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Forgotten your password? Penile size is a frequently observed concern in men of all ages. The penis has been regarded as a symbol of masculinity throughout history, hence penile size has long been a source of anxiety for many men. For centuries, men have undergone many different processes in an effort to enlarge and enhance their penises. For instance, the Sadhus, holy men of India, and men of the Caramoja tribe in Uganda use weights to increase the length of their penises. Only articles written in the English language were included; articles in which the only recommendation for penis augmentation was phalloplasty using extragenital tissue were excluded.

Recently, there have been several studies published on penile length and girth and what should be considered a normal penis size or a micropenis. The first studies to address penile size were published in the 19 th century, and the publication of such articles continued thereafter. The variability of the recorded values depended on the population included in the study, as well as on the measuring technique. In regard to girth, the average circumference ranged from 9—10 cm when flaccid and from 12—13 cm in the erect state.

The studies presented demonstrated that younger men usually have longer, wider penises. Unbiased standardisation is needed to make the comparison of data more accurate. In all cited studies, we saw differences in the technique used to measure penis size. There now exists a general consensus that penile length should be measured on the dorsal side of the penis, from the penopubic junction to the tip of the glans in the flaccid, flaccid stretched, and erect states.

Likewise, penile girth should be measured around the middle of the shaft of the penis in both the flaccid and erect state.

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The measurements should be made by a single physician and should not use self-reported questionnaire data. Given the huge variability in penile size and penile extensibility, penile evaluation should, without a doubt, be performed in flaccid and stretched states, with the specific final objective of reaching a consensus on the definition of what penile size encompasses and the associated method of measurement. After considering these studies, Dillon et al.

Average erect penis length ranged from The term micropenis refers to a series of congenital and acquired conditions that result in an abnormally short penis; this state can be associated with functional and psychological problems. A true micropenis results from hormonal disruption during gestational development and results in either an isolated micropenis, or a micropenis as part of a sexual development disorder. All patients in whom there is a suspicion of a micropenis condition should undergo karyotyping and hormonal evaluation, as well as a detailed examination by an endocrinologist.

Nonsurgical treatment of the true micropenis in infancy involves the correction of reversible metabolic defects. However, surgical treatment such as gender reassignment or penis augmentation surgery in childhood should be carefully evaluated. In many cases, reconstructive surgery offers patients a feasible option for restoring penis length and function penile reconstructive surgery, grafting, penile prosthesis, etc. Nevertheless, adequate counselling is necessary to create realistic post-operative expectations among these patients and to support their long-term rehabilitation.

Ghanem et al. Examination revealed that After application of a structured management and counselling protocol, Only nine patients decided to seek further surgical treatment. Of the nine patients who underwent penis augmentation surgery, only one true micropenis patient and two normal-sized penis patients were satisfied with the results of the surgery, with the remainder of the patients reporting poor satisfaction with the achieved size.

The results of this study suggest that the majority of men complaining of a small penile size are misinformed, while some suffer from body dysmorphic disorder BDD in the form of penile dysmorphophobia. In this population of dysmorphic men, we can achieve better results through counselling and support from psychologists and psycho-sexologists, than by offering surgical augmentation. There are several distinct types of penile augmentation surgery, each aimed at a different outcome; some increase length or girth, and a third group aims to achieve both of these objectives.

In addition, there are several related plastic surgery procedures aimed at reconstructing the skin surrounding the penis. In a position statement draft regarding penis augmentation surgery, the Sexual Medicine Society of North America has concluded that penile lengthening and girth enhancement surgery can only be regarded as experimental surgery, as there are no peer-reviewed, objective, or independently monitored studies or other data that prove the safety or efficacy of penis lengthening and girth enhancement surgery.

As Ghanem et al. In all of these patients, education regarding normal variations in penile size is very important, as is psychotherapy. Several techniques have been described to increase penis length. This achieves a visual lengthening of the penis.

Dissection of the suspensory ligament enables the penis to move forward and to appear longer in the flaccid state by 1. Reattachment of the ligaments and de novo penile shortening need to be avoided. Alter et al. This procedure is often combined with inverted V-Y plasty or Z-plasty to increase penile length further, or use of the circumcision approach to prevent visible scarring on the lower abdomen.

They described the use of suspensory ligament release resulting in an increase in length of 4 cm in their group of patients. In patients with penoscrotal webbing that results in a hidden penis, the reconstruction of the penoscrotal angle and scrotal and penile skin by Z-plasty can resolve the problem without additional procedures for penile lengthening.


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In , Alter 23 reported that overly aggressive circumcision in which too much ventral penile skin is excised results in penile shortening due to penoscrotal webbing in the majority of patients. In , Perovic and Djordjevic 24 reported penile lengthening in 19 patients using the penile disassembly technique, a technique involving the placement of the autologous rib cartilage between the corpora cavernosa and glans cap; however, long-term follow-up data are not available.

A special group of patients requiring penile elongation procedures are those with epispadias and bladder extrophy. The most commonly used procedure for epispadias repair is the Cantwell—Ransley staged procedure. In , Djordjevic et al. Penis girth enhancement procedures are even more controversial than penis lengthening procedures. There is no standardised recommendation or indication for penile girth enhancement in the medical literature, and no guidelines have been proposed for such an intervention.

Instillation of different exogenous substances under the skin for penile girth enlargement is very common in some culture settings and is present even today. Paraffin injection causes an intense inflammatory reaction leading to granulomas, ulcers, and skin necrosis, with the risk of penis loss Figure 1. Figure 1: Severe penile skin necrosis after penile enhancement with paraffin injections.

Liquid injectable silicone LIS became very popular in aesthetic surgery in the s and appeared to be relatively safe. Not too long ago, while texting a prospective Tinder date, she requested I send a picture of my bulge. So, I did what any man in my situation would have done and obliged her request.

In my cotton gray track pants, I grabbed my dick and balls at the base, lifted them for effect , and presented my veiled genitals to the smartphone lens. This idea intrigued me. Click here to read the full article…. Because, yes, penises can decrease in size as men age. David Shafer.

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Penis size and length is a sensitive topic for guys. Many men are self-conscious about the size of their penis. The most popular filler is Juvederm Voluma which is made of a naturally occurring molecule, HA, found in the skin. Juvederm Voluma from Allergan is an HA gel which is typically injected into face wrinkles to smooth the skin, into cheeks to lift the face and into the lips to add shape and contour.

He focuses on social media for his external marketing efforts. David Shafer developed a painless, instant, minimal down-time office-based procedure to dramatically increase the width and girth of the male organ. Click here to read more…. Added bonuses: Shafer Meet our Providers Dr. Procedure S hafer W idth A nd G irth New technology with dermal fillers has allowed a breakthrough in penile enhancement.


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