What they're experiencing is small penis anxiety (SPA) or body dysmorphic disorder (BDD). Silicone Implants like the FDA-approved Penuma device provide more consistent girth improvement with satisfaction rates reaching 80-90% in some studies. Fat Injections and Dermal Fillers can initially add about an inch in girth, but up to 80% of injected fat may be reabsorbed within a year. This doesn't actually enlarge the penis—it simply allows more of the existing penis to extend outside the body. In our experience, such procedure resulted to be fully ideal to allow surgical treatment, devoid of complications and major side effects, widely liked by patients and guaranteed brief protected discharge times (180 ± 30 minutes). Our penoplasty options offer the maximum potential increase in both length and girth size of penis. At Morganstern Medical, our surgeons provide an array of ground-breaking, proven techniques to medically increase penis size. Nobody hears about the happy implantees, he said, because “unfortunately people are not willing to come out and talk about penile enlargement.” A surgical technician had covered the patient’s body in sheets until only his penis, gleaming beneath the overhead lamp, was visible. Psychological factors significantly influence how patients perceive the success and satisfaction of penile enlargement procedures. Detailed clinical evidence includes findings on surgical and nonsurgical methods, documented in peer-reviewed journal on sexual medicine and comprehensive reviews of penile enhancement techniques and patient satisfaction. Among surgical options, the Penuma implant is an FDA-cleared silicone device recognized as an effective solution for both penile girth and length improvement (exploring surgical penis enlargement methods). Patients seek protocols that have been improved over time and have been medically reviewed. The majority of men who call Morganstern Medical are seeking a 1-2 inch or 2.54 cm to 5.08 cm increase in width or length or both. Has the success rate been medically reviewed in studies? Yes, if done properly using medically reviewed and effective techniques and protocols. I cover health and the environment and the agencies that govern them, including the Environmental Protection Agency. We have experience in discussing solutions for issues, including any sexual health concerns or erectile dysfunction. If you are considering penis enlargement, it is important to research the safety and effectiveness of all options out there. Elist testified with brio about his victimization at the hands of Cornell, who’d violated “the sanctuary” of his operating theater; the judge ruled with Penuma’s attorneys that the negative experiences of patients like Mick were irrelevant to the question of theft at hand. Elist emphasized to me that “the best advantage of Penuma over any other procedure” was how easy it was to remove. One ad, in Korean, for the surgery center where Elist operated sounded a familiar note, promising a “life changing” procedure with no complications and “guaranteed results,” performed by “the Highest Authority in Urology in Beverly Hills,” “approved by the state government” and “authorized by the FDA.” A limitation is that the body reabsorbs a significant portion of the injected fat (often up to 50%), leading to unpredictable, uneven, and lumpy results. Girth enhancement is often attempted through fat grafting or the injection of synthetic fillers like hyaluronic acid. Penile traction devices, or extenders, are the only non-surgical method with limited scientific backing, primarily for length increases. The penile tissue, primarily composed of erectile chambers and fibrous tissue, does not respond to topical creams or oral supplements by increasing in size. He said he’d experienced complications and, in 2011, he’d had his second implant removed. He had undergone multiple surgeries with Elist, with two different iterations of the implant. Not long ago, I met Bryan, Elist’s former penis model, at a coffee shop in Orange County. In June, his company rebranded the updated Penuma as the Himplant, and the Augmenta trial unfolded in a federal courthouse in downtown Los Angeles. “The Penuma is going to be the only procedure that surgeons not just in the United States but worldwide are going to accept,” Elist told me. The Psychological Perspective These methods are generally safer, with fewer complications, often limited to minor swelling or skin reactions. The risks of infection, scarring, and functional impairment highlight the importance of thorough medical consultation and consideration of alternative treatments. Injectable materials such as silicone or liquid paraffin have been linked to severe adverse events like embolism, pneumonitis, and even necrosis that may require surgical removal. More serious issues include tissue necrosis, autoamputation, and sexual dysfunction, resulting from damage or adverse reactions to the intervention. Among the most common complications are penile deformity, undesirable scarring, granuloma formation, and migration of injected materials, which can lead to irregularities or asymmetry. Jackson didn’t find the other men online until 2018, around the time a doctor at the Cleveland Clinic told him his implant had fractured into pieces that were floating under his skin. (Elist’s spokesperson said Jackson volunteered his positive comments in the video, and Master P, who once featured Elist on his Playboy Radio show, said through his own spokesperson that he was not involved with any YouTube testimonials for the implant.) The others had also read the GQ article about the Penuma, learned that the implant was “reversible” and, heartened by the FDA’s clearance, put down their deposit. (Elist said through a spokesperson that the patient didn’t follow post-op advice, and that, while he was not able to respond to some of the accounts in this story because