Surgical techniques to lengthen a penis (enhancement phalloplasty) or increase its circumference (girth enhancement) are nothing new. They were first introduced in the United States in 1991. Unfortunately, there arent enough studies of penis enlargement surgery to provide an accurate picture of results and risks. However, one study at the Institute of Urology in London concluded that only 35% of the patients who underwent surgery were satisfied with the results, and half went on to seek further surgery.
Generally, procedures meant to thicken the penis are more effective than those intended to increase penile length. The currently advertised techniques used for penis enlargement include:
When done for cosmetic reasons, penile enlargement surgery is not covered by medical insurance, which means the patient must pay all fees himself.
Another category of penis enhancement surgery uses inflatable penile implants. Introduced in the 1970s, this primarily therapeutic surgery is performed on men suffering from erectile dysfunction (ED), which is the inability of a man to attain and/or maintain an erection sufficient for sexual activity. Implants may be the last hope for men who cannot take ED medications or for whom those medications do not work. Implants are also used in men with Peyronies disease, a disorder that causes internal scarring that can lead to bent or painful erections.
Penile implants, or prostheses, are devices that are implanted completely within the body. They produce an erection-like state that enables the man to have normal sexual intercourse. Implants come in two basic designs. The inflatable (hydraulic) implants are filled with saline from a reservoir implanted in the groin or scrotum and then deflated. Semirigid, or rod, implants are always somewhat firm.
Penile implant surgery is complex and permanent. It is usually done at a surgery center or hospital by a urologist. The surgery generally takes between 1 and 2 hours under general or spinal anesthetic administered by an anesthesiologist. It is costly, but if done for therapeutic reasons it may be covered by medical insurance, including Medicare. Neither the operation nor the implants interfere with sensation, orgasm, ejaculation or urination. A penile implant erection will be shorter than the erection the patient once had normally.
Through an incision above the penis where it joins the abdomen or under the penis where it joins the scrotum, the surgeon stretches the two tissue-filled erection chambers (corpora cavernosa) that normally engorge with blood during an erection and implants the cylindrical prostheses. No tissue is removed and blood loss is minimal. If inflatable implants are used, the surgeon also places a pump inside the scrotum. Depending on the design of the inflatable implants, a fluid-filled reservoir is either part of the pump mechanism or it is implanted separately in the lower abdomen. Semirigid implants, which are used less often, do not require a pump or a reservoir.
The decision about which type of implant to have is based on the patients preference and medical situation. It should be made in consultation with the surgeon performing the procedure.
Candidates for penile implant surgery are first evaluated by their surgeon to determine the cause of their erectile dysfunction and to determine if they are a good candidate for surgery. They should be in good general physical and mental health and have any chronic conditions (diabetes, asthma, cardiovascular disease) under control. They should also have realistic expectations about what the surgery can and cannot do for them. The surgeon should also make sure that the patient has an understanding of the procedure, its risks and complications. Including the patients partner in the consultation is a good idea.
Penile implant surgery is usually the last option for men suffering from erectile dysfunction. For men who are considering cosmetic penile enlargement, however, there are usually other options. A mans first step should be to consult with his personal physician about his concerns. The doctor may be able to allay many of them. Sometimes something as simple as trimming the pubic hair, losing weight, or better physical conditioning can make the penis appear longer. Another option is pubic liposuction, which involves removing excess fat from the pubic mound that conceals the penis in obese men. By removing the fat, the penis appears larger, although its actual size does not change. And, if a mans concerns center on being inadequate as a lover, open communication with his partner can go a long way towards dispelling that belief.
Changing the size of the penis is expensive, risky, sometimes unstudied, and most likely irreversible. Ask yourself, Are the supposed benefits worth the risks?
Bitar Cosmetic Surgery Institute
3023 Hamaker Court
Fairfax, VA 22031
Bitar Cosmetic Surgery Institute
8650 Sudley Road
Manassas, VA 20110
George Washington University Hospital
2150 Pennsylvania Avenue
Washington DC, DC 20037