Penile Relaxation Therapy in Chicago: XPand Flow
- Targeted neuromodulator
- Supports blood flow
- 15 to 30 minutes
- No surgery
XPand Flow™ uses botulinum toxin, the same neuromodulator used in medical and aesthetic applications for decades, injected into the smooth muscle of the penile shaft. The purpose is mechanical: relax the smooth muscle tissue so blood moves through it more efficiently. This is a function procedure, not a size procedure. It addresses how the tissue works, not how it looks. The treatment takes 15 to 30 minutes in our Chicago office with topical numbing and fine-gauge needles. Dr. Marc Adajar, a board-certified surgeon (FACS) with over 20 years of experience, performs every treatment. Results are temporary, typically lasting 3 to 4 months on a first treatment and extending with repeat sessions, which means you see what the treatment does before deciding whether to continue.
- Board-certified surgeon, 20+ years
- Specializes exclusively in men
- Patients' Choice Award, 9 consecutive years
- Topical numbing only, immediately reversible
What Does XPand Flow Actually Do?
XPand Flow relaxes smooth muscle in the penile shaft.
The penis contains smooth muscle tissue that plays a direct role in blood flow and engorgement. When that tissue is tense or contracted, blood flow is restricted. XPand Flow uses botulinum toxin to temporarily reduce that muscle tone. With the smooth muscle in a more relaxed state, blood can move through the tissue with less resistance. That is the core mechanism: reducing tension so the tissue functions more efficiently.
This is a function procedure, not an aesthetics procedure.
XPand Flow does not add size, volume, or girth. It works on the mechanics of how blood moves through penile tissue. If your primary goal is girth enhancement, XPand Girth™ (penile filler) is the right treatment. XPand Flow addresses what happens underneath, at the level of smooth muscle and blood flow.
The treatment takes 15 to 30 minutes.
You receive topical numbing cream and cooling before treatment. Dr. Adajar uses fine-gauge needles to place the neuromodulator into targeted smooth muscle structures. There are no incisions, no stitches, and no general anesthesia. Most patients describe minimal discomfort during the procedure.
Results are temporary, and that is intentional.
Botulinum toxin wears off as your body clears it. The effect of XPand Flow typically lasts 3 to 4 months on a first treatment. With repeat treatments, many patients report effects lasting 4 to 6 months or longer. That built-in timeline gives you full control. You see what the treatment does, decide if it fits your goals, and choose whether to maintain it.
How XPand Flow Works
XPand Flow works by targeting one specific tissue type. Here is the mechanism in direct terms.
The smooth muscle in the penile shaft is involuntary muscle tissue, meaning it contracts and relaxes on its own without conscious control. When this muscle tissue carries excess tension, it creates resistance to blood flow. That resistance can contribute to tighter flaccid hang, reduced engorgement, and less efficient vascular function in the area.
Botulinum toxin temporarily blocks the nerve signals that tell smooth muscle to contract. When those signals are reduced, the muscle relaxes. With the smooth muscle in a more relaxed state, the tissue allows blood to flow through with less resistance. The result is a mechanical improvement in how the tissue functions.
The injections are placed into specific smooth muscle structures based on your anatomy and goals. Nothing is cut, removed, or permanently altered. Because the change is muscular and temporary, the tissue returns to its baseline once the treatment wears off. That reversibility is a core feature of the treatment, not a limitation.
Off-label use: what that means and why it matters
Botulinum toxin is FDA-approved for several medical and aesthetic applications, including muscle spasticity, migraine, hyperhidrosis, and facial aesthetics. Its use in penile smooth muscle is off-label, meaning the FDA has not specifically approved it for this application. Off-label use is legal and common in medical practice when a licensed physician determines it is appropriate based on clinical evidence and the patient's individual needs. Many established medical treatments, across multiple specialties, are used off-label.
Dr. Adajar evaluates each patient individually and discusses off-label status openly during the consultation. You will know exactly what the treatment involves, what the evidence supports, and what the limitations are before you make any decision.
Is XPand Flow Safe?
XPand Flow uses botulinum toxin, a neuromodulator with a well-documented safety profile across decades of medical use. The treatment is performed in a controlled clinical setting by a board-certified surgeon, not a technician or general injector.
