One of the most common concerns men have about their bodies is the size of their penis. Research indicates that 35% of gay men [1] and 45% of heterosexual men [2] say they wish they could be a different size—and almost all of these men want to be larger (less than 2% wish they were smaller). Why is this the case? Because guys are constantly told that “bigger is better,” especially by the porn industry, where men who practically have third legs are routinely glorified. As a result of this social pressure, guys are increasingly going under the knife in order to enhance the size of their packages. But do these surgeries work as promised and are they worth the exorbitant costs?

Let’s first discuss how these surgeries work. One is a lengthening procedure, in which the suspensory ligament (i.e., the structure the anchors the penis to the pubic bone) is snipped, thereby allowing more of the penis to hang outside of the body. There is also a “girth” (i.e., width) enhancing surgery that can take one of two forms. The first involves injecting fat from the patient’s abdomen into the shaft of the penis; the other involves placing donor tissue grafts (i.e., tissue harvested from dead people who have donated their bodies) underneath the skin of the penis. Another procedure some doctors are offering is “galnular enhancement,” in which a specific type of acid is injected into the head of the penis in order to temporarily increase its size. As you can see, you need to be comfortable with knives and needles around the penis in order to pursue any type of penile augmentation. And you need to have deep pockets too—the lengthening and widening procedures are about $6,000each.

So now for the million dollar question—does it work? According to the doctors who offer such procedures, “Of course it does.” And they fill their websites with glowing testimonials from patients boasting about their improved confidence and how random strangers now comment on their “VERY LARGE PENIS” (and, yes, they are apparently so pleased that they feel the need to write this all in caps). The procedures are also presented as being very safe, and complications are said to be incredibly rare. For instance, in this recent interview with a penis enlargement surgeon, he states that the only complications are “some swelling, a scar, and some pain for two to three days afterward,” and possibly a lower angle of erection if you have the lengthening procedure (i.e., your erect penis will point down instead of up because the suspensory ligament is no longer there to provide support). However, research suggests that the risks are more serious than this.

For example, one study I came across reported on dozens of patients who experienced penile deformities after undergoing one of these surgeries [3]. Complaints included very prominent scarring, penile humps and lumps, as well as a disappearance of injected fat. Many of these men needed to have reconstructive surgery in order to address the deformities. Unfortunately, the full extent of complications arising from these operations is unknown. A recent review paper on this topic highlighted the fact that many studies do not discuss complications and concluded the following:

“Penile enhancement surgery is a highly risky procedure. There is no standard surgical technique, and much of the performed procedures are experimental with minimal objective pre- and postoperative data.” [4]

In other words, when you sign up for one of these operations, you may not know exactly what you’re getting because there is a lot of variability in how they’re performed and we don’t have good data on the outcomes. So, if you’re thinking about pursuing penile enlargement, I would encourage you to think again about your reasons for doing it. If it’s because you don’t feel good about yourself, keep in mind that cosmetic surgery isn’t necessarily going to fix that. Many, many people have visited the plastic surgeon thinking that a nose job, breast implants, or penile augmentation would give them a "perfect" body or life, only to find that it didn’t. Indeed, research has found that the outcomes of cosmetic surgery are mixed, and the factors that predict worse outcomes include being young, male, thinking that cosmetic surgery will save your relationship, and having a history of depression and anxiety [5]. Also, if you are a heterosexual guy and you’re hoping that an elongated penis will allow you to better please your partner, think again—most women report that a longer penis makes no difference in their likelihood of reaching orgasm.

In short, if you’re not happy with yourself or secure in your relationship, all of the cosmetic surgeries in the world won’t make a bit of difference. And if you do opt for penile augmentation, keep in mind that you don't always know what you're signing up for with one of these surgeries.

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[1] Grov, C., Parsons, J.T., & Bimbi, D.S. (2010). The association between penis size and sexual health among men who have sex with men. Archives of Sexual Behavior, 39, 788-797.

[2] Lever, J., Frederick, D.A., & Peplau, L.A. (2006). Does size matter? Men’s and women’s views on penis size across the lifespan. Psychology of Men and Masculinity, 7, 129–143.

[3] Alter, G. (1997). Reconstruction of deformities resulting from penile enlargement surgery. The Journal of Urology, 158, 2153-2157.

[4] Dillon, B.E., Chama, N.B., & Honig, S.C. (2008). Penile size and penile enlargement surgery: A review. International Journal of Impotence Research, 20, 519-529.

[5] Honigman, R. J., Phillips, K. A., & Castle, D. J. (2004). A review of psychosocial outcomes for patients seeking cosmetic surgery. Plastic and reconstructive surgery, 113, 1229.

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