a bar patron about the documentary before his stand-up set, explaining that the film is about “mental health” and “normalizing” the procedure, only for the man to respond with gleeful skepticism. “Having a small dick makes you crazy?” he wonders jokingly.“There’s a limit to what a scalpel and a syringe can provide,” Alex Tatem, a prosthetic urology specialist, says in the film. “I can fill your penis with filler, but I cannot fill the hole in your heart.”There is a pressure on men to constantly improve, and Manhood suggests that perhaps Moore, despite his seemingly genuine intentions, has exploited that need. His “girth enhancement” procedure, which costs between $2,500 and $4,000 per visit, basically runs like a subscription model where he encourages men to visit three, four, even five times. The catch is that if they want to maintain their desired girth, they have to visit once a year for the rest of their life.Several subjects in Manhood take injections to increase their girth. Courtesy of Outerboro Films“You would think that this technique would have stayed in the hands of urologists, but now this is something that is in the hands of corporate marauders,” Paul Perito, a board-certified urologist explains in the film. PhalloFill has expanded to 32 clinics across the US.More men are pushing their bodies to the limit for validation in ways they never did before. They have outpaced women as the fastest-growing demographic for plastic surgery in the US and are undergoing cosmetic procedures at a higher rate compared to years prior to 2020, according to the International Society of Aesthetic Plastic Surgery. Among Gen Z and millennials, nonsurgical cosmetic treatments—everything from skin resurfacing to body sculpting—are growing more widespread.Nowhere is this trend more pronounced than in the looksmaxxing movement, popular in manosphere and incel circles, where young men are encouraged to undergo extreme physical modifications in order to be more sexually desirable. One 21-year-old looksmaxxing YouTuber I interviewed last year likened the trend to a “looks inflation.”“It is ridiculous how much it’s meant to be a sign of strength,” one client says, lying on the operating table as Moore pokes tiny needles into the shaft of his penis. “There are even allegations of, like, ‘Oh, a terrorist must have a small dick’ … And you’re a guy, so you’re just gonna take it.”Morag Yule, president of the Society for Sex Therapy, puts it another way. “Insecurity is big business, and there is money to be made” off people who will “do almost anything to feel better about themselves.”While Lombroso never paints Moore purely as a villain or savior, it is evident that PhalloFill is part of the larger wellness industry exploiting male insecurities. A 2026 study by researchers from the digital safety organization Reset Tech argued that the manosphere operates more like a pyramid scheme, preying on the vulnerabilities of men like Ruben, who, in the end, ends up pouring so much money into injections that he and his wife are forced to move out of their house and relocate to Phoenix with his “first baby momma.” “We weren’t making enough money to afford everything,” Ruben says.What ultimately emerges in Manhood is a darker truth about exploitation and profit motives in the medical industry. Doctors and practitioners are recast as cash-thirsty business sharks. “When they see money, that excites them,” Lombroso says. “I think that’s a really unfortunate thing that we don’t talk enough about. A lot of the people in the movie are trained urologists who could be doing penile reconstructions or helping men with [erectile dysfunction]. Instead, they see a quick way to make a buck putting lip filler in people’s dicks.”