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Penis Enlargement Surgery: Types, Risks and Rewards

Martin Miner, MD

Reviewed by Martin Miner, MD

Written by Geoffrey C. Whittaker

Published 10/08/2020

Updated 01/10/2024

Let’s be honest: when it comes to your performance, it’s totally normal to wonder about how you compare with other guys. And for men, few sex-related measurements are as important as penis size.

Anyone who finds out they’re on the low end instantly worries that their “small penis” must be the reason for so-so sexual activity — and might wonder if this problem can be solved by plastic surgery. 

Many guys would wish for a bigger penis if they happened across a magic lamp — especially a no-strings-attached instant increase.

Unfortunately, penile enhancement is much more difficult, expensive and painful in the real world, because it usually involves surgery.

A “normal” penis size is hard to pin down, but researchers at King’s College in London once found that the average penis size is 3.6 inches from the base of the penis at the pubic bone to its tip (when flaccid).

Going bigger is possible if you’re on the low end of the spectrum. There are several types of penis enlargement surgery available, including procedures that involve severing a ligament in your penis, prosthetic implants and even fat transfer surgery to add additional girth to your member.

Below, we’ve covered everything you need to know about penile augmentation surgery, from the most popular types of surgery available today to the scientific evidence to support each one, the typical recovery process and potential risks and complications.

We’ve also shared some other, non-surgical options that you may want to consider if you feel unhappy about your sexual performance.

Search online for cosmetic surgery procedures and you’ll find options for just about everything, from surgically reshaping your nose and chin to reducing the size of your waist and increasing definition in your abs. 

Penis enhancement surgery is any surgical form of dick enhancement that increases length or girth. Penile implants, fat or tissue grafting and the injection of dermal fillers similar to those used for enhancing the face and lips are all options. 

But we have to caution that all of the penis enlargement procedures that are available today are viewed as experimental, and most aren’t as widely accepted as other forms of cosmetic surgery.

Below, we’ve explained the forms of penis enlargement surgery that are currently available in more detail, including how each type of procedure works, its potential results and risks to be aware of. 

Penis Lengthening Surgery

In our opinion, penis lengthening surgery is the scariest, knife-iest option on the market. Also referred to as penile elongation surgery or suspensory ligament release, this technique involves surgery that carefully releases the ligament that attaches the penis to the middle of the pelvis, which makes your penis jut out further from your pelvis.

This creates the perception of a lengthier penis, as the penis looks more defined and separate from the body due to its lower angle.

Although relatively few scientific studies have been conducted on the effectiveness of this type of surgical procedure, the research that’s available suggests that it can increase the perceived length of the penis by around 2.5cm, or just under one inch.

While this might sound good, this type of procedure has some serious downsides. One of these is that it’s possible for the severed ligaments to “heal” and reattach to the penis. To prevent this, men who undergo this type of procedure may have to perform exercises or use weights to put continual pressure on the affected area and prevent reattachment.

The second risk is that this type of procedure can cause adverse events, including shortening of the penis in certain circumstances and a lack of support for the penis during erection.

This isn’t surprising, as the ligaments that hold the penis in place and reduce its perceived size are also responsible for supporting it when it’s erect. This can potentially create problems during sexual intercourse, as the support provided by the suspensory ligament helps to hold the penis at the correct angle during penetration.

Like with other surgical procedures, there’s also a recovery time with this procedure that could get in the way of sex, masturbation and other types of physical activity. 

For these reasons, patient and partner satisfaction rates for penis lengthening surgery are low overall, with 30 to 65 percent of men and their partners reporting satisfaction with the results of this type of surgery.

Penile Prosthetics and Implants

While cosmetic implants are widely used to augment the breasts, buttocks, chin and other parts of the body, options are limited when it comes to size-increasing penile implants. 

Part of this comes down to the structure of the penis itself, which contains blood vessels and erectile tissue that make surgical penis enlargement with a length or girth-increasing implant a risky and challenging process. 

Because of this, most penile implants that are available aren’t used to increase size, but to treat sexual function issues such as erectile dysfunction. 

These problems can develop after medical procedures such as radical prostatectomy (surgery to remove the prostate gland and surrounding tissue), which can cause severe erection issues that require the use of vacuum pumps and other implantable devices.

However, there are few implant devices on the market that are designed to increase the size of the penis.

One, known as Penuma®, has a single piece of research analyzing its effectiveness as a penis enlargement device. The study, which was published in the Journal of Sexual Medicine in 2018, was performed by the device’s inventor, Dr. James Elist.

Penuma is a silicone sleeve that is implanted into the shaft of the penis. Men can choose from a range of implant sizes, including large, extra-large, or extra-extra-large. It’s perhaps not much of a surprise that none of the Penuma implants are classified as “small.”

Other penile implants — either semi-rigid or inflatable — are largely designed to help men who have erectile dysfunction, rather than increase the size of a fully-operational penis. These are generally only used when all other treatment options for erectile dysfunction fail. 

Fat Transfer, Tissue Grafting and Dermal Filler Injections

Although increasing the length of the penis is a complicated, challenging process, it’s possible to increase the thickness of the penis with procedures such as autologous fat injection and dermal fillers.

