Although penile augmentation (PA) remains a subject of controversy, glans penis augmentation (GPA) has been applied in penile reconstructive surgery for selected patients with small glans size or aesthetic concerns. Since 2003, injectable hyaluronic acid (HA) gel has been widely used for GPA due to its favorable safety profile and reversibility. The popularity of HA fillers has spurred interest in alternative materials, including irreversible fillers designed to enhance longevity. However, these materials have introduced new challenges, including complications such as painful nodules, tissue fibrosis, and difficulties with removal. Indirect glans augmentation techniques, such as dermofat grafts or scaffold implantation between the corpus spongiosum and the distal corpus cavernosum, have also been employed to address limitations of HA—particularly volume longevity and surface irregularities. Yet, these approaches are associated with significant risks, including hard, painful masses and, in some cases, glans necrosis due to vascular compromise following blunt dissection. This chapter reviews the current status of GPA, focusing on the complications associated with both HA-based and alternative techniques. Additionally, we present selected complex cases referred to our center, providing insights into management strategies for these challenging situations.