men had requested anonymity, complications were rare.) Dr. Tuncay Taş and the team at Safe Clinic continue to offer ethical, personalized solutions to support both physical and psychological well-being. Penis size concerns are more common than most men admit. Fortunately, several medical treatments and surgeries can manage or correct the condition. Surgical & Combination Approaches: Outcomes & Risks In addition to encouraging Bryan, the spokespenis, to post positive comments on My New Size, Elist tracked his own mentions on PhalloBoards and Thunder’s Place, other online forums for male enhancement, demanding that their moderators stop harboring “defamatory” statements. The subculture of penile enhancement remains shrouded in stigma, because for a man to admit that he wants to be bigger suggests that he isn’t big enough. For dozens of Penuma patients who spoke to me, the shock of the new was the prelude to graver troubles. As one pleased Elist patient counseled others, “You have to treat your penis like a Rolex.” Elist’s consent forms included a provision releasing the clinic from “any liability” if a patient receives post-op treatment elsewhere, but Mick, confused about whom to trust, online or off, decided to seek out a second professional opinion — and then a third, a fourth and a fifth. Eighty-one percent of the subjects who responded to the questionnaire indicated “high” or “very high” levels of satisfaction. To counteract retraction and scarring after removal, some men engage in an elaborate penile rehab regimen. Mick (his middle name) wanted a bigger penis because he believed it would allow him to look in the mirror and feel satisfied. Patients and clinicians alike must carefully weigh the benefits against limitations, prioritizing safety and informed decision-making in pursuing penile augmentation. Emerging technologies in tissue engineering and innovative implants offer hope for safer, more effective options in the future. Cosmetic penile enhancement surgery: a 3-year single-centre retrospective clinical evaluation of 355 cases The average erect girth, or circumference, measured at the widest point, is about 11.66 centimeters (4.59 inches). A large 2015 systematic review, based on measurements taken by healthcare professionals, established the average erect length as approximately 13.12 centimeters (5.17 inches). The men who see the best penis growth results maintain realistic expectations, follow proper techniques, and prioritize their overall wellbeing. Clinical Trials and Studies Sexual satisfaction depends far more on communication, technique, and emotional connection than size. A comprehensive 2015 study found that 85% of women were perfectly satisfied with their partner's penis size. What about judging a man's erect size by his flaccid penis? Penile Length, Girth & Glans Non-Surgical An FBI agent in his early 30s said that he was afraid he would never date again, let alone start a family, because his penis had shrunk to a stub. “This is a tiny smear of people, and they are fucking cutthroat,” one high-volume implanter told me of the intellectual property dispute. Later that year, when Elist discovered that Wang was listed as the Augmenta CEO and had assisted the penile startup with its cadaver studies, Elist and his company added Wang as a party to the suit. Yet, after biological explanations for impotence triumphed and urologists wrested the penis away from the psychoanalysts, they seemed to overlook the man and the society to which it was attached. Men using the Andropenis traction device for 6 hours daily over 4 months gained an average of 1.7 centimeters (about 2/3 of an inch) in length. Clinical studies show modest but measurable penis growth results. These devices work by applying gentle, consistent stretching force to the penis for extended periods. The cosmetic phalloplasty candidate is a healthy and potent man with no congenital or acquired abnormalities or urogenital diseases. The circumference of the penis was measured at rest at mid-shaft. Measurement was always performed in the same room, by the same operator and using the same flexible measure after a brief introductory interview, performed to put the patient at ease. Complications, Risks, and Limitations in Penis Enlargement Procedures The one time they tried to have sex, she told me, the corners of his implant felt like “someone sticking a butter knife inside you.” Richard Hague Jr., a 74-year-old pastor at a Baptist church in Niagara Falls, said his implant made him feel like “a wild stallion.” Contented customers told me they were feeling better about their bodies and having better sex, too. Kaelan Strouse, a 35-year-old life coach, was thrilled by both the “restaurant-size pepper mill” between his legs and the kilts he began wearing to accommodate it. “It makes you look like you’re always semi-erect,” a health-spa vice president said of his Penuma. A truck driver whose device dug into his pubic bone told me that he felt like a “prisoner in my own body.” An executive at an adhesive company, who hid his newly bulging crotch behind a shopping bag when walking the dog, began to have nightmares in which he castrated himself. Importantly, the integration of psychological assessment ensures that men's mental health is safeguarded throughout the process.The necessity for repeat procedures and the possibility of long-term health effects are significant disadvantages.For patients underwent fat grafting, a total of ml of fat was injected for penis enlargement.The risks linked to penile girth and length enhancement differ depending on the chosen method.The availability of regulatory data per defined population would be essential not only for diagnostic and therapeutic purposes, but also to reassure patients who display feelings of inadequacy1,7,9,10 and to manufacture correctly sized prophylactics11.It was also, as far as Mick could tell, the only