Penile Enlargement Surgery: Types, Risks and Rewards
Medically reviewed by Jill Johnson, FNP
Written by Our Editorial Team
Last updated 2/09/2022
When it comes to sexual health and function, it’s common and normal to wonder about how you compare with others. For men, few sex-related characteristics are worried about as frequently or intensely as penis size.
Many men wouldn’t pass up the gift of a larger penis, especially if that gift came with no strings attached. But in the real world, getting a larger penis can involve surgery, which typically comes with a long list of downsides, costs and potential complications.
We, as a society, and men specifically, put a lot of value on penis size. We make jokes about it, movies about it, and sometimes suggest men lucky enough to have bigger packages are, both figuratively as well as literally, “bigger” men.
It may be because of this focus on penis size that many men question whether they’re normal or inadequate, regardless of their actual genital size.
A “normal” penis size is hard to pin down, but according to a review of study data performed by researchers at King’s College in London, the average penis size is 3.6 inches from the base of the penis at the pubic bone to its tip when flaccid.
Even within these size ranges, it’s far from uncommon for men who feel inadequate to consider getting penis enlargement surgery.
Currently, 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.
These surgeries may offer benefits in some circumstances, but most have major disadvantages and a real potential for complications.
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 for improving your sexual performance that you may want to consider if you feel unhappy about your penis size.
TL;DR: What You Need to Know About Penis Enlargement Surgery
Currently, there are several different approaches for increasing the length and/or girth of the penis. These include penile implants, fat or tissue grafting, as well as the infection of dermal fillers similar to those used for enhancing the face and lips.
Another is penile elongation surgery, which involves surgically detaching the suspensory ligament that holds the penis upright. This may provide extra length, but has downsides such as affecting the angle of the penis.
Satisfaction rates for penis enlargement surgery are mixed. Most procedures only offer mild benefits, such as less than an inch of extra length, and surgical complications may occur.
Although non-surgical penis enhancement techniques such as jelqing don’t appear to be effective, medications like sildenafil (the active ingredient in Viagra®) can improve sexual performance and self-confidence.
Research suggests that penis size just isn’t that big of a deal for most women (nor is the average flaccid penis that big), meaning it’s usually better to accept what you’ve got than to deal with the pain, cost and inconvenience of surgery.
Types of Penis Enlargement Surgeries and Implants
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.
Currently, there are several cosmetic procedures for increasing penis size. However, 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.
Nonetheless, some plastic surgeons do offer these procedures, and men who feel unhappy or uncomfortable about their penis size are often interested.
Below, we’ve listed the forms of penis enlargement surgery that are currently available, as well as how each type of procedure works, its potential results and risks to be aware of.
Penis Lengthening Surgery
Penis lengthening surgery, also referred to as penile elongation surgery or suspensory ligament release, involves carefully surgically releasing the ligament that attaches the penis to the middle of the pelvis.
By releasing this ligament, the penis sits at a more obtuse angle to the body, meaning it juts out further from the 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 healing.
The second 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 is 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.
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 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 semirigid 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 penis size during erection.
Dermal filler injections involve using fillers, typically produced using 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 the most common.
Does Penis Enlargement Surgery Actually Work?
The short answer here is, it depends. Penis enlargement surgeries can potentially result in a bigger penis. However, the size increase is generally either a result of the angle of your penis changing, or solely in terms of girth.
With this said, some research suggests that some procedures to enhance the penis do lead to extra size.
For example, a review of 12 surgery types found that among all penis enlargement surgeries, average length increases were from 1.7cm to 3.5cm, or 0.7 to 1.4 inches. Girth increases, on the other hand, were from 1.5cm to 3.35cm, or 0.6 to 1.3 inches.
The authors of the review do caution, though, that treatments for increasing penis size tend to be supported by “scant, low-quality evidence,” and that men concerned about their penis size should take part in counseling before undergoing surgery.
They also noted that surgery and injectable treatments should generally be used only as a last option.
Risks and Complications of Penis Enlargement Surgery
Now, let’s talk about trade-offs. 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.
In fact, 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.
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
In some cases, 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.
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What You Can Do Instead of Penis Enlargement Surgery
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.
The first is to 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 how big their penis needs to be to satisfy their partner.
Contrary to what porn may suggest, 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.
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.
You can also improve your sexual confidence by using medication to deal with issues such as erectile dysfunction and premature ejaculation.
For example, medications like sildenafil (the active ingredient in Viagra®) can help you to stay harder during sex, reducing feelings of performance anxiety and increasing the perceived size of your penis.
You can view our browse of erectile dysfunction and premature ejaculation treatments online, with prescription treatments available following a consultation with a healthcare provider who will determine if a prescription is appropriate.
The Bottom Line on Penis Enlargement Surgery
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 recommended due to the significant risk of complications, as well as the fact that most guys really don’t need it.
Many men who consider penis enlargement solutions actually have normal penises. True penis abnormalities are rare, and the general consensus amongst experts is that these risky surgical procedures should be saved as a last resort for men with a true medical need.
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.
Not only are these things that you can improve without surgery -- they’ll generally have a bigger impact on both your sexual enjoyment and that of your partner.
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.