Dr. Marc Adajar, MD, FACS, performs every XPand Flow treatment at XPand MD™. He is a board-certified surgeon with over 20 years of experience who specializes exclusively in men. His practice covers the full scope of male body contouring, sexual wellness, and performance optimization, including surgical procedures, penile enhancement, and testosterone replacement therapy. He is board-certified by the American Board of Surgery, a Fellow of the American College of Surgeons (FACS), a member of the American Academy of Cosmetic Surgery, and holds additional certification in anti-aging medicine. He has also completed specialized training and certification in male genital enhancement techniques, including penile filler injection (XPand Girth), platelet-rich plasma therapy for penile rejuvenation (XPand Restore™), and scrotal neuromodulator therapy (XPand Smooth™). He has received the Patients' Choice Award for nine consecutive years.
Because the treatment is temporary, the tissue returns to its baseline as the neuromodulator clears your system. There is no permanent structural change. If you do not like the result, or if you decide the treatment is not for you, you simply do not repeat it. The effect wears off on its own.
Common, temporary side effects
- ·Mild swelling or tenderness at injection sites
- ·Minor bruising, typically resolving within a few days
- ·Temporary sensitivity changes in the treatment area
Less common side effects
- ·Uneven effect or localized muscle weakness (typically corrects as the treatment wears off)
- ·Allergic reaction to botulinum toxin (rare; patients with known sensitivity are not candidates)
Serious complications are rare when the procedure is performed by a qualified, experienced provider in a medical setting. The key risk factor is not the substance itself, it is the skill and training of the provider. Precise placement into the correct tissue layer requires knowledge of penile vascular and muscular anatomy that most general injectors do not have. No procedure is risk-free. A confidential consultation with Dr. Adajar covers your specific situation, including off-label status, before you commit to anything.
Individual results may vary.
What Happens During the Procedure?
The entire process takes about 15 to 30 minutes in the office. There is no general anesthesia, no operating room, and no overnight stay. Here is what to expect, step by step.
Step 1: Consultation and planning
Dr. Adajar reviews your goals, examines the treatment area, and maps the injection sites based on your anatomy. This is where you confirm the plan and ask any remaining questions.
Step 2: Topical numbing and cooling
A medical-grade numbing cream is applied to the treatment area, along with cooling to further reduce sensation. You stay awake and alert the entire time.
Step 3: Injection
Dr. Adajar uses fine-gauge needles to inject the neuromodulator into targeted smooth muscle structures in the penile shaft. Injection sites depend on your anatomy and goals. The injections are precise, controlled, and take only a few minutes.
Step 4: You leave
There are no stitches, no bandages, and nothing to manage post-treatment. You walk out of the office the same way you walked in.
Pain level
Pain is the most common concern men raise before booking. The combination of topical numbing cream, cooling, and fine-gauge needles keeps discomfort minimal. Most patients report the sensation as mild pressure or a brief pinch. On a 1 to 10 scale, the majority rate the discomfort between a 1 and a 3.
Recovery
Most patients return to normal daily activity the same day. Avoid sexual activity for 48 hours. Avoid hot tubs, saunas, and steam rooms for 48 hours. Resume exercise within 24 to 48 hours based on comfort. Dr. Adajar provides specific recovery instructions at your appointment.
The procedure is performed at the River North office in Chicago. You arrive, numb, treat, and leave, typically within 45 minutes including prep and numbing time.
Individual results may vary.
Who Is a Good Candidate for XPand Flow?
Most men who are considering XPand Flow share a common concern: something about how the tissue functions is not where they want it to be. That can show up in several ways, and this treatment is designed for men experiencing one or more of the following.
Good candidates share a few things in common:
Reduced flaccid hang or frequent retraction. If the penile shaft regularly pulls tight or sits shorter than expected at rest, smooth muscle tension may be a contributing factor. XPand Flow relaxes that tension.
Interest in supporting blood flow and function. Some men notice that blood flow feels restricted or that engorgement is not as full as it once was. XPand Flow addresses the mechanical component of blood flow through smooth muscle relaxation, though it is not a standalone treatment for erectile dysfunction.
Non-surgical preference. If you want to address function without surgery, implants, or daily medication, XPand Flow offers a temporary, in-office option.
Complement to other XPand treatments. Men who are already pursuing XPand Girth (penile filler) or XPand Restore (PRP) often add XPand Flow to address the functional side alongside aesthetics or regeneration.
Stable overall health. No active infections in the treatment area and no uncontrolled medical conditions.
Who is NOT a good candidate:
Men with an active infection in or near the treatment area
Men with a known sensitivity or allergy to botulinum toxin
Men seeking a permanent solution (this treatment is temporary by design)
Men whose primary goal is girth or size (XPand Girth is the right fit for that)
If you are uncertain whether XPand Flow fits your situation, that is what the consultation is for. Dr. Adajar evaluates your anatomy, discusses your goals, and tells you directly whether this treatment makes sense for you. There is no obligation and no pressure to schedule the same day.
