Penis Enlargement Options and If They Work

There are various options if you are interested in penis enlargement. These range from supplements, vacuum pumps, and traction devices to injectable fillers, surgeries, and penile implants. Whether or not penis enlargement works, and whether it is safe and worth the price, depends on which of these you use and why.

For example, some people seek penis enlargement simply because they would prefer a larger penis. Others may do so because they have a medical condition that affects the shape or function of the penis. Their outcomes may be different even if they use the same method.

This article explores the various reasons people pursue penis enlargement and the different techniques used, some of which can be performed at home and others which require specialist treatment. It also weighs the benefits and risks, as well as how effective—or ineffective—the various options are.

Reasons for Seeking Penis Enlargement

There are many reasons why a person might seek penile augmentation. There may be medical, such as problems with fertility or the ability to urinate, and/or psychological reasons that directly impact a person's self-esteem or quality of life.

Physical Reasons

In some cases, a person's penis might be genuinely smaller due to a genetic or hormonal disorder that causes micropenis. Micropenis is defined as a stretched penis length of under 3 inches.

Having a penis this size may interfere with a person's ability to direct a urine stream. It can also make sexual intercourse difficult and decrease the odds of conceiving.

There are other conditions associated with reduced penis size:

• Microphallus: Microphallus is an abnormally small penis accompanied by hypospadias (a congenital defect in which urine exits on the underside of the penis).
• Peyronie's disease: Peyronie's disease is a condition in which the penis will suddenly develop an abnormal curve. Fibrosis (scarring) at the site of the bend can cause the shortening and narrowing of the penis, along with painful erections or erectile dysfunction.
• Prostate cancer surgery: Studies suggest that radical prostatectomy (in which the entire prostate and surrounding tissues are removed) can also reduce penis size by an average of 16%.
• Buried penis: "Buried penis" is a term used when a penis is concealed within excess pelvis fat. It is common in prepubescent boys who have obesity, many of whom have normal-sized penises and will eventually outgrow the condition.

Psychological Reasons

Other people seek penis enlargement out of the belief that they are "smaller than average." Many of these individuals fail to realize that the typical erect penis is around 5 to 6 inches long with a circumference of 4 to 5 inches.

There are even some people with above-average penises who have an abnormal preoccupation with their penis size. When the preoccupation interferes with their quality of life, it is typically diagnosed as penile dysmorphic disorder (PDD). It is a condition that may benefit more from psychological counseling than penile enlargement.

According to a 2019 review in Sexual Medicine Review, counseling was effective for the majority of people who felt inferior about their penis size, with most coming to understand that their penis size was normal and in no need of augmentation.

If you think that your penis is too small, be sure to measure it accurately. Even if it is shorter than average, it's important to place the size of your penis in context and ask yourself why it is causing you such distress. It sometimes helps to speak with a psychologist who can help you sort through your feelings and provide the perspective you need.

If you decide to pursue penile augmentation, meet with a specialist known as a urologist to discuss the benefits and risks of the procedure. Ask about the response rate and possible complications. If you're concerned about infertility, speak with a fertility specialist first to get an accurate picture of your sperm count and sperm motility.

Home Remedies and Lifestyle

There are numerous websites that recommend penis exercises to increase the length or girth of the penis. The rationale behind penis enlargement exercises is that repetitively rubbing the penis creates "micro-tears" in tissues that make the penis seem bigger or thicker when healed.

There is one popular technique called jelqing in which the thumb and forefinger are wrapped around the penis to repetitively stretch the shaft from the base to the tip for 20 minutes every day.

If you want to enhance the appearance of your penis because it makes you feel more confident, there are simpler ways to do so:

• Lose weight: If you are overweight, those extra pounds can make your penis appear smaller. Losing weight reduces pelvic fat and allows more of the penis to be seen.
• Get in shape: A muscular physique may add to this visual effect and make you feel more confident about the size of your penis.
• Groom your pubic area: Shaving around the penis (referred to as "manscaping") can make the penis appear larger since it is no longer buried in hair.
  

Over-the-Counter (OTC) Therapies

There are several options advertised to people who are dissatisfied with the size of their penis. While these may be tempting, don't be misled by false claims. Speak with a urologist for insights on what may work for you and what won't.

Penis Enlargement Supplements

There are many companies that claim their supplements can enhance penis size. At best, they will do nothing more than waste your money. At worst, they may contain traces of Viagra (sildenafil) or other drugs dangerous to individuals with heart disease.

Supplements like L-citrulline or L-arginine are said to increase nitric oxide levels in the blood, which may improve circulation to the penis. Although some people claim this helps improve erections, there is no evidence that doing so increases penis size.

Penile Traction

While there has never been an FDA-approved device for a penile extension, there has been growing interest in products that may help increase penis length using traction. With penile traction, a weighted device is connected to the shaft of the penis and worn for a specific amount of time each day to gradually stretch the penis.

Penile Clamps and Rings

These devices marketed for penis enlargement wrap around the shaft and provide a gentle squeezing pressure to "stretch out" the penis. Some are suggested for use during an erection, while others are used while the penis is flaccid.

There is no evidence that wrapping anything around the penis will lengthen it. In fact, this can cut off the blood flow, causing bruising, hematomas, and nerve damage.

Topical Penis Enlargement Treatments

Lotions, creams, and oils advertised as being able to increase penis size by being applied directly to the organ often contain hormones, vasodilating medications that increase blood flow, and essential oils said to promote cell proliferation.

There is no evidence that any of these works; some may even cause skin irritation or allergy.

