From the Guidelines
Penile enhancement procedures are not recommended for purely cosmetic purposes due to limited evidence of effectiveness and significant risk of complications, and patients should prioritize thorough consultations with qualified urologists to understand the potential risks versus benefits. Penile enhancement procedures include both surgical and non-surgical options, each with varying effectiveness and potential side effects. Surgical procedures include:
- Penile lengthening (suspensory ligament division), which can provide 1-2 cm of visible length but may result in penile instability, scarring, and erectile dysfunction 1
- Penile widening procedures involve fat transfer or dermal grafts to increase girth but can lead to lumpy appearance, asymmetry, and fat reabsorption over time
- Penile implants, primarily used for erectile dysfunction, involve placing inflatable or malleable devices within the penis, carrying risks of infection, mechanical failure, and erosion, with infection rates ranging from 1-6% 1 Non-surgical options include:
- Vacuum devices that temporarily increase size through blood engorgement but may cause bruising, numbness, or skin irritation with prolonged use
- Penile extenders or traction devices require consistent use (4-6 hours daily for months) and can cause skin irritation or pain
- Injectable fillers provide temporary girth enhancement but risk granuloma formation, infection, and asymmetry It is essential to note that the use of antibiotic prophylaxis in penile implantation surgery is crucial, but recent evidence suggests that the recommended regimens may be associated with a higher postoperative infection rate than nonstandard regimens 1. Therefore, patients considering enhancement should have realistic expectations and thorough consultations with qualified urologists to understand the potential risks versus benefits.
From the Research
Penile Enhancement Procedures
- Penile extenders: a non-invasive technique that can provide modest benefits and patient satisfaction 2
- Vacuum devices: a non-invasive method that has been shown to be ineffective for penile elongation, but may provide psychological satisfaction for some men 3
- Surgical techniques: various procedures such as penile lengthening, girth enhancement, and corporoplasty, which can be performed at the time of penile prosthesis insertion 4
- Suspensory ligament release: a surgical technique that can be used to increase penile length, often combined with tissue grafting and flaps 5
Side Effects and Complications
- Penile deformity, paradoxical penile shortening, disagreeable scarring, granuloma formation, migration of injected material, and sexual dysfunction have been reported as complications of penile enhancement surgery 6
- Haematoma of the penis and glans numbness have been reported as complications of vacuum treatment 3
- Patient dissatisfaction and development of psychological disorders such as Penile Dysmorphic Disorder and Small Penis Syndrome are common outcomes of penile enhancement procedures 5
Psychological Aspects
- Most men seeking penile enhancement techniques have a normal penile size and may be suffering from penile dysmorphophobia or small penis syndrome 2, 6, 5
- Structured psychological counseling is recommended as the initial standard of care for men seeking penile augmentation surgery 5
- Social forces can contribute to the perception of inadequate penis size, leading to anxiety and psychological disorders 5