genital enhancement on the market to have received the blessing of the Food and Drug Administration.Augmenta’s team endeavored to put the safety record of the Penuma on trial, securing Elist’s confirmation in a deposition that 20% of the patients in his 2018 study had reported at least one adverse post-surgical event. The HA and PLA groups both saw their penises get thicker12. They checked if penises got thicker at 6 months, aiming for less than a 0.42 cm drop11. Researchers studied HA and PLA in men aged 20 to 66 wanting a bigger penis11. Our before and after gallery showcases real results from patients who have chosen penis enlargement surgery at Moorgate Andrology.Detailed clinical evidence includes findings on surgical and nonsurgical methods, documented in peer-reviewed journal on sexual medicine and comprehensive reviews of penile enhancement techniques and patient satisfaction.Soon afterward, the pandemic began fueling a boom in the male augmentation market — a development its pioneers attribute to an uptick in porn consumption, work-from-home policies that let patients recover in private and important refinements of technique.The previous year, Cornell had asked to learn about the Penuma “expeditiously,” saying that he saw a “real opportunity to expand the level of service” he offered to patients.It's worth noting that no major medical organization endorses penis surgery purely for cosmetic reasons.Ongoing research is essential to establish rigorous clinical guidelines that define the safety, efficacy, and standardized protocols for both surgical and nonsurgical modalities.Excess weight, especially in the pubic region, may visually reduce penis length. Beyond measurable improvements, patients frequently describe heightened self-confidence and greater sexual satisfaction. Reliable clinical guidelines for penile girth augmentation are largely lacking, and many procedures remain experimental. Psychological distress often underlies the desire for enlargement, making comprehensive psychological evaluation vital to ensure patients benefit mentally and physically from treatments. Many men seeking penile enhancement suffer from penile dysmorphophobic disorder (a subtype of body dysmorphic disorder), which complicates realistic expectations and can lead to dissatisfaction. This suggests that improvements tend to be specific to body image and sexual confidence rather than comprehensive mental health changes, indicating the need for holistic psychological support alongside physical treatments. This ensures realistic expectations, reduces dissatisfaction, and improves long-term patient contentment with penile enlargement interventions. The overall success of these procedures depends not just on surgical results but also on addressing underlying psychological needs. For example, patients with higher BMI, Peyronie’s disease, or a history of prostate surgery tend to report lower satisfaction. These procedures, however, come with higher risks, including penile deformity, scarring, sexual dysfunction, and paradoxical shortening in some cases. PMMA, a semi-permanent filler, has shown sustained girth increases over years with high patient satisfaction. These findings confirm polylactic acid injections provide durable effects, appealing to those seeking nonsurgical options5. There are both surgical and nonsurgical options available. However, before considering these options, it's crucial to check for signs of body dysmorphic disorder (BDD). Clinics worldwide report higher numbers of men seeking either surgical or nonsurgical enhancement procedures, influenced by cultural pressures and personal concerns.He had two holes, and the skin between them eventually eroded so that a corner of the implant emerged, pearlescent.He was referring to the “momentous discovery which little girls are destined to make” about their lack of a phallus, but his description more precisely captures the “penis envy” that some men told me they’d felt after catching a glimpse of the competition.What about judging a man's erect size by his flaccid penis?Hyaluronic acid injections are gaining popularity for nonsurgical penile enhancement.These technologies promise more precise, customizable, and safer solutions for patients seeking penile enhancement.A young Iraq War veteran whom Jackson met through PhalloBoards warned him that having the implant out could be even worse than having it in.A study looked at how well hyaluronic acid (HA) and polylactic acid (PLA) work for making the penis larger.The future of penile girth and length enhancement is moving towards an integration of advanced medical techniques and comprehensive psychological care.In this episode, Dr. Rena Malik, MD explores the evidence-based ways to increase penile length. Not every man starts with the same penis size and same health conditions at birth. The following year, Bryan ended up flying to Philadelphia for the first in a series of revision and enhancement procedures with Solomon, whom he’d learned about on PhalloBoards. Elist said through his attorney that innovative procedures like his are routinely reviewed by regulators; that many specifics in the complaint are false; and that a previous medical board complaint against him was resolved in 2019, when he agreed to improve his recordkeeping. Alleging gross negligence and incompetence, the board accused Elist of, among other lapses, recommending that patients treat what appeared to be post-op infections with Neosporin, aloe vera and a bloodflow ointment; asking them to remove their own sutures; and deterring them from seeking outside medical care. Since Mick had filed his complaint, the California medical board had investigated the surgeon’s treatment of 10 other Penuma patients, including the contest winner Emmanuel Jackson and other men I interviewed. This underreporting can obscure the true frequency of adverse events and hinder the