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Penile Enlargement: Illusion or Fact

Everyday single day come-on ads offering a bigger penis are plastered in magazines and web pages all over the internet. Drugs, herbs, spices and pills are advertised which can increase the penis size all claiming to be the magic panacea to a man’s troubles. And the sad fact is that many men fall prey to such ads because they all believe that they have a smaller penis and secondly that some pill can make the penis bigger. And for those still in search for Nirvana, there is surgery to enlarge the penis. Beneath this perception of an inadequate penile length, a number of men may benefit from psychological counseling.

Hospital estimates reveal that at least a quarter of a million men have some type of penile enlargement procedure each year. The surgery for penile enlargement is based on two principles: the first step is to increase the length by making an incision at the base of the penis and excising the ligament that normally anchors the penis to the pubic bone. The procedure alone allows for extension of the penis by 2-4 cms.

The second part of the surgery involves widening of the penis to increase the girth. This part of the procedure requires the addition of a “filler” under the kin of the penis. The filler can increase the girth by 20-30%.

The Small Phallus

Men in general have little clue as to what a normal sized penis is. The majority of men feel that they have a small penis and this feeling is not helped by the explosion of pornography on the internet and TV. Even males with large penis start to feel sexually inferior after viewing all the pornography.

Throughout history, size of the penis has been a major preoccupation with men. Feelings about small penile size has led many men to lose confidence, develop anxiety and become socially withdrawn. Most men believe that penis size is important for a men’s ego and identity, and this is the only thing that sexually satisfies a woman. Like all things American, bigger is better is a deeply embedded myth.

Today, most studies indicate that across all ethnic groups, the average size of the flaccid penis is 3-4 inches in length and when erect the average size is 5-6 inches. Despite most women claiming that penile size is not important, men still remain preoccupied with the size of the phallus. Ask any men and all would love to have a longer penis.

Bigger Penis

There is a multi millionaire dollar market advertising ways to enlarge the penis. Every day, a new drug, herb or pill is discovered to enlarge the penis- all of this is based on no scientific data. Despite this, men flock by the thousands in search for this penile “Shangri la”. The pills offer an illusive glorious sex life, with women screaming for more and more sex. Every non-surgical method of penile enlargement claim that the pills are safe, effective, cheap and will even enlarge the penis at night by several inches. Despite 3 decades and millions of pills sold for penile enlargement, not a single individual has even a 1mm extension to his organ.

History of penile enlargement surgery

The idea of penis enlargement is not novel. Almost every culture has had a preoccupation with a small penis and made attempts to increase the size. Some cultures have used traction on the penis, others have inserted pins and needles in the penis and yet others have used weights tied to a string to enlarge the penis and some courageous Incas have even let snakes bite their penis- albeit none of them was successful in enlarging the penis but all led to severely deformed penis.

However, our North American forefathers were not amused by these techniques of penile enlargement and North Americans had to wait until the 1980s for surgical techniques to be developed. The pioneering surgery on the penis was first done in China but it is the Americans who wanted to have the biggest and the best, and so it is here that penile enlargement techniques have flourished. Despite the fact that penile enlargement techniques are still in infancy and not recognized by the various Surgical Boards, the market for this surgery is immense. No set rules, standards or quality control measures exist for this surgery, even today.

Despite the surgery having being done for about 2 decades, the procedure is still considered experimental and risky. Complications are still widely common, and difficult to predict. Like the beginnings of any new surgical procedure, penile enlargement is still in its infancy and fraught with unchartered territory. The procedure is still only done by a few surgeons and the procedure remains unrecognized by the Surgical Organizations.

Psychological counseling

Many in the medical community strongly believe that men, who are dissatisfied with their penis size, should think very carefully before subjecting themselves to surgery which is experimental and high risk, especially when the penis is normal to begin with. A psychological referral may be appropriate to reassure the men that they are normal and do not require cosmetic surgery to satisfy their partner.

