WebMD Health - Healthy Men

Dec 16, 2009 6:20 PM

Penis Enlargement: Does It Work?

Don't deny it. Ever since you first saw those penis enlargement ads in the back pages of a porn magazine years ago the pictures of sinister-looking devices, the big letters screaming "Add Inches to Your Penis!" you've always wondered: Could I be bigger?

"Guys ask me about it all the time," says Michael O'Leary, MD, a urologist at Harvard Medical School and Brigham and Women's Hospital in Boston. "They say they'll do anything to have a bigger penis." So is there anything they can do?

Not really. "It's pretty much bunk," O'Leary says wearily. After all, if simple, effective penis enlargement were possible, every other guy in America would be a foot long.

Yet common sense isn't enough to stop some of us. And thanks to our culture's restless drive for self-improvement, information about penis enlargement is everywhere. Liberated from the classifieds of behind-the-counter smut, penis enlargement pills are hawked on TV. Without even requesting it, you might have ads conveniently delivered to your email inbox every day. More than 10,000 men in the U.S. probably many more have gone on the operating table to get highly controversial penis enlargement surgery.

But don't open your wallet and unbuckle your pants yet. We've explored the sordid world of penis enlargement so you don't have to.

Should my penis be bigger?

First, even if you think you're small, odds are that your penis is a normal size. The average erect penis is four to six inches long, with a circumference of four to six inches. There's more variation in the size of flaccid penises. But that just means that a guy who looks well hung in the locker room isn't likely to get much bigger when erect; conversely, a guy who looks small will grow a lot.

Second, if you insist that you're small even when the ruler says you're not, you may earn yourself a psychiatric diagnosis: penile dysmorphic disorder. It's similar to the perceptual distortion of anorexics who still think they're fat no matter how stick thin they get. According to one study, the majority of men who get penis enlargement surgery have this condition. They are also the least satisfied with the results.

"Men who have a normal penile length but are convinced they're small might benefit from seeing a psychiatrist instead of a surgeon," says Karen Elizabeth Boyle, MD, assistant professor of urology and director of Reproductive Medicine and Surgery at Johns Hopkins Hospital in Baltimore.

Pumps and pills, horny goat weed, and other penis enlargement nonsense

But enough of the sensible expert advice. Here is a rundown of your options if you are still looking for a larger penis.

  • The vacuum pump. This is the classic of the penis enlargement device genre. You stick your penis into a cylinder attached to a pump that sucks out the air. The resulting vacuum draws extra blood into your penis, making it erect and a little bigger. You then clamp off the penis with a tight ring like a tourniquet to keep the blood from escaping back into your body.
    Penis pumps do have a real medical use: They help men with erectile dysfunction. But the pump has no lasting effect on the size of your penis. You will deflate to normal size once you remove the ring.
    Risks include temporary impotence, blisters, bruises, ruptured blood vessels, and discolored and thickened skin. The clamping should not be done for longer than 20 to 30 minutes at most since it will eventually cause tissue damage.
  • Exercises, weights, and devices. First, know this: You can't bulk up your penis with exercises, as you can your biceps. It is not a muscle. However, some devices and types of stimulation are purported to stretch the skin and lengthen the penis itself.
    One popular example is "jelqing," a regimen of tugging or "milking" exercises. Naturally, it has an "ancient" (which means "bogus") pedigree: Web sites tell us it's an old Arabian technique passed down from well-hung father to son. The details are veiled behind web pages demanding your credit card, but jelqing exercises generally involve a lot of work 30 to 60 minutes of firm yanking most days of the week. The real trick is that you are supposed to do this without your penis getting erect. So you had better have a lot of self-discipline, a lot of free time, and a door with a lock.
    Other penis enlargement options include devices that you clamp onto your penis to stretch it sometimes for as long as eight hours a day with tension or weights. "A manufacturer sent me one," says O'Leary. "It looks like a medieval implement of torture.
    Will any of this work? Boyle says no. O'Leary very cautiously says it might be possible to stretch the skin of the penis. However, this would have no effect on the size of your erection. It would also require superhuman dedication. Risks include tearing of the tissue, burst blood vessels, and other problems. O'Leary recently saw a patient who was hanging heavy weights off his erect penis and fractured it, snapping the tissue. The result was terrible pain and surgery.
  • Pills, supplements, and creams. Hogwash. Every last one of them. Most are mixtures of herbs like yohimbe (the "herbal Viagra"), ginseng, and, of course, horny goat weed. They have never been shown to have any effect on penis size.