establishment of safety protocols, as discussed in the Penile enhancement controversy and complications review.Jackson didn’t find the other men online until 2018, around the time a doctor at the Cleveland Clinic told him his implant had fractured into pieces that were floating under his skin.While surgery can offer permanent structural changes, non-surgical options such as injectables tend to provide temporary or semi-permanent effects, requiring repeat procedures for maintenance.The majority of men who call Morganstern Medical are seeking a 1-2 inch or 2.54 cm to 5.08 cm increase in width or length or both.Elist’s first big catch was Steven Wilson, formerly a professor of urology at the University of Arkansas, who, until his apparent unseating by Paul Perito, a spirited upstart in Miami, was feted as the highest volume implanter in the country.Despite carefully planning the explantation, Walsh found himself disconcerted in surgery by the sight of his patient’s erogenous zone ensnared by the patch of plastic. Tissue engineering approaches using biodegradable scaffolds have reported girth gains of up to 4 centimeters, with low complication rates, proving promising in early trials. Tissue engineering strategies, involving biodegradable scaffolds, have demonstrated girth expansions of 1.9 to 4.1 centimeters. Partners' Satisfaction with Orgasm increased most. In the operation, silicone pears were connected to form a ring-shaped implant, which was then implanted under the dartos fascia. (“Our Tom Brady,” Yafi said of Wilson, admiringly.) Wilson, a paid consultant for Elist’s company, helped vet skilled surgeons around the country who could be trained to perform the Penuma procedure. Elist’s first big catch was Steven Wilson, formerly a professor of urology at the University of Arkansas, who, until his apparent unseating by Paul Perito, a spirited upstart in Miami, was feted as the highest volume implanter in the country. “It’s all about who has the biggest whatever and who has the bigger numbers,” Faysal Yafi, the director of Men’s Health at the University of California, Irvine, and himself a high-volume implanter, explained. Still, by 2014, the doctor was averaging barely 100 implant surgeries a year. Consistent, long-term use of VEDs is sometimes medically prescribed for erectile dysfunction or rehabilitation after prostate surgery, but not for cosmetic enlargement. While they temporarily increase the appearance of size due to swelling, they do not lead to permanent changes in length or girth. Maintaining a healthy weight makes a difference too – excess fat in the pubic area can hide up to an inch of penis length! No oral medication or topical cream has been scientifically proven to permanently increase penis size. Trimming pubic hair and maintaining a healthy weight can make your penis appear longer without any medical intervention. Despite growing demand, the field is marked by considerable variability in success rates, complications, and patient satisfaction. Penis enlargement remains a controversial yet sought-after medical and cosmetic practice worldwide. Therefore, pearls implantation is possible to enhanced sexual experiences both for man and their partners. Lately, skin fillers like hyaluronic acid (HA) injections have become a popular way to look better without surgery.Similarly, penile-extender devices used consistently over several months can increase flaccid length by approximately 1.7 cm to 2 cm.Peyronie’s disease leads to the formation of scar tissue inside the penis, resulting in curvature, pain, and often shortening.Morganstern’s Instant Penis Enhancement is the simple, low health risk and affordable opportunity for men to achieve a larger penis.(Elist said in a deposition that upgrades are “part of the process of the procedure,” noting that some patients “might need the upgrade with the larger implant or the longer implant, and that happens often.”) Faced with the prospect of more surgery, some men began, quietly, to seek other advice.As one pleased Elist patient counseled others, “You have to treat your penis like a Rolex.”This shows how important it is to check mental health in these situations.Dr. Mike O’Leary, MD, MPH says most men believe that bigger is better and would prefer a larger size for performance and confidence.There, he joined the vanguard of physicians who were treating impotence with a suite of novel procedures, such as injections and inflatable penile prostheses. Mechanical extenders require patient compliance and can cause discomfort or skin irritation. However, complications can occur, especially with injectables if performed outside licensed medical settings. Once a seemingly stable mixture was obtained, the syringes of crudely purified fat underwent centrifugation for two minutes at 1000 rpm. Each syringe was filled with fat again and each time the infiltration material was removed, repeating the decantation by sedimentation process many times. In our surgical centre we first performed the decantation through sedimentation of each 10 cc syringe in such a way as to put the harvested material through an initial process of purification. A nurse unwrapped an Extra Large implant from its box and handed it to Elist, who used curved scissors to smooth its top corners. Then, in a stage known as “degloving,” he began to flip the penis inside out through the hole he’d created at its base. The surgery, which Elist said was supposed to take approximately 35 minutes, lasted twice as long. “This procedure is like any other procedure,” he told me. “It has its own evolution.” Here's something many don't realize – many men seeking enlargement actually have perfectly normal-sized penises. When considering your options, non-surgical methods can produce modest penis growth results with fewer risks, but they require consistent, long-term use. It's worth noting that no major medical organization endorses