Penis Enlargement Surgery: What You Need to Know

Pros

• RealSelf members who rated penis enlargement "Worth It" say their procedure increased the girth and/or length of their penis, while boosting their self-esteem and sexual satisfaction for them and their partners.
• Augmentation with tissue or fat taken from your own body provides permanent augmentation.
• Compared to nonsurgical methods, penis enlargement surgery tends to yield better results with more staying power.

Cons

• RealSelf members who rated penis enlargement "Not Worth It" experienced erectile dysfunction or had a lump in their penis after fat transfer.
• If something goes wrong or you don’t get your desired results from male enhancement surgery, you may have to undergo another procedure or be left with permanent complications.
• There are several products and methods on the market that make dubious claims for an enhanced penis, have no proven effectiveness, and may also be risky, so be on high alert.

• Average Cost:
• $9,505

• Range:
• $6,000 - $15,000

Your cost will depend on the technique used, as well as your doctor’s practice location and level of experience.

You can finance your treatment with CareCredit.

See our complete guide to penis enlargement costs

Men at a healthy weight with an average or slightly below-average penis size may be good candidates for penile augmentation. Those with an average-sized or larger penis can also benefit from enhancement, if their goal is to achieve even more penile length or girth.

The average flaccid penis is between 3.5 and 5 inches long and 3.5 inches around, while the average erect penis is a little more than 5 inches in length and 4.5 inches in girth. 

Some men feel inadequate, even though their penis size is perfectly normal. Nearly 70% of men say they’re not happy with their size, and about half wish they could be larger. 

Others are born with what’s called a micropenis, defined by the American Urological Association as a stretched penile length of 7.5 centimeters or less. Micropenis is a medical condition with varying degrees of severity, which may include a hormonal imbalance. Having a micropenis does not necessarily make you a good candidate for penis enlargement surgeries.

A urologist or plastic surgeon specializing in penile augmentation can recommend the best course of action if you have concerns about your penis size or how it’s impacting your sex life.

These penis enlargement procedures vary in their effectiveness, and they all come with risks. 

Fat transfer

A common way for surgeons to add volume to the face,butt, and other areas, fat grafting is also an option for penis enlargement. Dr. Tim Neavin, a plastic surgeon in Beverly Hills, California, says that some surgeons have been doing penile fat transfer (also called composite augmentation phalloplasty) for decades.

In this technique, a surgeon takes excess fat from other areas of your body and injects it into the penis. It’s done primarily to increase girth, but modest gains in length can also be achieved.

Your surgeon starts by removing a small amount of fat from your belly, hips, or inner thighs via liposuction, sucking out the fat through a thin tube called a cannula. Some men have a “hidden penis,” buried by the fat of the lower belly or thighs; removing fat from these areas can make their penis look much larger.

Your penis is numbed with a local anesthesia, so you shouldn’t feel any pain when your surgeon injects the fat. Fat is injected circumferentially (all the way around), from the base of the penis to the glans.

The whole procedure should take less than two hours. Not all the grafted fat will survive, but results from fat transfer to the penis are considered permanent.

Penile implants

Penuma is a permanent silicone implant that’s been FDA-approved for penileenhancement. It’s made of malleable, medical-grade silicone, so the results look and feel like your natural penis.

This relatively new procedure is currently performed only in select cities in the U.S., but we expect its popularity and availability to grow.

Its manufacturer claims that clinical studies have shown very low adverse-event rates (infection in 3% of cases and seroma [fluid buildup] in 5% of cases). A study of 400 Penuma patients reported in The Journal of Sexual Medicine found that 81% of patients who underwent the procedure had “high” or “very high” satisfaction with their results.

Ligament release

The penis has a strong band of connective tissue at its base. In this procedure, also known as suspensory ligament release, your surgeon numbs the area before cutting this ligament at the base of your penis. “This allows the penis to fall farther from the body, giving the illusion of length, particularly in its flaccid state,” says Dr. Neavin. 

Ligament release comes with serious functional risks, including erectile dysfunction or difficulty with penetration. Because of this, some doctors strongly caution against it.

All penis enlargement surgeries and procedures carry some risks and side effects, some more serious than others.

• Ligament release is the riskiest option. Along with swelling and risks of infection, loss of sensation, and scarring, some patients develop erectile dysfunction. After ligament release surgery, you may even lack the support you need to properly penetrate your partner.
• Fat transfer results can be unpredictable because not all the transferred fat cells will survive, so you may be disappointed. Minor bruising and swelling for up to four weeks is normal. Other risks include infection, fat cell death (necrosis), or lumps, which can be avoided by kneading the penis to ensure even distribution of the fat. 
• Penuma implant risks include seroma, scarring, and infection, though reported complication rates are low. 

A study published in 2019 that looked at various penile enhancement procedures states that complications are “likely underreported.” The same study also says that the worst complications, although rare, can be “devastating.” These include penile fibrosis, sexual dysfunction, and even (in at least one case) death from pulmonary embolism. 

If you do decide to undergo a penis enlargement procedure, consider all the risks and follow your doctor’s post-op instructions carefully.

You can minimize the risk of complications by finding an experienced, board-certified surgeon and following their instructions for avoiding sexual activity and masturbation until you’re fully healed.

Your recovery process will depend on which procedure you have.

After a fat transfer, you’ll have swelling for about four weeks, Dr. Neavin says. Avoid having sex until you’ve fully healed and the swelling has subsided. Wrapping the penis and massaging it daily can help prevent lumps.

If you’ve had ligament release surgery, you’ll need to hang weights from your penis several times a day, often for several months, to get the maximum enhancement effect.

