What penis enlargement treatments exist?
Treatments aimed at increasing penile length or girth can be divided into two groups: non-surgical and surgical treatments.
- Surgical treatments.
- Non-surgical treatment:
From ancient times, men have tried a wide variety of treatments to enlarge the penis. Because of the sensitive nature of the problem, and because of the surrounding shame and embarrassment, concerned men are very vulnerable to exploitation by the unscrupulous. While most doctors and other health-care professionals act in a highly ethical manner, a few individuals will sell remedies and even perform surgery that they know has no evidence of long-term benefit. Some of them have been barred from practice as a consequence of their unethical behaviour. Others are still in practice, waiting to exploit the unsuspecting by relying on the fact that they are likely to be too embarrassed to complain to the authorities about an unsatisfactory outcome. A glance though the small ads in men’s magazines will reveal the following “treatments” on offer:
- Vacuum “developers” or pumps.
- Weights that attach to the penis to stretch it.
- Magnetic or electrical devices to stimulate penis growth.
- “Hormone” therapy, sometimes containing testosterone or related sex hormones (steroids).
- Remedies that contain assorted herbs from around the world.
Good-quality research evidence has not been published showing that any of these treatments produce a sustained increase in penis size. Vacuum devices and weights may produce very small, short-term increases in size, simply because the penis is elastic and can be stretched. However, like an elastic band, it snaps back with time.
More worrying are private clinics that advertise penile augmentation (enlargement) procedures, and make extravagant and misleading claims about their results. Surgery can be of benefit to some men, but certainly not all of them. Current cosmetic surgical procedures are largely unproven by research, unreliable in their benefits, and may carry the risk of serious complications. Urologists generally consider this type of surgery to be still experimental in nature and not a standard procedure
How is the penile enlargement surgery done?
Penile lengthening: The most common technique to lengthen the penis is to cut its suspensory ligament then perform plastic surgery to provide additional skin to cover its new length.
The results are difficult to judge, as surgeons have not collected data in a systematic manner. The results of the only reliable study indicate that dividing the suspensory ligament alone results in an average increase of 0.5 cm (around ¼ “) in length, while skin advancement increases the length gain to 1.6cm (around ¾ “). These figures do not compare well with the claims made by some clinics. Some people undoubtedly do better than average, and others undoubtedly do worse.
The suspensory ligament does have a role, in that it helps keep the penis pointing upwards during erection. After it has been divided, that support is no longer present. After surgery, some men find that they have gained a small increase in flaccid length, but the erect penis is about the same size and now points towards the floor!
Increasing penile girth (thickness): This treatment may be performed with a lengthening procedure or on its own. There are two techniques in common use:
- Injection of liposuctioned fat, from the abdominal wall or thighs, into the dartos fascia, under the skin of the penile shaft.
- Placing grafts of dermis (a layer of tissue from under the skin surface that is well supplied with blood vessels) and fat from the groin or buttock area within the penile shaft.
The results following injection of liposuctioned fat can be deeply disappointing. Up to 90% of the fat can disappear within a year. Grafts seem to do rather better, but there is no reliable published data on long-term results.
What are the complication following penile enlargement surgery?
At least one person has died from bleeding after augmentation surgery. Apart from the risks of infection and bleeding, specific complications exist for each procedure. Some include:
- Scrotalisation of the penis, in which the penis appears to arise from the scrotum instead of the abdominal wall.
- “Dog-ears” at each end of the operation scar.
- Sloughing of the skin used to increase penile length (the skin has a poor blood supply and therefore dies, leaving a deep, ulcerated area).
- Girth-increasing procedures:
- Loss of girth due to fat reabsorption.
- Nodule formation, if the implanted fat does not disappear uniformly. The penis can be left with a deformed appearance, with irregular fatty lumps all over it.
Why would a man consider penile enlargement surgery?
Almost all men experience anxiety about the size or appearance of their penis at some time. For most men, these feelings will pass but, for others, they can be persistent and disabling. A man’s concern about his penis can lead to avoidance of sexual relationships, and even of sporting and other activities where other men might see him naked. Such men are not only embarrassed by the apparent smallness of their penis, but frequently also feel ashamed and silly about their anxiety, too. This article includes information about the size of a so-called normal penis, about the abnormally small penis, and about treatment.
Men that are dissatisfied with the appearance of their penis should think very carefully before requesting cosmetic surgery, especially if the size falls within the normal range. A better option may be to seek the advice of a sexual and relationship therapist, who might be able to offer help and advice. Using surgery to treat a psychological problem is fraught with risks. If surgery is the only way in which a man can regain his self-esteem and improve his self-image, they should seek advice from an experienced surgeon working in a reputable clinic. Men should ask very carefully about the procedures that are offered, the surgeon’s results and any possible complications. They would also be wise to ask another trusted medical adviser for their view.
Men generally fall into two groups regarding their penis size and appearance. Some men have a short, fat, rather elastic penis when flaccid that stretches and expands very considerably during erection. Others have a long, impressive-looking flaccid penis that barely changes in size when erect, and simply becomes more rigid. Men in the first group who see men from the second group naked in the showers incorrectly think that they have an abnormally small penis. Both are normal, just different.
Obesity and very thick growth of pubic hair may make the penis appear smaller. Obese men develop a pad of fat in the pubic area and the flaccid penis becomes buried in it. Weight reduction will improve appearance, as will neatly trimming excessive pubic hair. Very obese men might not be able to see their penis at all, because of their large and pendulous abdomen.
Men should also remember that their penis will always look shorter when they look down at it, compared with looking straight at their penis in a mirror or across the changing room at another man’s penis. This is a simple optical illusion.