Autologous fat injection, or fat transfer, involves removing fat from elsewhere on the body using a liposuction device, then injecting the harvested fat cells into the outer, middle and deep layers of the fascia of the penis.

This type of procedure can add girth to the penis and is occasionally used to treat men who feel unhappy about their penile thickness.

Research suggests that autologous fat injection is generally safe and effective. However, as it doesn’t expand the erectile tissue of the penis, it may not result in a significant increase in your erect penis size

Dermal filler injections involve using fillers, typically produced with hyaluronic acid, to add girth to the penis. Research suggests that this type of procedure can increase the circumference of the penis by a significant amount — in some cases, approximately one inch.

However, as most dermal fillers dissolve over time, this type of procedure needs to be repeated every few months for consistent results.

Like with all cosmetic procedures, there’s also a risk of complications. In one study, researchers found that more than four percent of men who received dermal injections to the penis developed complications, with subcutaneous bleeding, nodules and infection being the most common.

With any surgery comes the balancing act of risks and benefits. As we mentioned, these surgeries are mostly considered experimental, and there’s little long-term data on the relative increases in health, happiness or satisfaction for men who go through with it. Below, we’ve highlighted the benefits and risks to help you weigh your potential outcomes.

Benefits of Penis Enlargement

Benefits of penile enlargement surgery vary from procedure to procedure. But common benefits generally include:

  • Penis enlargement surgeries can potentially result in the appearance of a bigger penis. 

  • Certain surgeries or implants can increase both length and girth.

  • Anecdotes from most procedures show that successful surgeries yield overall positive results.

  • A larger penis may indeed help men with low self-esteem feel more confident in bed.

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Risks of Penis Enlargement

While some procedures can result in a slightly longer or girthier penis, the overall risk of post-op complications with penis enlargement and implant surgeries is quite high.

The risks for each surgery type may be different, but they generally include: 

  • Loss of injected fat (the injected fat is reabsorbed into the body)

  • Irregular lumps, bumps and contours

  • Complete reversal of the surgery

  • Loss of sensation or function

  • Reduced elasticity or stretch to the penis skin

  • Pain with erection

  • Penile shortening

  • Scarring

  • Infection

  • Edema

Furthermore, any guy willing to go under the knife for a bigger dick should consider the following:

  • The same systematic review we mentioned above concluded that, because of the safety risks involved in penis enlargement surgery, recommending surgery for men with normal penile dimensions is “unscientific at best and unethical at worst.”

  • Because most surgical procedures for penis enlargement are relatively new, they don’t have a wide breadth of data behind them and most aren’t supported by “standard” surgical techniques that are common in other fields of medicine. 

  • Penis enlargement surgery may result in disfigurement, necrosis or death of the affected penis tissue, and even a need for follow-up surgeries to correct complications. 

Put simply, although penis enlargement surgery can produce a modest increase in penis size, it comes with a mixed success rate and a long list of potential complications, several of which may be severe.

Choose your chew

Because of the risks associated with most forms of penis enlargement surgery, and even with non-surgical penis enhancement procedures, going under the knife (or getting filler injections) solely to make your penis larger generally isn’t recommended. 

The good news is that there are other ways to improve your sexual performance and feel more confident in bed. Here are some things you should keep in mind if you’re feeling like your length isn’t quite up to snuff.

  • It’s not a big deal. Accept that, for most women, penis shape and size really isn’t as big of a deal as it’s often made out to be. Thanks to pornography and mass media, lots of guys have warped perceptions about genital size and assume they’re in possession of a micropenis when they’re actually very normal. 

  • Porn may have misled you. Contrary to what you may see in porn, research generally suggests that women prefer a penis of around average size. For example, in a study published in the journal PLoS One in 2015, 75 women were surveyed on their penis size preferences with haptic feedback technology. Using penis size models, the women chose a size of around six inches as preferable for a long-term partner.

  • Address the mental health side of the problem. If you have sexual performance anxiety, therapy may help you improve your sexual confidence without going under the knife. If you feel uncomfortable about your penile size, taking part in individual counseling or talking with a sex therapist could help you to deal with your worries.

  • A working penis is a good penis. You can also improve your sexual self-confidence by using medication to deal with issues such as erectile dysfunction and premature ejaculation. Erectile dysfunction treatments include medication and lifestyle changes — you might also want to try our chewable ED meds hard mints.

  • Enhance yourself in discreet packaging. Toys like penis sleeves can help you give her what she needs without permanent changes. 

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Regardless of how big you are, it’s easy to feel worried about your penis size. However, going under the knife or getting dermal fillers for a bigger penis generally isn’t medically recommended. Here’s our take for a takeaway:

  • Most men who consider male enhancement surgery actually have normal penises. 

  • Surgery is usually unnecessary — see the above takeaway. Most guys don’t really need it, and it comes with a significant risk of complications.

  • Instead of fretting about your penis size, try to focus on the aspects of your sexual performance that you can control, such as your erections and sexual stamina

  • Treating erectile dysfunction and premature ejaculation with prescription medications might be more beneficial than adding fractions of inches.