Penis Enlargement Surgery

Unlike most enlargement schemes, surgery can work. Even critics concede that. However, there are risks, and the results may be less impressive than you hope. One 2006 study published in European Urology found that the average length gain is less than one inch. Mark P. Solomon, MD, a plastic surgeon outside Philadelphia, agrees that the results are modest but says they are usually a bit better than that.

There are two basic penis enlargement surgeries.

  • Lengthening the penis. The penis is connected to your pelvis with a tough fiber called the suspensory ligament. This holds back some of the penis shaft and hides it inside your body. Surgically cutting the ligament releases the tension and theoretically more of the shaft becomes outwardly visible. To prevent the ligament from reattaching, you will probably need to attach weights or stretching devices to your penis daily for about six months.
  • Widening the penis. The original technique was to take fat from elsewhere in the body and inject it into the shaft of the penis to bulk it up. It didn't work. The fat would get partially absorbed and your penis would be left looking lumpy. "These penises looked like cobblestone streets," says Solomon.
    A newer version of this technique uses implanted allograft, tissue harvested from cadavers that's used in many types of reconstructive surgery. Surgeons who do the procedure such as Solomon and Brian J. Rosenthal, MD, a urologist in Beverly Hills say that the allograft lasts longer and provides a much better result. We'll never know how the tissue donors would feel about their second lives as penis stuffing.

Other penis enlargement surgeries are available. In overweight or obese patients, the fat at the base of the penis may be removed by liposuction. While some surgeons will do both lengthening and widening at once as a deluxe package, others prefer to do them in stages.

While Rosenthal predicts that penis enlargement is about to become as common as breast enlargement, Solomon disagrees. He says the biggest obstacle is the price. Penis lengthening costs anywhere from $5,000 to $10,000. But when it comes to widening, the cost of allograft alone is $5,000 to $7,000 omitting the costs of the surgery itself. To get the works, you might easily need more than $20,000.

Penis enlargement risks and disasters

However, before you take out a penile improvement loan and slap your penis down on the operating table, it's important to consider the risks. No major medical organization has approved of these surgeries for men with a normal penis. The American Urological Association stresses that they have not been proven safe or effective.

The few studies that have been done aren't encouraging. The European Urology study looked at 42 men who had lengthening procedures and found that only 35% were satisfied with the results; 50% went on to seek further surgery.

"I've seen some real disasters," says O'Leary, describing times he has repaired the damage caused by augmentation gone wrong. Known complications include scarring, infections, loss of a normal erection angle, decrease in sensation, and impotence. Occasionally, lengthening can actually make you shorter: Scar tissue reconnects the penis to the pelvis and draws more of the shaft into your body.

Surgeons who do the procedures say they have good outcomes and serious complications are rare. "I've done thousands of these surgeries," says Rosenthal. "Our techniques have improved a great deal and patients are benefiting."

They are also tired of the argument that men who want this surgery need psychiatric help. This surgery just allows men to feel better about themselves, they say. Of course, there are risks, but that's true of any cosmetic surgery. Would a woman who wants bigger breasts be called crazy? Why is penis enlargement any different?

O'Leary insists it is. Unlike breast augmentation, which has for better or worse become standard, penis augmentation has not.

"If I thought there was a legitimate procedure to augment the penis, I wouldn't have any problem with it," O'Leary says. "But we just don't have an effective, proven, and safe way to offer it."

Doctor-approved penis enlargement!

If you were hoping to find something that works, don't despair. There is one penis enlargement technique that all doctors actually recommend: weight loss. Yeah, it's a bit of a cheat, but it can help.

"A lot of the guys I see who think they're below average are pretty overweight," says Boyle. Their penises are normal but look shorter because they are buried in fat. Being overweight can also make your normal penis look proportionally smaller than the rest of you. So slimming down can help your penis look bigger and longer.

Be wary of everything else. Most penis enlargement techniques are a waste of money. Surgery is expensive, risky, and unstudied. If you have terminal cancer, getting an experimental surgery is often worth the risk. But that's not what we're talking about.

Look at it this way: The penis is an incredibly delicate and sensitive organ. That's what makes it so fantastic. So think very, very carefully before you start messing with it. Is it worth risking an average-sized penis that works to take up the quest for a porn star monster that might not?

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