85% of women reported being satisfied with their partner’s penis size, while only 55% of men mentioned being satisfied with theirs. Hence, multiple non-surgical and surgical procedures claim to improve the length and girth of the penis due to the high dissatisfaction in the population and the psychological consequences it carries.
Jelqing exercises and vacuum pumps work by increasing the blood flow to the penis; nevertheless, they have not been proven to cause any lasting effect on penis size; furthermore, they can cause lesions to the elastic tissue of the penis, which can have consequences on the quality of the erections.
Stretchers involve attaching a traction device to the penis; some studies have demonstrated an increase of 1 to 3cm in penile size but require consistent use of the device for a long time (4-6h/day for many months). Additionally, more studies are required to evaluate its safety.
Injections with hyaluronic acid can be used to improve girth by around 2.5cm. As hyaluronic acid is a key component of the extracellular matrix, it is considered a safe option when used as a filler. A downside is that it can be reabsorbed decreasing up to 15% of the girth obtained by this procedure in a 5-year period.
Transection of the suspensory ligament of the penis is a technique that can make the penis look bigger, although the real size does not change. It is important to note that this surgery can cause instability of the penis while having intercourse.
Penis implants: the Penuma is the first FDA-approved penile implant; it is made with silicone and can improve the flaccid length and girth as well as the erect girth from 3 to 6cm. The most frequently reported adverse events are seroma (4.8%), scar formation (4.5%), and infection (3.3%). It is important to note that this implant goes bellow the skin but outside the corpora cavernosa which is different from the inflatable penile implats used for the treatment of erectile disfunction and do not modify the lenght or the girth of the penis.
Elist JJ, Valenzuela R, Hillelsohn J, Feng T, Hosseini A. 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. J Sex Med. 2018;15(9):1216-1223. doi:10.1016/j.jsxm.2018.07.006
Quan Y, Gao ZR, Dai X, et al. Complications and management of penile augmentation with hyaluronic acid injection. Asian J Androl. 2021;23(4):392-395. doi:10.4103/aja.aja_78_20
Veale D, Miles S, Bramley S, Muir G, Hodsoll J. 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 Int. 2015;115(6):978-986. doi:10.1111/bju.13010