Fat grafting to the penis has recently become popular in some parts of the country. Surgery is commonly performed in the office, where peer review is lacking or nonexistent. A single case is reported documenting a poor cosmetic and functional result after irregular resorption of grafted fat. The external appearance of the penis remained stable for months, even though later biopsy revealed all the grafted fat to be dead. Analogy with pseudolipoma of Glisson's capsule is provided, showing that dead fat cells can survive for years or even a lifetime without absorption by the body. Several complications are examined in this article, and other potential risks are also discussed. The operation, although technically easy to perform, has many serious potential side effects that should be understood.