Dissatisfaction over genital size can influence a man’s sexuality and have negative psychological outcomes.
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Average penis size of 13 cm or 5 inches (when erect) is considered normal. Despite having a normal penile length, many men have an exaggerated idea regarding normal size and this assumption leads to an interest in various interventions that claim to increase penile length or girth.
Which are the various penis enlargement methods?
Several options are available that attempt to increase penile length/girth; some of them are described below:
1. Pills and lotions
Pills and lotions for penile enlargement generally contain herbs, hormones, and vitamins that the marketers claim to increase penis size; however, these products can be marketed directly to consumers with no studies to show that they work. As per some researchers, these products may contain traces of lead, pesticides and may be harmful.
2. Vacuum devices
Certain vacuum devices such as pumps are also used for penis enlargement. A vacuum pump technique involves placing a tube-like structure over the penis and then pumping out the air to create a vacuum, which draws blood into the penis and makes the penis swell and appear large. These pumps are used for the short-term treatment of impotence; however overusing it can damage the tissue of the penis, leading to weaker erections.
3. Penile extenders
Penile extenders use traction to stretch the penis. Though there have been some positive outcomes with this technique; experts recommend physician supervision before using such a procedure.
Jelqing is a pulling exercise aimed at increasing the blood circulation in the tissues of the penis, which ultimately makes the penis look larger; however, this technique too lacks scientific evidence. It may also cause pain or scarring over time.
There are two main types of penis enlargement surgery: Penile augmentation and suspensory ligament release.
Penile augmentation may be done in two ways - either by grafting fat cells from elsewhere in the body onto the penis or by the injection of fat cells into the penis. Over time, the body can reabsorb the fat, returning the penis to its former size.
In the suspensory ligament release technique, the ligament which holds the penis to the pubic area is surgically removed. This procedure is meant to change the angle of the penis, which can make the penis appear longer. However, when erect, the angle of the penis will differ, and this may interfere with sex.
Clinical studies on penis enlargement surgery
As per a recent meta-analysis study, penis enlargement surgeries are usually ineffective and can cause substantial psychological and physical damage to men. The study found that the suspensory ligament incision and injection of derma fillers were the two most common forms of procedures performed for penis enlargement.
The study which analyzed 17 studies described that even though some men reported a significant size increase, complications were not infrequent, and none of the techniques were validated. Further, the study found that these surgeries were associated with poor treatment outcomes and low satisfaction rates.
Adverse effects on penis enlargement surgery
The safety and efficacy of penile length and girth enhancement surgery has not been established. Penile enlargement surgery can result in the following complications.
- Poor wound healing. Wound dehiscence, surgical complications in which wound ruptures partially or completely along the sutures
- Distal flap loss
- Pubic deformation or buried penis
- Silicone injection can result in drifting, distant migration, and swelling. They can also cause penile distortion and granulomatous reactions. Silicone injection can also damage blood vessels and nerves, which, in turn, may lead to decreased sensation and erectile dysfunction
- The use of fat transplantation to increase penile girth can lead to fat necrosis and reabsorption. It can also lead to penile curvature, nodules, or calcification
Penis enlargement surgery in normal men is associated with serious risks and is based on only low-quality evidence. Penile dysmorphophobic disorder is a psychological condition in which a man suffers from severe preoccupation with penis size despite having a physiologically normal penis. In such cases, patients may benefit from psychotherapy. Structured counseling should be always performed rather than risky procedures. Consulting a doctor or sex therapist is highly recommended in people concerned about the size of their penis.
Marra G, et al., (2019). Systematic Review of Surgical and Nonsurgical Interventions in Normal Men Complaining of Small Penis Size. Sex Med Rev. PII: S2050-0521(19)30012-5. DOI: 10.1016/j.sxmr.2019.01.004.
Furr J, et al.,(2018). Complications of Genital Enlargement Surgery. J Sex Med. 2018;15(12):1811-1817. doi: 10.1016/j.jsxm.2018.10.007.
Penis-enlargement products: Do they work? Mayoclinic. Available at: www.mayoclinic.org/.../art-20045363. Accessed on: 19 November 2019.
Penis-enlargement. NHS. Available at: https://www.nhs.uk/live-well/sexual-health/penis-enlargement/. Accessed on: 19 November 2019.