penis surgery purely for cosmetic reasons. Multiple scientific studies have found zero relationship between foot size and penis length. You've probably heard that shoe size correlates with penis size. The internet is swimming with misinformation about penis enlargement. Other surgical methods, including fat grafting and skin flaps, have shown increases ranging from 1.4 to over 5 centimeters, often with acceptable complication profiles. Similarly, implant-based techniques like Penuma® implants typically result in a girth increase of around 2 to 4 centimeters, with reported satisfaction rates up to 81%. Injectable procedures, such as hyaluronic acid, polylactic acid, and PMMA, generally lead to girth increases between 2.3 to 3.8 centimeters. This integration aims to optimize not only the physical improvements in penile size but also enhance psychological well-being and quality of life for patients (Increasing penile length and girth). Clinics specializing in penile enhancement, like Moorgate Andrology and others, report positive patient feedback highlighting natural results and satisfaction with the safety and effectiveness of procedures. Clinical data and patient testimonials often cite length increases ranging from 2.5 to 5 cm, with similar gains in girth achieved through methods such as surgical ligament release and autologous fat transfer. This boost in confidence reflects the significance of perceived improvements in penile size on individuals' overall self-esteem. Corporoplastic phalloplasty with vein grafts is another surgical method that uses grafts to enhance girth. Other specialized approaches include the FDA-approved Penuma implant, a silicone device wrapped around the dorsal shaft to augment girth with structural support. Patients typically undergo this minor surgery on an outpatient basis and return home the same day. About half of the men receiving nonsurgical penile girth augmentation report increased self-confidence and greater sexual pleasure post-procedure. The fat harvested from the patient is implanted into the subdartoic space with the objective to symmetrically and uniformly increase the circumference of the penis29. Discomfort over genital size can influence satisfaction and man’s sexual function and push him to look for surgical and non-surgical solutions for penis alteration. Men’s satisfaction and sexual function is influenced by discomfort over genital size which leads to seek surgical and non-surgical solutions for penis alteration. The spokesperson said Elist was not aware of any patients suffering extreme dissatisfaction or sleeplessness or mental health crises as a result of Penuma surgery, and noted that complications were more likely when patients failed to comply with post-op instructions. Sections of his website and of a book he self-published in 2015, “A Matter of Size,” are devoted to chronicling the macabre complications that can result from skin grafts and fat injections to the penis. “How do you allow yourself to put something on the patient’s body that you know gets infected? Elist has always been keen to distance himself from other purveyors of controversial penile enhancement techniques — “gimmick” surgeons, he has called them. Elist cauterized more tissue by the pubic bone to make sure the implant would fit there, and at this the patient’s breaths rose into a moan. His paintings often depicted a human body glowing, as if transfigured, in a geometric landscape. None of Mick’s romantic partners ever commented on his size, but his preoccupation had a way of short-circuiting the mood. He had trouble imagining what shape the satisfaction would take, since it was something he’d never actually experienced. Seeking counseling from a mental health professional is safer and more effective than pursuing risky physical alterations. This psychological condition is often related to Penile Dysmorphic Disorder (PDD), a specific manifestation of Body Dysmorphic Disorder. Vacuum erection devices (VEDs), or penis pumps, create a vacuum around the penis, drawing blood into the shaft to induce an erection. These products are often unregulated and may contain ingredients that pose a health risk without offering lasting benefits. Many products marketed for enlargement, such as pills, supplements, and creams, lack scientific evidence to support claims of permanent growth. Having invested so much, financially and psychologically, in the implant, Mick felt grateful for the doctor’s assurances and tried to focus on his paintings, producing several large acrylic canvases in which forlorn human figures appeared to be tossed about by waves. During a call in January 2020, four months after Mick’s Penuma surgery, Elist told him that the sensation in his penis would return in time. “What can we do to keep patients out of the hands of these charlatans? The fringe penoplasty fads of the ’90s — primitive fat injections, cadaver-skin grafts — had now been surpassed not just by implants but by injectable fillers. Soon afterward, the pandemic began fueling a boom in the male augmentation market — a development its pioneers attribute to an uptick in porn consumption, work-from-home policies that let patients recover in private and important refinements of technique. In all cases we found that the measurements were coherent with the morphometric values of reference of adult men according to Wessels and Ponchietti9,12 and this information was shared with the patients. The length of the penis is defined as the linear distance along the dorsal side of the penis between the pubo-penile junction and the tip of the glans, either in the flaccid or stretched states. The 5-item International Index of Erectile Function (IIEF-5) is a validated diagnostic test that we administered to all the patients included in this study. Penis size is an anthropometric measurement12 and is correlated to anthropometric measurements such as