Penis Vacuums and Pumps

Penis pumps and vacuums are popularly used as sexual aids to promote erections in men. They are also used by some with the intent of increasing penis size. These devices are placed over the penis (and sometimes the scrotum) and use suction to engorge the penis with blood.

If used consistently over a long period of time, they can cause the skin of the penis to become "spongy" and have a thicker appearance. Despite their popularity, there is no evidence that vacuums or pumps can increase the length of a penis.

Vacuum pumps can cause injury if the suction is too extreme or the device is worn for too long. Urethra bleeding and bruising can occur as superficial veins in the penis are ruptured. This can reduce penis sensitivity and impair erections.

Penis Enlargement Procedures

Some people with penises seek the injection of natural and synthetic fillers to increase the girth of the penis. Others seek surgery if a smaller penis size or penile abnormality is interfering with the ability to urinate.

Small penis size usually is not an indication for surgery to treat infertility. In such cases, assisted fertility procedures may be the better option.

Penile Injections

Penile injections have been around since the early 1900s, often performed by non-medical professionals and often with disastrous results. In recent years, three injectables have been used by aesthetic physicians to increase penile girth, each of which has its pros and cons:

• Autologous fat injections involve the extraction of fat via liposuction, which is then injected along the shaft of the penis. While safe, much of the injected fat is reabsorbed. Injecting too much fat can cause uneven absorption, leading to an abnormal shape of the penis.
• Hyaluronic injections involve a naturally occurring, gooey compound known as hyaluronic acid (HA). While effective, it takes a high level of skill to inject HA evenly. As with autologous fat, HA can be reabsorbed by the body, albeit at a slower rate. A loss of penis sensitivity is not uncommon among individuals who undergo this procedure.
• Polymethylmethacrylate microspheres are a newer product made with tiny acrylic spheres. While longer-lasting than hyaluronic acid (with some results lasting up to seven years), polymethylmethacrylate microsphere (PMMA) injections have a high rate of complications, including the formation of indentations, hard ridges, and nodules.

Some people have been known to self-inject synthetic materials, like silicone and paraffin, in an attempt to increase the girth of their penis. Practices like these are dangerous and can lead to infection, abscesses, induration (tissue hardening), tissue necrosis (death), and even penis loss.

Surgery to Enlarge the Penis

There are no FDA-approved surgical treatments for penis enlargement, but that has not stopped some people from aggressively seeking them. The construction, reconstruction, or modification of the penis is referred to as phalloplasty.

These are the most common:

• Free fat grafting (FFT) starts with the extraction of fatty tissue from the thighs of thin men, the lower abdomen of normal-weight men, or the pelvic area of overweight men. The tissues are centrifuged (spun at a high rate) to break up the cells and injected into the penis with a syringe or flexible tube called a cannula. This final step helps prevent the irregular clumping of fat cells. Because 20% to 80% of the fat cells will be reabsorbed by the body in the first year, multiple procedures may be needed.
• Dermal fat grafting (DFG) involves the extraction of a patch of skin from the patient's own body (usually the lower back, lower abdomen, or buttocks) along with a layer of fat. After the skin is removed from the penis, the extracted tissue is grafted in its place. Because the extracted skin is thicker, it will increase the circumference of the penis. By taking tissue from the patient's own body, the risk of rejection is low.
• V-Y plasty is a surgical technique in which the ligament that anchors the penis to the pelvic bone is severed, releasing the shaft of the penis and allowing it to extend forward. The procedure is so-named because it involves a triangular incision, the edges of which are sewn together in a "Y" shape. While effective at elongating the penis, it also makes the penis less stable when erect.
• Suprapubic lipectomy primarily is performed on overweight people for whom weight loss has not improved the appearance of a buried penis. Suprapubic lipectomy involves the removal of a squarish piece of skin from above the penis. The ends are sutured together, lifting the pelvic skin to expose the underlying penis. The procedure is relatively safe; the side effects are limited to postoperative pain, bleeding, or infection.
• Sliding elongation is sometimes used in those who have experienced a shortening of the penis due to Peyronie's disease. The procedure involves the temporary "degloving" of skin from the shaft of the penis. The scarred tissue surrounding the shaft is then severed, allowing the penis to straighten and lengthen. Although the surgery does not involve any grafting, nerve injury is possible.
• Penile disassembly is a more invasive form of sliding elongation surgery in which the degloved shaft is completely severed just below the head of the penis. The gap is then filled with a section of rib cartilage taken from the patient and reassembled by suturing the degloved tissues back into place. While less commonly used, the surgery can be effective for individuals with micropenis, congenital defects, or deformities resulting from penile cancer,
• Penile implants are generally reserved for individuals with erectile dysfunction as they do nothing to make the penis bigger. With that said, they are often used with V-Y plasty, sliding elongation, or penile disassembly to help stabilize the penis and increase girth.

Summary

Penile augmentation is often pursued by people who think that their penis is too small or have a medical condition that affects the penis size. This includes people with congenital disorders like micropenis or microphallus, who have experienced a loss of penis length due to surgery or Peyronie's disease, or have a "buried penis." Psychological reasons are often better addressed with counseling.

No home remedy, exercise, supplement, cream, or device has ever proven effective in significantly increasing penis size. Some devices, like vacuum pumps, may increase girth by creating scar tissue but can also permanently injure the penis if overused.

Specialist treatments used to increase penile girth include injectable fillers and fat-grafting surgery. Penile length may be increased with more invasive surgeries such as V-Y plasty and penile disassembly, although they come with significant risks.