What Results Can You Expect?
XPand Flow is a function procedure. The results are about how the tissue works, not how it measures. Set your expectations around mechanics, not size.
Improved flaccid hang. When the smooth muscle relaxes, the penis hangs more naturally at rest instead of pulling tight or retracting. This is a side benefit of the muscle relaxation, not the primary clinical mechanism, but it is the most immediately visible change most patients notice.
Supported blood flow. With reduced smooth muscle tension, blood moves through the tissue with less resistance. Some men notice improved engorgement and firmness. Results vary, and XPand Flow is not a standalone treatment for erectile dysfunction.
This is NOT a size procedure. XPand Flow does not make the penis bigger permanently. It does not add girth or length. If girth enhancement is your goal, XPand Girth (penile filler) is the appropriate treatment.
May support erectile function. Some men report improved firmness and engorgement after XPand Flow. This effect is adjunctive, meaning it works alongside your existing physiology and any other treatments you may be using. It is not a replacement for ED medication or a guaranteed solution for erectile dysfunction.
May reduce premature ejaculation symptoms. Some men notice reduced hypersensitivity and less muscle tension after treatment, which may help with premature ejaculation. This is a reported benefit, not a guaranteed one, and results vary by individual.
Onset timeline
- ·Initial changes: 3 to 5 days after treatment
- ·Full effect: approximately 2 weeks
Duration of results
- ·First treatment: 3 to 4 months
- ·Repeat treatments: 4 to 6 months or longer (many patients find results extend with maintenance sessions)
Maintenance. Most patients who choose to continue schedule repeat treatments every 3 to 6 months. Each session is the same quick, in-office procedure. There is no cumulative downtime.
Why we do not show before and after photos
Given the sensitivity of this procedure, patients do not want their photos published. We respect that completely. Results are discussed in terms of functional improvement and patient-reported outcomes, not visual comparisons.
The results were exactly what was discussed during my consultation. Natural look, natural feel. My partner noticed the difference immediately.
I researched this for over a year before pulling the trigger. Glad I did it. The whole process was straightforward and private.
Individual results may vary based on anatomy, baseline function, and how your body responds to the treatment. Dr. Adajar discusses expected outcomes based on your specific situation during your consultation.
How Much Does XPand Flow Cost?
Pricing for XPand Flow is discussed at your consultation. The cost depends on the dose required, your specific goals, and whether XPand Flow is combined with other XPand procedures in the same visit.
We discuss pricing at the consultation rather than publishing a fixed number because the dose varies based on individual anatomy and treatment goals. Dr. Adajar determines the right approach for your situation after evaluating you in person.
What the cost covers. Your fee includes the neuromodulator, topical numbing, the injection procedure, and your follow-up. There are no hidden facility fees or anesthesia charges. You are awake the entire time in a private treatment room.
Financing options
If paying upfront does not fit your budget, three financing plans are available:
CareCredit
Medical financing with promotional interest-free periods
Cherry
Flexible monthly payment plans
Alphaeon Credit
Healthcare credit line with multiple term options
All three offer applications you can complete before your consultation so you know your approval amount in advance.
Combination pricing. Many patients combine XPand Flow with XPand Restore (PRP) or XPand Smooth (Scrotox) in the same visit. When procedures are combined, Dr. Adajar discusses bundled pricing options. The XPand Performance Collection™ (Flow + Smooth + Restore) is available as a package for men who want to address function, comfort, and tissue health together.
Your consultation includes a complete cost breakdown with no hidden fees. You will know the total before you commit to anything.
- Board-certified, American Board of Surgery
- Fellow, American College of Surgeons (FACS)
- American Academy of Cosmetic Surgery
- 20+ years in practice
- Patients' Choice Award x9
Why Choose Dr. Adajar and XPand MD?
Dr. Marc Adajar, MD, FACS, is a board-certified surgeon who specializes exclusively in men. Every surgery he performs, every treatment he administers, and every optimization protocol he designs is for male patients. His practice spans male body contouring, sexual wellness, and total-body performance optimization through testosterone replacement therapy. He is board-certified by the American Board of Surgery, a Fellow of the American College of Surgeons (FACS), a member of the American Academy of Cosmetic Surgery, and holds additional certifications in anti-aging medicine and male genital enhancement procedures, including penile filler injection (XPand Girth), platelet-rich plasma penile rejuvenation (XPand Restore), scrotal neuromodulator therapy (XPand Smooth), and penile relaxation therapy (XPand Flow). He has been in practice for over 20 years and has received the Patients' Choice Award nine consecutive years.