Interested in improving your sexual performance? Our guide to having better sex shares simple but effective tips that you can use to increase intimacy and improve your sexual satisfaction, all without any need for costly, risky surgery.

If you’re having sexual anxiety issues, we offer online therapy as part of our range of mental health services, allowing you to quickly and easily connect with a licensed therapist from the privacy and comfort of your home. We also offer ED medications like sildenafil (generic for Viagra), tadalafil (generic for Cialis) and Stendra (avanafil). 

So keep your options open for improving your sexual confidence and keep your junk away from surgeons — you’ll save money, pain and make your love life better without a long healing process.

9 Sources

  1. Veale, D., Miles, S., Bramley, S., Muir, G. & Hodsoll, J. (2015, June). ​​Am I normal? A systematic review and construction of nomograms for flaccid and erect penis length and circumference in up to 15 521 men. BJU International. 115 (6), 978-986. Retrieved from https://bjui-journals.onlinelibrary.wiley.com/doi/full/10.1111/bju.13010
  2. Campbell, J. & Gillis, J. (2017, February). A review of penile elongation surgery. Translational Andrology and Urology. 6 (1), 69-78. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5313298/
  3. Symptoms & Causes of Erectile Dysfunction. (2017, July). Retrieved from https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/symptoms-causes
  4. Lin, H. & Wang, R. (2013, March). The science of vacuum erectile device in penile rehabilitation after radical prostatectomy. Translational Andrology and Urology. 2 (1), 61-66. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4708600/
  5. Elist, J.J., et al. (2018, September). A Single-Surgeon Retrospective and Preliminary Evaluation of the Safety and Effectiveness of the Penuma Silicone Sleeve Implant for Elective Cosmetic Correction of the Flaccid Penis. The Journal of Sexual Medicine. 15 (9), 1216-1223. Retrieved from https://pubmed.ncbi.nlm.nih.gov/30145095/
  6. Kang, D.H., et al. (2012, August). Efficacy and safety of penile girth enhancement by autologous fat injection for patients with thin penises. Aesthetic Plastic Surgery. 36 (4), 813-818. Retrieved from https://pubmed.ncbi.nlm.nih.gov/22527585/
  7. Quan, Y., et al. (2021). ​​Complications and management of penile augmentation with hyaluronic acid injection. Asian Journal of Andrology. 23 (4), 392-395. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8269832/
  8. Marra, G., et al. (2020, January). Systematic Review of Surgical and Nonsurgical Interventions in Normal Men Complaining of Small Penis Size. Sexual Medicine Reviews. 8 (1), 158-180. Retrieved from https://www.sciencedirect.com/science/article/abs/pii/S2050052119300125
  9. Prause, N., Park, J., Leung, S. & Miller, G. (2015). Women's Preferences for Penis Size: A New Research Method Using Selection among 3D Models. PLoS One. 10 (9), e0133079. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4558040/
Editorial Standards

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references. See a mistake? Let us know at [email protected]!

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Martin Miner, MD

Dr. Martin Miner is the founder and former co-director of the Men’s Health Center at the Miriam Hospital in Providence, Rhode Island. He served as Chief of Family and Community Medicine for the Miriam Hospital, a teaching hospital of the Warren Alpert Medical School, from 2008 to 2018. The Men’s Health Center, under his leadership, was the first such center to open in the US. He is a clinical professor of family medicine and urology at the Warren Alpert Medical School of Brown University in Providence and has been charged with the development of a multidisciplinary Men’s Health Center within the Lifespan/Brown University system since 2008.

Dr. Miner graduated Phi Beta Kappa from Oberlin College with his AB in biology, and he received his MD from the University of Cincinnati College of Medicine. Upon receiving his MD, he completed his residency at Brown University. He practiced family medicine for 23 years, both at Harvard Pilgrim Health Care and in private practice.

Dr. Miner presently holds memberships in the American Academy of Family Physicians, the Rhode Island and Massachusetts Academy of Family Physicians, and the American Urological Association, and he is a fellow of the Sexual Medicine Society of North America. He is the former president of the American Society for Men’s Health and the current historian. He is the vice president of the Androgen Society, developed for the education of providers on the truths of testosterone therapy. Dr. Miner has served on the AUA Guideline Committees for erectile dysfunction, Peyronie’s disease, testosterone deficiency, and early screening for prostate cancer. He has served on the testosterone committees of the International Consultation on Sexual Medicine. He has presented both at the NIH and the White House on men’s health initiatives and has authored over 150 peer-reviewed publications and spoken nationally and internationally in multiple venues. He has co-chaired the Princeton III and is a steering committee member and one of the lead authors of Princeton IV, constructing guidelines for the evaluation of erectile dysfunction, the use of PDE5 inhibitors, and cardiac health and prevention.

Dr. Miner was chosen as the Brown Teacher of the Year in 2003 and 2007 and was recognized by the Massachusetts Medical Society’s Award as achieving the most significant contribution to Men’s Health: 2012.

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