height, weight and body mass index (BMI)12,13. It is possible to permanently increase penile size using medical procedures. Penis enlargement procedures present a complex interplay of measurable success, potential complications, and psychological factors shaping patient demand and satisfaction. Yes, achieving a permanent increase in penis size is possible primarily through surgical procedures. Both non-surgical and surgical methods show real, lasting results with improvements not only in penile size but also in men's self-confidence and sexual satisfaction. (Solomon now notes his expertise in treating complications from “penis enlargement implants” instead.) A sign in Elist’s waiting room instructed patients not to speak to one another about medical issues (the better to protect their privacy, Elist said through the spokesperson). They could cede the augmentation market to quacks and overconfident plastic surgeons, or they could embrace their vocation as the so-called champions of the penis, and in their hygienic, well-lit clinics provide patients with what they’d been asking for and might otherwise find an unsafe way to secure. Dr. Taş confirms that penis enlargement surgery is an option for eligible men.About half of the men receiving nonsurgical penile girth augmentation report increased self-confidence and greater sexual pleasure post-procedure.When erect, the average length increases to 5.16 inches (13.12 cm) with a circumference of 4.59 inches (11.66 cm).In the operation, silicone pears were connected to form a ring-shaped implant, which was then implanted under the dartos fascia.Tissue engineering strategies, involving biodegradable scaffolds, have demonstrated girth expansions of 1.9 to 4.1 centimeters.This was followed by a complete section of the suspensory ligament of the penis, taking care to adequately section the lateral ligaments as well.Use consistent measurement techniques in both flaccid and erect states, documenting length, girth, and overall volume.They produce immediate, temporary increases in both length and girth that typically last several hours.For example, patients with higher BMI, Peyronie’s disease, or a history of prostate surgery tend to report lower satisfaction. Hyaluronic acid fillers offer temporary girth gains but can result in migration, palpable nodules, or disfigurement, requiring further corrective procedures. Fat grafting involves harvesting fat from another area of the body and injecting it beneath the penile skin. Division of the ligament may necessitate additional procedures to stabilize the penis and prevent retraction. Lengthening procedures typically involve cutting the suspensory ligament, which connects the base of the penis to the pubic bone. What surgeons continually emphasized — the implanters with pride, the explanters with dismay — was that most of the men they were seeing had been of at least average size before going under the knife. But, especially in the case of men with an unrealistic self-image, the critics worried that doctors seemed too eager to pitch a risky surgical procedure for what is a cultural, and, in some instances, a psychiatric, phenomenon. It has been hypothesized that a longer penis confers an evolutionary edge in launching the reproductive payload into the vaginal canal. The penis diameter, penis appearance score (PAS) and treatment satisfaction scale (TSS) were evaluated. Preoperative and 6-month postoperative data of patients and their partners were collected. While the market is flooded with misleading products, scientifically backed methods and expert medical care remain the safest and most effective approach. It’s crucial to understand that these procedures are cosmetic and not covered by insurance. HA showed good results and made patients happier and more confident in their sex lives13. Teaching about normal sizes and improving self-image can lessen the bad feelings around penis size8910. Small penis syndrome (SPS) isn't about actual size but feeling not good enough. Men who think their penis is smaller than it should be may have more body dysmorphic disorder (BDD)8. It's tied to depression and anxiety, making men's body image and mental health worse. PENIS ENLARGEMENTS FOR OPTIMAL PENILE AUGMENTATION Founded by health enthusiasts, we’re a community focused on well-being, with expert guidance from Joshua Johnson.A surgical technician had covered the patient’s body in sheets until only his penis, gleaming beneath the overhead lamp, was visible.(Elist’s spokesperson said Jackson volunteered his positive comments in the video, and Master P, who once featured Elist on his Playboy Radio show, said through his own spokesperson that he was not involved with any YouTube testimonials for the implant.)While they temporarily increase the appearance of size due to swelling, they do not lead to permanent changes in length or girth.Another choice for penile enlargement is polylactic acid injections.Surgery provides permanent changes in both length and girth. Multiple patients who said they’d turned to Elist for a functional issue alleged that they’d been upsold enhancement procedures that resulted in their disfigurement. (Elist said in a deposition that upgrades are “part of the process of the procedure,” noting that some patients “might need the upgrade with the larger implant or the longer implant, and that happens often.”) Faced with the prospect of more surgery, some men began, quietly, to seek other advice. This increase is largely driven by psychological and societal factors, with many men seeking enhancement even when their penis size is within the normal range. Furthermore, procedures often do not meet patient expectations, with many men experiencing dissatisfaction regarding size gains or aesthetic outcomes. All methods and procedures were carried out in accordance with the principles contained in the Declaration of Helsinki. The availability of