Penile girth augmentation is a domain of extensive controversy and debate. A variety of methods is available for the choice of the surgeon including dermal-fat grafts and flaps. The need for a simple procedure with minimal donor site has lead to proposing injection therapy for penile augmentation, whether by fat or synthetic materials. This work reports on a male patient suffering a deforming subcutaneous mass in the penis following penile girth augmentation by injection therapy using synthetic material, and describes its management, and pathologic analysis of the extracted tissue. The mass was excised through a circumferential subcoronal incision while maintaining skin vascularity and integrity of the corpora. The excised tissue was microscopically examined. Cosmetic and functional results of surgical correction. Cosmetic and functional outcome were acceptable. Pathology examination revealed features of foreign body granuloma. Injection of fillers for girth augmentation of the penile shaft may result in delayed complications including migration, granulomatous reaction, and resorption that may occur beyond the follow-up span of the currently available study that recommends its use.