With the Penuma silicone implant, you’ll also need to wait for a month to fully heal before having sex or masturbating, or you’ll risk complications like infection or seroma.

Fat transfer

You'll see initial results within four weeks and final results in four months. It takes about a month for the swelling to go down and the fat to incorporate, Dr. Neavin says. 

Some transferred fat is resorbed by the body, but what remains after four months should be permanent. 

In one study, patients who returned for a follow-up appointment 12 months after fat transfer showed an average girth increase of 1.57 cm and an average length increase of 3.1 cm.

Ligament release

You'll immediately look about one-half to one inch longer. The surgery can also change the angle of your erections so the penis doesn’t rise, but just elongates while pointing straight down.

Between that change and the risk of erectile dysfunction, it’s no surprise that many men find this option unappealing. If this is not a compromise you want to make, it’s wise to avoid this procedure.

Penile implants

You’ll see immediate results from a Penuma implant while you’re flaccid, but you’ll need to wait until you’re fully healed to see more length in your erection. Avoid masturbation and sex for about four weeks.

Men who've had this procedure grew 56% larger in circumference on average and reported increased confidence and self-esteem.

Penuma implant results are permanent, unless you decide to have the implant removed.

The penis enlargement photos in our gallery have been shared by the provider who performed the procedure, with the patient's consent.

Penis fillers

Hyaluronic acid (HA) fillers like Juvéderm and Restylane—which are often used to plump lips or restore lost facial volume—are a noninvasive option for increasing penis length and girth.

A numbing cream, followed by an injected numbing agent, prevents pain. “Depending on the patient’s goals, a filler is chosen and then injected into the corpus cavernosum of the penis [two columns that contain most of the blood during an erection]. The filler is then worked through the penis, to achieve a uniform increase in length and girth,” says Cedar Grove, New Jersey, physician Dr. Muhammad Mirza in aRealSelf Q&A.

Expect the doctor to use about 10 syringes of filler on your first visit—maybe more, if you have a longer penis. NYC plastic surgeon Dr. David Shafer says that some patients have as many as 15 syringes. It takes a lot to make a difference in size, which can get expensive, says Dr. Neavin. “It’s also hard to get a uniform distribution around the penis,” he adds. “It comes out kind of lumpy.” 

You should see immediate results, with final results visible within two weeks. At this point, you can decide if you want more. “We like to see patients back about four to six weeks after their first treatment,” Dr. Shafer says. “At that appointment, some patients choose to get additional injections, for added effect.”

Filler injections can cause some soreness or minor bruising, which shouldn’t last beyond a few days. There’s also the possibility of infection, so avoid sex for at least 48 hours after your treatment, to let the injection sites heal to minimize your risk. 

Hyaluronic acid–based dermal fillers can last up to two years, with the proper follow-up visits; but everyone metabolizes dermal fillers differently, so your experience may vary. HA fillers can also be dissolved early using hyaluronidase, if you do have a problem or don’t like your results.

PRP injection, aka the P-Shot

The Priapus Shot, or P-Shot, is named after the Greek god of fertility. Dr. Charles Runels developed this procedure to help men with erectile dysfunction as well as curved erections caused by Peyronie’s disease.

Some doctors say it can increase blood flow to the penis and improve the function of nerve endings. “It may improve sensation or erection temporarily,” Dr. Neavin says. “It probably doesn’t add any permanent size increase, with the exception that if you have an improved erection, it will give you more volume.”

Like injectable fillers, these platelet-rich plasma (PRP) treatments involve injections into your penis. First, you get a local and topical anesthetic to keep you comfortable. Then your doctor draws blood from your arm and spins it in a centrifuge to separate the red and white blood cells and concentrate the platelets, which are rich in growth factors. They then inject the platelets into several different areas of your penis.

You can have fat transfer in combination with PRP injections to increase both size and sensation, a procedure Dr. Neavin calls a super-concentrated thrombocyte injection with fat (STIF) shot. It’s done to improve penile girth and (to some extent) length, for permanent results.

Another variation of the super-concentrated thrombocyte injection is the STIM shot, another term coined by Dr. Neavin. The STIM shot combines PRP injections with the application of a penis pump to apply negative pressure and create micro injuries in the tissue. This allows PRP to spread evenly throughout the penis and target the tissue with its reparative and rejuvenating properties.

While you may see an improvement in your erections from this technique, don’t expect a huge size boost. Men who had STIM shots gained only about .2 inches in length and girth per injection, and results typically last just two to three months. But repeated treatments could expand the vessels and tissues in your penis and provide longer-lasting results over time.

PRP is still considered an experimental treatment, meaning that there hasn’t been enough research to confirm its safety and effectiveness. Side effects from PRP are usually limited to minor bruising, bleeding, or swelling. Using a penis pump vacuum device at home for a few minutes a day can improve your odds of success.

More alternatives to penis enlargement surgery

Other methods and techniques exist to increase penis size, but their effectiveness and safety are still up for debate.

• Some extenders or penile traction devices have been proven to achieve results of up to 1.4 cm in increased length.
• Vacuum pumps with a plastic tube that fits over the penis pull in blood, making it swell up. They’re often used to treat erectile dysfunction, and while results are only temporary, overuse can lead to tissue damage.
• The urology community has seen no evidence that pills, creams, lotions, or other penis enlargement products advertised online for “male enhancement” work, and doctors caution that some could be risky.Jelqing is a do-it-yourself massage method meant to improve penis size without surgery. Though tugging and pulling on the penis may increase blood flow, no research is available to show that this technique increases size. There’s also some concern that applying too much pressure could cause tissue damage.