The size of a man’s penis plays a huge role in his self esteem.

Having a small member can proliferate feelings of being less masculine or appealing to the opposite sex.

And so, men blighted by a smaller manhood may abstain from sexual encounters – or shy away from the locker rooms at the gym.

These feelings of inadequacy can lead to depression, problems with intimacy and potentially even suicidal thoughts.

However, a Beverly Hills urologist, Dr James Elist, has developed a revolutionary penile enhancement procedure that offers new hope to men with small penises.

A silicone implant is inserted into the penis during the $13,000 (£9,000) procedure – instantly increasing the length and girth by approximately two inches.

Dr Elist told Daily Mail Online that patients have the option of choosing between three implant sizes for the procedure: Large, extra large and double extra large.

The surgeon explained: ‘Nobody wants to have a small or medium one.’

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Dr James Elist, a urologist in Beverly Hills, has developed a breakthrough penile implant (pictured) - made of soft silicone - that increases the length and girth of a man's member by approximately two inches

Dr Elist has been working as an urologist for more than 35 years.

He has always had an interest in men’s sexual dysfunction – and even garnered notoriety as the first doctor to link cigarette smoking with impotence.

‘If men see the sign on cigarettes that say smoking can cause impotency, they can blame it on me,’ he said.

For decades, the doctor was one of many who performed an operation on men with erectile dysfunction, in which a prosthesis was inserted into the arteries of the penis.

The procedure was designed to allow blood to properly flow through the arteries, so that a man could achieve an erection.

Dr Elist explained: ‘I noticed after insertion of the implant, between a year or two, most men were complaining that the size of their penis shrunk.

‘They did have an erection, but the girth and length of the penis decreased.’

In 2002, the doctor discovered a solution for the ‘shrinking’ problem.

At the time, there were many penile enhancement treatments available – but none were effective.

Fat injections were previously used to increase the girth, but Dr Elist told Daily Mail Online that fat is absorbed after five or six months.

He said: ‘It gives the patients total deformity, because it was forming lumps and bumps under the penis.’

Furthermore, foreign tissue transplants and even gel fillers – which are commonly used on the face to decrease wrinkles – proved to be ineffective as well.

That’s why Dr Elist came up with the idea of implanting a soft silicone sheath under the penis.

Dr Elist (pictured) developed the implant after noticing men who underwent surgery for erectile dysfunction were reporting that their penises 'shrunk' after the procedure. Since fat injections and gel fillers were ineffective in increasing the size of the penis, he decided to take the matter into his own hands

The penis implant is available in three sizes - large, extra large and double extra large - and is inserted during a $13,000 (£9,000) procedure. It boosts both the girth and the length of the penis

‘This is similar to breast implants – but a breast implant is a bag filled with silicone gel or in some cases saline,’ the urologist explained.

‘My implant is different; it’s not filled with anything.

‘The material is very soft silicone with the shape of the penis – which covers the penis for 270 degrees around and the whole length of the penis.’

The doctor patented his invention in 2002 – and began performing operations to insert the implants in 2004.

This is similar to breast implants – but a breast implant is a bag filled with silicone gel or in some cases saline. My implant is different; it’s not filled with anything Dr James Elist

Since then, he has tinkered with the design, shape, techniques and even the surgery procedure.

Dr Elist said: ‘Now at this point in time, we have the perfect product: Something that I’m really very happy and even proud to present to the community.’

The implant is inserted through a small incision of an inch to an inch-and-a-half in the groin.

During the short procedure, the patient is under local anesthesia, unable to feel anything that is happening.

The doctor inserts the implant through the skin of the groin, until it gets under the skin of the penis.

Immediately after the procedure, a man’s penis will have expanded between 1.5 and 2.5 inches, Dr Elist said.

He said: ‘For most of the patients after surgery, the length of the penis and the girth of the penis are very similar.’

However, whether the doctor inserts a large, extra large or double extra large implant is partially up to the patient – but also dependent upon the man’s skin.

‘Some patients, unfortunately, are born with tight skin – or when they had the circumcision, a lot of skin was removed, so they don’t have enough skin,’ Dr Elist said.

‘So for them we start with large.’

The implant (pictured) spans the length of the penis, and also wraps 270 degrees around the member. It is inserted through a small incision made above the groin

The implant is put under the skin of the penis, and immediately increases its size. Dr Elist said that the implant is designed to last a man's entire life - but upwards of 15 per cent of his patients choose to have a second procedure to increase their size even more

But for patients with ‘good skin’ the doctor generally begins with an extra large implant.

The implant is designed to last for the man’s entire life.

However, the doctor noted, 10 to 15 per cent of the doctor’s patients opt to ‘upgrade’ after the procedure.

In those instances, the doctor uses the double extra large implant.

We did a study of 400 of our patients retrospectively, and we noticed that the self-confidence of patients has increased significantly Dr Elist

Recovery from the procedure doesn’t take too long, he said.

The men are able to go back to their daily activities and routine the following day.

However, it is vital that men abstain from sexual activities – including masturbation and oral sex – for four to six weeks afterwards.

Dr Elist said: ‘That is very important, unfortunately, some of our patients did not follow the instructions and we had some problems.

‘The skin is thin at that point, so it can get infected and you’d have to remove it.’

The surgeon has become renowned around the world for his work in penile enhancement.

Patients fly from all over to seek his help – even as far away as Moscow and Brazil.

Currently, he performs two of the implantation procedures each day.

Dr Elist told Daily Mail Online that the vast majority of his patients see a huge improvement in their self confidence after undergoing the operation.

‘We did a study of 400 of our patients retrospectively, and we noticed that the self-confidence of patients has increased significantly,’ he said.