regulatory data per defined population would be essential not only for diagnostic and therapeutic purposes, but also to reassure patients who display feelings of inadequacy1,7,9,10 and to manufacture correctly sized prophylactics11. Male genital image is correlated, albeit not in a necessarily linear manner1, to overall body image, psychosocial variables and sexual health2; in turn, sexual health is correlated to genital image3. Provides impressive increase in penis girth with FDA-approved filler injections. In the paperwork Mick had initialed on the day of the surgery, a clause said, “The clinic highly discourages seeking information elsewhere as the information provided can be false, misleading, and inaccurate.” One day, though, Mick opened Google and searched “Elist,” “Penuma,” “numb.” But the numbness of his penis reminded him of having a limb fall asleep, indefinitely. For the Penuma procedure, which is not covered by insurance, that same surgeon can pocket six times as much. Inserting an inflatable penile prosthesis to treat erectile dysfunction brings a surgeon around $800. He displayed a slide highlighting an ad by Victor Loria, an osteopath and erstwhile hair transplant specialist headquartered in Miami, whose permanent penile filler injections were on sale for $14,950. While fillers can produce visible girth improvement, they do not increase length. Of all Moorgate Patients about 90% will choose length and girth surgery at the same time, for the best results. Our Mens before and after photos shows real patient results, helping men see what is possible with surgery or fillers. A blunt-tip cannula 2 mm in diameter was used for the implantation.During a call in January 2020, four months after Mick’s Penuma surgery, Elist told him that the sensation in his penis would return in time.The one time they tried to have sex, she told me, the corners of his implant felt like “someone sticking a butter knife inside you.”The following year, Bryan ended up flying to Philadelphia for the first in a series of revision and enhancement procedures with Solomon, whom he’d learned about on PhalloBoards.The penile tissue, primarily composed of erectile chambers and fibrous tissue, does not respond to topical creams or oral supplements by increasing in size.“It’s been 70 days since surgery and yet it feels like a shrimp,” he wrote in November. More people are trusting these non-surgical procedures to safely improve their looks. They also make us question how well penis enlargement methods work. Individuals with PDD experience intense distress over a perceived flaw in their penile size or appearance, even when it is medically normal. For many men seeking enlargement, the preoccupation with size relates to a distorted perception of their own body, not objective measurement. For patients underwent fat grafting, a total of ml of fat was injected for penis enlargement. For men with PDD, surgical procedures are likely to result in dissatisfaction, as physical change rarely resolves the underlying psychological distress. Our before and after gallery showcases real results from patients who have chosen penis enlargement surgery at Moorgate Andrology. Its a great help to new patients to see just what possible either with length and girth surgery, penis lengthening surgery or penis thickening surgery. When erect, the average length increases to 5.16 inches (13.12 cm) with a circumference of 4.59 inches (11.66 cm). The average flaccid (non-erect) penis measures about 3.61 inches (9.16 cm) in length with a circumference of 3.67 inches (9.31 cm). Interestingly, only 55% of men felt satisfied with their own size—highlighting how many of us are unnecessarily hard on ourselves. Perhaps most reassuring is what research tells us about partner satisfaction. This rare condition affects only about 1.5 in 10,000 male births in North America and typically requires medical intervention during childhood. Importantly, the integration of psychological assessment ensures that men's mental health is safeguarded throughout the process. Minimally invasive surgical advancements reduce recovery times and complications, while techniques like fat grafting and injectable fillers continue to evolve with better safety profiles. For additional surgical option details consult resources about the Penuma implant, Penuma implant, Penuma implant, Penuma implant, and Penuma implant. The current methods of fat transfer were popularised and extensively described by Sydney Coleman18,41,42 who in 1986 began to transplant fat in iatrogenic deformities from liposuction and subsequently in the face.He said he’d experienced complications and, in 2011, he’d had his second implant removed.More serious issues include tissue necrosis, autoamputation, and sexual dysfunction, resulting from damage or adverse reactions to the intervention.Many products marketed for enlargement, such as pills, supplements, and creams, lack scientific evidence to support claims of permanent growth.Emerging innovations like tissue engineering, biodegradable scaffolds, and improved implant technologies such as the Penuma implant offer potential for safer and more effective augmentation with natural results.The challenge of removing a Penuma, Walsh told Mick, can lie in the detachment of a rectangular piece of mesh from the tip of the penis.A nurse unwrapped an Extra Large implant from its box and handed it to Elist, who used curved scissors to smooth its top corners. Stretched length significantly increased at 2 (14.02 ± 0.07), 6 (13.7 ± 0.08) and 12 (13.5 ± 0.09) months, compared to baseline (12.4 ± 0.06) (all p 2B). The quantity to be implanted varied considerably depending on the space to be filled, also considering that 30% of the implant would be resorbed within the first/second month. A blunt-tip cannula 2 mm in diameter was used for the implantation. Two mini-incisions of about 4 mm were made close to the