Those credentials matter because this procedure requires precise placement of a neuromodulator into smooth muscle tissue with complex vascular anatomy. In untrained hands, inaccurate injection depth or placement can lead to uneven results or unintended effects. A surgeon who specializes in male anatomy and has trained specifically in these techniques can target the correct tissue structures reliably.
It also matters for a treatment whose results vary. A surgeon who tells you honestly what penile relaxation therapy can and cannot do is worth more than a clinic that promises an outcome the science does not support.
One surgeon, not a rotation. Dr. Adajar performs every XPand Flow procedure himself. You will not be handed off to a physician assistant or nurse injector. The same hands that evaluate your anatomy in the consultation are the ones performing your treatment.
Built exclusively for men. XPand MD is not a general aesthetics clinic that added penile relaxation therapy to a menu of facials and lip injections. Dr. Adajar treats only male patients. The entire XPand system is designed around male physiology:
- ·XPand Girth: penile filler for girth enhancement
- ·XPand Flow: neuromodulator for smooth muscle relaxation and blood flow support (this page)
- ·XPand Restore: platelet-rich plasma therapy for sensitivity and tissue health
- ·XPand Smooth: Scrotox for scrotal comfort and aesthetics
- ·XPand Optimize: testosterone replacement therapy and hormone optimization
Having all five services under one surgeon means your treatment plan accounts for the full picture, not just one piece of it. If your consultation reveals that blood flow support would work even better paired with PRP therapy, Dr. Adajar can address both instead of sending you to a separate provider.
Discretion is built into the process. The clinic is located on the second floor of a River North medical building. There is no signage that identifies the procedure. Check-in, treatment, and checkout happen in a private suite. Dr. Adajar performs the procedure himself, with no other staff in the treatment room.
The XPand Protocol: Flow Is One Piece of the Full Picture
You came here for blood flow and function. XPand Flow is the treatment that addresses it. But Dr. Adajar treats the full picture, and most men who come in for one treatment discover there is more available to them than they realized.
The XPand Protocol™ is not a sequential program. It is a modular set of treatments, each targeting a different aspect of male function, performance, and physical results. You choose what fits your goals. Some patients do one treatment. Others combine two or three. Dr. Adajar performs all of them, so your treatment plan does not get split across multiple providers.
XPand Girth
Penile filler that adds measurable girth using FDA-approved hyaluronic acid. Non-surgical, in-office, immediately reversible. XPand Flow supports blood flow mechanics, and XPand Girth addresses the structural side.
XPand Restore
Platelet-rich plasma therapy for penile rejuvenation. It uses your own plasma to support tissue health, sensitivity, and erectile function. Pairs well with XPand Flow for a regenerative plus relaxation combination. Cost is $1,800.
XPand Smooth
A neuromodulator applied to the scrotal tissue for a relaxed, smoother appearance and reduced discomfort and sweating. Part of the XPand Performance Collection alongside Flow and Restore. Cost is $1,800.
XPand Optimize
Testosterone replacement therapy and full hormone optimization. It addresses total-body performance, energy, libido, and body composition from the inside out.
If you want to address function, comfort, and tissue health together, XPand Flow, XPand Restore, and XPand Smooth are available as the XPand Performance Collection, a bundled package. This combination is designed for men who want comprehensive, non-surgical support across multiple dimensions rather than targeting one area alone.
Your consultation is the right time to ask about any of these. Dr. Adajar reviews your goals and health picture and tells you directly which treatments, if any, make sense to combine with XPand Flow. Book a confidential consultation.
Frequently Asked Questions
Take the Next Step
Your consultation covers everything you need to make a decision. Dr. Adajar reviews your anatomy, discusses your goals, evaluates candidacy, explains the off-label status, and walks through pricing and financing options. You ask questions. He gives you direct answers. No pressure, no follow-up calls.
You have done the research. Now talk to a board-certified surgeon who specializes in this.
XPand MD · River North, Chicago310 W Superior St, Floor 2, Ste 201, Chicago, IL 60654The information on this page is for educational purposes only and does not replace a medical consultation. Individual results vary based on anatomy, goals, and treatment plan. Consult with Dr. Adajar to determine if this procedure is right for you. All procedures are performed by Dr. Marc A. Adajar, MD, FACS, a board-certified surgeon. Botulinum toxin use in penile smooth muscle is off-label. Off-label use is legal and common in medical practice when determined appropriate by a licensed physician. Last medically reviewed: May 2026.