Question: I hate the idea of scalpels you-know-where, but I wouldn't mind more bulk in my briefs. What's the lowdown on penis enlargement?
Answer: Given his druthers, the average guy would prefer a penis different from the one he's got: longer, bigger around, straighter, even smaller--you name it. There is no more sensitive subject.
Unfortunately, we don't really know what qualifies as "small" or "big." Only Kinsey's 1948 study looked at an ample number of men (3,500) and used thorough statistical methods. That work found an average penis length of 3.89 inches flaccid and 6.21 inches erect. Average circumference was 3.75 inches flaccid and 4.85 inches erect
What is too small? I could offer a statistical definition based on the above numbers, but I doubt that it would sway anyone. Basically, too small is whatever a man thinks is too small. After all, we're not talking function here. Size has nothing to do with satisfying a partner or producing offspring. At one of the most prolific surgical practices for penile augmentation, four out of five patients choose surgery because of "self-image." This probably has more to do with the locker room than the bedroom.
I won't try to talk you out of wanting a different penis. Instead, I'll tell you about the various methods that attempt to deliver one.
STRETCHING THE TRUTH
The penis is not a muscle; you cannot build it up through exercise. But it certainly can be stretched. The problem is keeping it stretched.
One method of stretching is the vacuum pump. By placing the penis inside a cylinder and sealing it against the abdomen, pressure can be reduced around the penis, helping it to inflate with blood. A constriction ring applied to the base of the penis keeps the blood in once the pump is removed. Constriction rings, a.k.a. cock rings, should be left in place no longer than 30 minutes. After that, you risk damaging delicate tissue, which could lead to permanent damage.
Over the decades, hundreds of my patients have used vacuum pumps to achieve erections. When used appropriately, they are safe and effective, so much so that the FDA approved them--for treating erectile dysfunction, that is, not for growing bigger penises. Pumps may make the penis somewhat larger than it normally would be when erect, but the effect is temporary. (For more on penis pumps, see Health Update, July 2001.)
Likewise, there are myriad sites on the Internet that would like to sell you programs by which you can stretch your penis. From having you tug on it with your hands to applying contraptions, they all claim to somehow permanently elongate or increase in volume the tissues of the penis. None of them has been proved to work long-term.
For the most part, there's probably not much harm--other than to your wallet--in such machinations. I do worry, though, about aggressive manipulation of the penis. On the whole, it's a pretty durable organ, but it can be damaged. Fractures are possible when erect, and it's possible that abuse could lead to the scar tissue that causes Peyronie's disease, a painful condition marked by severe curvature of the penis.
Surgical penile augmentation has a long, checkered history. The first recorded operation was in 1893. Over the intervening century, the techniques have become more sophisticated, but they can still be broken down into two basic approaches.
To make the penis "longer," a surgeon severs or moves the suspensory ligament, which holds the penis to the pubic bone. I put "longer" in quotes because this doesn't actually lengthen the penis; it just allows some of the portion inside the abdomen to be moved out and skin to be grafted in place. But I suppose seeing more penis is, in effect, having more.
I have read claims of 1 1/2 inches of lengthening from this procedure, although results dearly vary depending on both the individual and the surgeon. Some men see no lengthening at all. It's also important to understand that the lengthening is almost entirely when flaccid; when erect, the difference will amount to less than half an inch. Also, when the suspensory ligament is severed and not reattached, the angle of erection will be considerably lower than before.
To add girth to the penis, the surgeon extracts fat from the groin area and adds it to the penis in one of two ways. The fat may simply be aspirated with a syringe and injected into the penis, or a layer of skin and the fat below it may be removed from the groin area and attached in place of the normal skin of the penis.
Injection is easy, but not very effective. Most of the fat cells don't survive, and the layer drops to a fraction of its initial thickness over a few months. A lumpy appearance and scar tissue may also result.
Grafting may result in a more aesthetically pleasing effect when done by a skilled surgeon, but it's difficult to maintain normal sensation. It's also considerably more involved--which brings up the point that none of these surgeries is trivial. A urologist and a cosmetic surgeon may both be required in order to produce a result without ugly scars. Expect to pay $3,000 to $8,000--depending on how extensive the work is and what the market will bear--for their services and perhaps another $4,000 in other charges. And infection is always a risk.