pubo-penile junction at 10 o’clock and 2 o’clock respectively. In particular, the patient was urged to abstain from intense physical activity for 30 days and from sexual and masturbatory activity for 60 days. The patient was discharged that evening with directions for medical therapy at home and adequately informed of the recovery period. In fact, statistically at least 30 days are needed for the implant to be consolidated and the fat integrated and it is useful to limit the movement of the fat during this period using the elastic bandage. We delve into various methods—ranging from injectable fillers and penile extenders to advanced surgeries—to present a comprehensive picture of what men can expect from these transformative procedures. In addition, we describe in detail inclusion and exclusion criteria for patient selection and technical aspects of our surgical procedure which ensure reproducibility of our findings and should be adopted in future clinical studies of cosmetic phalloplasty. In Italy, there is no validated test for the measurement of patients’ satisfaction in cosmetic penoplasty and the absence of a measurement of patients’ satisfaction is also a limitation of our study. Patients who undergo combined elongation and girth enhancement phalloplasty are particularly satisfied compared to those who undergo a single operation which is probably linked to the availability of an overall greater penile volume40. Also, while 55% of men are okay with their size, the rest still feel unsure4. This idea has made many men interested in making their penises look better. People believe that being bigger means better sexual skills and more confidence. Erect penis lengths went from 4.8 inches to 6 inches in a study of 55,761 men1. In order to avoid post-surgical scar retraction of the ligament, inverse periosteal-fascial sutures were used. This was followed by a complete section of the suspensory ligament of the penis, taking care to adequately section the lateral ligaments as well. The suprapubic area was incised using the inverted V technique (V-Y Plasty), which is more preferable than the Z technique or other techniques since it guarantees a better aesthetic result16 and is widely used in plastic surgery (Fig. 1). Reducing the time and the number of rpms, with respect to the original Coleman’s technique which involves centrifugation for 3 minutes at 3000 rpm, the integrity of the adipose globules, whose integrity is in turn responsible for the good integration of the fat, was safeguarded. In February, the rapper 50 Cent settled his claims against the Shade Room, a gossip blog he’d sued for falsely insinuating that he’d had work done on his penis and subjecting him “to ridicule.” Only six of the 49 enlargement patients I spoke to agreed to have their last names printed, also fearing ridicule. Despite the FDA imprimatur, persuading men to get the implant was a challenge, even after one of his patients, Bryan, a 20-something with biceps the size of porterhouse steaks, began modeling it for prospective customers. As evidence accumulates, we can expect a shift toward materials and procedures that minimize risks while maximizing patient satisfaction and functional outcomes. A true medical condition known as micro-penis is defined by an erect length of less than 7.5 centimeters (under 3 inches). Flaccid length is a poor predictor of erect size, as many smaller flaccid penises expand significantly upon erection. While concerns about size are widespread, most men seeking intervention fall within the normal range of penile dimensions. The device, called the Penuma, had been invented by James Elist — a silver-haired urologist who has been described on TMZ as “the Thomas Edison of penis surgery.” Elist’s procedure was touted as reversible, and, according to a rapturous article in GQ, more than a thousand men had already undergone it. Novel implant options like Penuma® silicone devices are providing effective cosmetic enhancements with reported median girth gains between 2.0 and 4.0 cm. In conclusion, the global demand for penis enlargement is on the rise, driven by complex social and psychological factors, with a variety of techniques available to meet this growing interest. Studies indicate that psychiatric comorbidities, including distress or body image concerns, can adversely affect satisfaction rates. Patients with untreated psychiatric conditions may have overly unrealistic expectations or may be more prone to dissatisfaction, regardless of surgical outcomes. However, preoperative mental health plays a crucial role in predicting postoperative satisfaction. Many men seek these surgeries driven by self-esteem issues, societal pressures, or dissatisfaction with their perceived size. In a previous study, the post-surgical use of extensors, for at least three consecutive months, resulted in an increase of length of no more than 1.3 cm40. Evidence shows cases of apparent hypoplasia distinguishing it from (a) “hidden” penis, secondary to the presence of abdominal fat or the cutaneous relaxation of the abdomen28 and (b) a “buried” penis where the penis shaft is beneath the suprapubic skin as a result of obesity and/or radical circumcision29. The baseline characteristics of the patients are summarized in Table 5. Medical professionals define a micropenis as being 2.5 standard deviations below the average stretched length, which translates to approximately 3 inches (7.5 cm) when erect. Your genetic makeup and hormonal factors—especially testosterone levels during puberty—largely determine penis development. These figures provide a reliable baseline for understanding normal size. When exploring penis growth results, it's crucial to separate scientific facts from marketing hype. My experience has taught me that realistic expectations, consistent application, and evidence-based approaches are key to satisfaction in this personal journey.