How can a male increase his penis size?

Penis Enlargement: Evidence-Based Reality

There is no proven safe and effective method to increase penis size in men with normal anatomy, and all interventions should be considered experimental with potentially devastating complications. 1, 2

Critical First Step: Psychological Evaluation

The overwhelming majority of men seeking penile enlargement have physiologically normal penises but suffer from penile dysmorphophobic disorder or "small penis syndrome"—a severe preoccupation with penis size despite normal dimensions. 1, 3

Structured psychological counseling is the recommended initial standard of care and should always be performed first. 2, 3 When counseling is provided, the majority of men come to understand their penis is normal and become unwilling to undergo further treatment. 2

What Actually Works (Minimally)

Penile Traction Devices (Extenders)

• The only intervention with any evidence-based support for length increase in normal men. 4, 2
• Requires prolonged daily use of 2-8 hours per day for at least 3 months. 4
• Average length increase: 1 cm (less than 2 cm in most studies). 4, 2
• No serious adverse events reported, only transient mild discomfort and temporary redness. 4
• This should be the only option considered for men who remain dissatisfied after counseling. 2

What Doesn't Work or Is Dangerous

Pills and Supplements

• No evidence of efficacy whatsoever. 5
• These products are not scientifically validated. 5

Vacuum Devices

• Do not increase penis size. 2
• While effective for erectile dysfunction initially (90%), efficacy drops to 50-64% after 2 years. 4

Injectable Fillers (Hyaluronic Acid, Fat, Other Materials)

• Can increase girth by 0-4.9 cm. 1, 6
• Associated with high complication rates including penile fibrosis, sexual dysfunction, and devastating deformities. 1
• Complications are likely underreported. 1
• Should be considered experimental and unethical outside clinical trials. 2

Surgical Interventions

• Include suspensory ligament release, tissue grafting, dermal fat grafts, and flaps. 2
• Complications are not infrequent and may be devastating, including infection and death. 1
• None of the surgical techniques has been externally validated. 2
• Patient satisfaction is often poor, particularly regarding length concerns. 7
• Should remain a last option and be considered unethical outside of clinical trials. 2

Clinical Guidelines Position

Clinical guidelines are lacking for penile augmentation in normal men, and all procedures should be considered experimental. 1 The European Association of Urology only recommends penile traction therapy in the specific context of Peyronie's disease (penile curvature from fibrosis), not for normal anatomy enhancement. 7, 4

Common Pitfalls to Avoid

• Do not proceed with any intervention without first providing structured psychological counseling. 2, 3
• Do not offer injectable or surgical procedures outside of ethical board-approved clinical trials. 7, 2
• Recognize that social forces and unrealistic expectations drive most requests—address these directly. 3
• Understand that men seeking these procedures typically have normal penile dimensions and psychological disorders, not anatomical defects. 1, 3

The Bottom Line

Set realistic expectations: penile traction devices may provide modest gains of approximately 1 cm after months of daily use, but this is the only intervention with any supporting evidence in normal men. 4, 2 All other methods lack rigorous evidence, carry significant complication risks, and should not be offered outside research settings. 1, 2