Unfortunately, the majority of men never opt for this therapy because their logical sense of thinking is lost. It is the responsibility of every professional involved in sexual medicine to provide balanced and well-supported advice on these issues.

Surgery for penile elongation

Penile elongation is done in several ways. In obese individuals, the penis is always hidden by the enlarged pubic mound. In such cases, the surgeon removes the fat by liposuction and this makes the penis appear longer. Another method is to cut the suspensory ligaments which hold the penis at the base of the pubis. These two techniques give the illusion that the penis has elongated by several cms.

Another related procedure for penile elongation is the advancement of an infrapubic skin flap onto the penis. The rationale for this technique is to protrude the external portion of the penis via a skin flap.

Girth enlargement

Penile width enlargement is a controversial procedure with no medical indications for it. Penile width is usually increased by injection of various substances just below the penile skin. Fat, collagen or silicone have all been injected into the penis to increase the girth. This is not without complications and the procedure can cause deformation, distortion and an uneven penis.


Like any surgery, there is always the potential for complications. Besides the risk of complications from anesthesia, the penis will appear swollen, there is moderate pain, bruising of the skin is common, infection is possible, there may be altered sensation and the ability to have an erection will be lost for a few weeks.

Unfortunately no reliable data are available regarding the criteria for success or complication rates of these techniques. A few reports indicate that release of the suspensory ligament can decrease the angle of elevation of the erect penis. Paradoxical penile shortening can also occur, as a result of spontaneous reattachment of the ligament to the pubis bone. Skin advancement can cause severe deformities, including unnatural hair growth proximal to the penile stump. Utilizing a large flap can impair blood supply, leading to poor wound healing, possible dehiscence, and in some cases hypertrophic scarring.

Penile enlargement, even in the best of hands, has a number of healing related complications. In some cases, the deformity of the penis is so severe that sexual function is impaired. In such cases, an artificial penile prosthesis may be needed to be inserted at the time of such surgery. A number of individuals require repeat surgery for one of these problems- and the results of the second surgery are even less predictable than the first surgery

Post surgery

After surgery, it is recommended that you wear jockey shorts and keep the area clean and dry. The penile area is usually bruised and tender for about 2-3 weeks. Sutures are generally removed at the first post surgery visit which is about 7-10 days. Manual stretching at one week and a weight program is highly recommended. Various light traction devices are available and used for 2-3 weeks. Some patients go over board and place traction for 3- 6 months to further lengthen the penis. Masturbation and sexual intercourse is avoided for 4-8 weeks. No sports is recommended during this time


The surgery is by no means cheap and can cost anywhere from 6-10,000$. As with all cosmetic surgery, one should never forget that the penile enlargement is strictly cosmetic. Penile widening is always more expensive when the girth is widen with fillers. The procedure is done on an outpatient basis and done under general anesthesia. The procedure takes about 2-3 hours


Plastic surgery for the penis is here to stay and men will continually seek surgeons to increase the length and width of their penis. The majority of these men, they have a distorted body image perception of their genitalia. These men would be best served by psychological counseling before undertaking surgery. In an environment where medicine and money go hand in hand, the surgeon is not the appropriate person to seek advice on the reasons for surgery.

Penile enlargement is not a simple undertaking and is an elective cosmetic procedure. If you choose to obtain surgical penis enlargement, be sure to check the credentials of your surgeon (e.g., board certification) and carefully weigh the risks and potential benefits. The surgery is expensive and the results unpredictable. Today the procedure is done by the urologist, plastic surgeons and some other cosmetic surgeons. One has to have realistic expectations about the results.

Like any cosmetic procedure there is a band wagon of individuals performing it and there is a lot of money involved. So in the final analysis, ask and be informed not only about the surgeon but also the results and possible complications. If still in doubt, a visit to the psychiatrist as to why one wants a cosmetic procedure may not only be cheaper but safer in the long run.