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In Pursuit of Extra Inches

The ads scream that you can add length to your penis in only a few weeks. But only surgery can increase penis size -- and once you hear what you have to go through, you may reconsider.

By Martin Downs
WebMD Feature

Reviewed By Michael Smith

The offers certainly are enticing: "Add 2 or more inches to your penis in just weeks!" one product's web site promises. "Doctor-approved pill will enlarge your penis up to 3 inches," another claims. But are they for real? No.

Surgery is the only legitimate way to permanently enlarge your penis, and the best possible results are much less dramatic than you might hope for. Claims of massive gains by other methods -- such as pills, pumps, and exercises -- are either overenthusiastic or blatantly fraudulent.

There are three operations that plastic surgeons perform on men who want a bigger penis. Only one can make it look longer.

Part of the penis is held inside the body by the suspensory ligament, which attaches the penis to the pubic bone. A surgeon can cut this ligament so that the penis slides down and more of it is visible outside the body. You may gain up to 1 inch in length by having this surgery.

To widen the penis, a surgeon can harvest fat from elsewhere on your body and inject it into the shaft of the penis. A newer way to add girth is called dermal grafting. In this procedure, a surgeon buys skin from a tissue bank and grafts it underneath the skin of the penis shaft.

Not for Everyone

A statement from the American Urological Society (AUA) on surgical widening and lengthening says there is no proof to show that the procedures are safe or that they work.

Ira Sharlip, a California urologist and president of the Sexual Medicine Society of North America, says there just isn't enough data from credible studies for the society to endorse these procedures. But that doesn't mean all doctors dislike the idea. "I would love to see that data," Sharlip says.

Mark Solomon, MD, a cosmetic surgeon in Pennsylvania, insists that surgery is only for men who are really serious about it. "I'm not out on the Internet sucking up hundreds of patients for penis enlargement," Solomon says. "I'm careful about who I operate on."

He says he won't take any patient who has unrealistic expectations, like dreams of turning an average 6-inch penis into one that's 9 or more inches long. He won't operate on uncircumcised men, either, because the risk for complications is greater. "I turn down most patients," he says.

What's more, many men reconsider after hearing all the details.

What Price Size?

After the ligament-cutting procedure, a man must wear weights on his penis to keep scar tissue from forming that would make it shorter again. Solomon compares the discomfort of recovery from this surgery to that of a hernia operation.

Besides leaving you tender and unable to have sex for at least one month, there is another down side, literally, to the lengthening operation. The tension of the suspensory ligament is what makes the penis point upward when erect. A penis lengthened by cutting the ligament points downward when erect, and it may wobble during sex.

Fat injections for thickening the penis caused problems for men who had it done early on. The fat tended to move around under the skin, making the penis look lumpy. But Tom Lue, MD, a professor of urology at the University of California San Francisco, says the procedure has been refined in recent years and the results men get today are "much better than five to 10 years ago."

Lue points out that fat injections and dermal grafting widen only the shaft of the penis, not the head. Some may think a surgically widened penis looks strange because the shaft is wider than the head.

GUARANTEED!!!* (*Not)

If you look at enough Web sites that sell enlargement products and techniques, you'll notice that they all try to debunk each other's methods to shore up their own claims. Taken all together, the whole enterprise discredits itself.

Here's one claim about "natural" penis enlargement, or so-called "ancient secret" techniques, which involve torturing your penis by hand:

"The key to size growth is breaking down the cells in the penis by forcing blood into them and stretching them out.  The penis 'repairs' itself by regrowing the cells, expanding the erectile tissue and allowing the penis to hold more blood.  End result: the penis becomes longer and thicker."

Sharlip puts his medical opinion about this in layman's terms: "That's bull----," he says.

Lue says you can hurt yourself this way. If you rupture the fibers of the penis wall, you can get Peyronie's disease -- a bent penis.

The penis pump is another method that's not "ancient" but that has been around for decades. Pumps create a vacuum around the penis, which engorges it with blood. This can help men who have erectile dysfunction achieve an erection. Lue says if you use a pump regularly for a long time, your penis may get fatter. But if you stop using it, the swelling will disappear.

There are also many hucksters who claim that taking herbal pills will enlarge your penis permanently. Does this work? "There's no reason to expect that it would," Sharlip says.

Lue's final advice is, "Don't mess around with the penis." He says men often come to him in tears over what they've done to themselves. And Sharlip doesn't offer much sympathy to the size-obsessed man. "If a man's self-esteem is largely dependant on the size of his penis, he has more of a problem between his ears than between his legs," he says.

Martin F. Downs is a health writer in New York City. He was formerly an editor at CBS HealthWatch. He has also written for Health.com, Salon.com, and POZ magazine and is the editor of the Alicubi Journal.

Originally published March 18, 2002.

Medically ypdated Sept. 2, 2003.

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