Does Penis Enlargement Surgery Work?

There are many ways to go wrong with penile surgery. Most interventions marketed to increase penis size can be very destructive. "Permanent fillers" such as silicone, radiesse sculptra etc should never be injected and tend to create life changing disasters. In my opinion incision based interventions should not be performed in general. Ligament transection, v-y plasty and other incision based techniques can cause pathological scarring and actually shrink the length of the penis and threaten its function. In my practice I offer a structural fat based technique that allows lengthening and dramatic increase in girth of the penis while avoiding the complication profiles of other techniques. Using the patient's own fat, I push the base of the penis away from the abdominal wall and stent out the length, shape and increase the girth of the penis. Patient satisfaction is very very high and deleterious consequences are avoided. There is a limitation to the length and girth that can be obtained  but dramatic gains can be delivered safely. I hope this helps!All the best,Rian A. Maercks M.D.

I have written a few papers about penis enlargement, augmentation phalloplasty, and evidence-based outcomes. Safety is always the priority.
Penis enlargement surgery can offer modest improvements in both length and girth, but there are risks and limitations that should be carefully considered. Always go to an experienced provider. Complications can be devastating.
Lengthening Surgery: The most common method involves cutting the suspensory ligament that attaches the penis to the pubic bone, which can result in an increase of about 1 inch in flaccid length. However, this may not significantly affect erect length. Additionally, some men experience a "drooping" effect where the penis no longer rises in erection, but instead points downward.
Girth Enhancement: This can be achieved through fat grafting (using the patient’s own fat) or the insertion of dermal fillers or collagen-based materials. These techniques can add circumference, though fat grafts may have issues with uneven absorption, and synthetic fillers can lead to complications like infection, ulceration, or extrusion. The use of Alloderm (a type of cadaveric tissue) has been controversial due to risks of tissue reabsorption or complications.
Minimally Invasive Alternatives: Non-surgical treatments, like platelet-rich plasma (PRP) injections or fillers, are also options for improving penis girth and overall appearance. These methods generally have shorter recovery times and lower complication risks compared to surgery.
While surgery can lead to some visible improvements, the results may not meet all expectations, and the risks of complications are significant. For those seeking a modest increase in size, non-surgical options may offer safer alternatives. Consulting with an experienced surgeon is essential to determine the best course of action.
Krishna Vyas, MD, PhD, MHSHarvard, Hopkins, & Mayo Clinic Trained Aesthetic Plastic SurgeonNew York, New York

Many patients consult me for penis enlargement and one of the first things they say is: "I don't
want surgery, no matter what." But after discussing the pros and cons of surgery, many
patients decide on having surgery. I am not suggesting surgery for everyone seeking penis
enlargement. What I am advocating is the right procedure for the right indication. The right
procedure can be either non-surgical or surgical, or it could be both. Some patients do much
better with non-surgical treatment while others may require surgery to attain their desired
result.When is surgery indicated for penis enlargement? Generally, there are two aspects of penis
enlargement, the length and the girth. For patients who want an increase in the erected length,
the only way is by minor surgery done through a small incision concealed by the pubic hair
above the base of the penis. The length of the penis when flaccid, will also be increased with
this surgical procedure. However, very often the length of the penis when flaccid will also be
increased after non-surgical girth enlargement such as by injection of fillers or fat. Briefly, the
only way to get an increase in erected length is by a minor surgery.
Girth (circumference of the shaft) enlargement can be done either non-surgically by injection of
filler or the patient's own fat. Or, it can be done surgically by insertion of a sleeve of collagen
via the same incision used for the penis elongation, so that no additional incision is needed.
The best option for you can only be determined by you and your treating doctor in a person-toperson consultation. Select a physician who does both non-surgical and surgical procedures, so
that the doctor can offer you both options. The non-surgical procedure uses filler injection or fat injection to enlarge the shaft. There are different types of fillers. Some are made of hyaluronic acid. They are temporary and what most doctors use. Some are permanent; the most common of which is Bellafill.
The other type of injection is with the patient’s own fat. Its major advantage is that it is safe
because it comes from the patient himself and there is no risk of allergic reaction.
Another way to increase the girth of the penis is by a minor surgery in which a sleeve of
collagen (such as Alloderm or Surgimend) is inserted and wrapped around the penis just above
the Buck’s fascia and underneath the skin. This, by itself, will increase the volume and,
therefore, the girth of the penis. In addition, the presence of this layer of collagen stimulates
the body to form more collagen and, therefore, further increases the girth. Injection of fat or
filler on top of the sleeve at the same time as surgery further increases the girth of the penis
and can also even out any unevenness, especially at the edge of the sleeve. This insertion of the
sleeve and injection of filler can increase the girth by a great amount and the penis will feel
natural without the “mooshiness” associated with injection of filler alone. If the patient wishes
to have a greater increase in girth, the treatment of choice is insertion of the sleeve plus
injection of filler. The insertion of the sleeve can be done via a small incision just above the base
of the penis within the pubic hair and is thus camouflaged by the hair and becomes virtually
invisible.
The base of the penis is attached to the bone in the pubic area by suspensory ligaments. To
increase the length of the penis, the suspensory ligament has to be divided, and the penis
pushed forward beyond the edge of the bone. Thus, the functioning and visible part of the
penis is lengthened, both when flaccid and erect. When done properly, an average of 1 inch of
increase in penile length can be achieved. This is variable, depending on the anatomy of the
patient. I have seen as much as 2½ inches of increase and as little as no increase in the length of
the penis. However, the average is a 1 inch increase. This whole procedure can be done through
the same incision used for girth augmentation; no additional scar will result.
In summary, the only way to increase the length of the penis is by minor surgery. The girth can
be increased by non-surgical injection of filler or fat, or by insertion of a collagen sleeve plus
injection of filler or fat. These procedures offer immediate and permanent results. Stretching
and PRP injections may improve erections, giving the illusion of increased penis size.

Victor Liu, MD

After looking at all the various surgical options available for male enhancement, Dr. Malik has concluded that the Prometheus procedures are the safest and most effective methods available today. Simply put, we feel the lack of predictable gains associated with more aggressive surgical procedures are not worth the risks. We recognize that each patient is different, both in their physical appearance and their individual goals, and we work to provide the individual shape and size each patient wants to achieve. While the procedure requires technical expertise, there is also an art needed to shape and sculpt the penile shaft and head to the liking of the patient.

Extension and thickening are performed in penis enlargement surgery. An extension of the penis at the back-root part of the penis is also made during the lengthening of the penis, so there is a short stitch trace in the form of a zig zag or Y. These stitches are left between the hairs, the absence of genital hair can hide the scar. In the penis thickening operation, the penis part becomes thicker and becomes thicker than the penis head (glans penis). Thickening can be understood from the difference in diameter. Since the head of the penis consists entirely of spongy tissue and there is no skin that can be separated on it, there is no thickening of the penis head. Only the penis part of the thickening is made, after the operation, the penis body is thicker than the head of the penis. Thickening can only be understood here that.

Alloderm used to be used more frequently.  If you weren't aware, Alloderm is a type of ADM (acellular dermal matrix). In other words, it is cadaveric tissue.  The results can be less than satisfying since the tissue can reabsorb or be felt.  Dermal grafts may be more predictable than Alloderm but requires a donor site on the body to harvest the tissue. Ligament release is somewhat controversial because it isn't clear if any real gain is achievable with erection and post op weights are often required to maximize gains in the flaccid state. Suprapubic liposuction may be preferable to ligament release in the right candidate. I prefer to use fat and PRP (platelet rich plasma).  The results can be less predictable than dermal grafts but the procedure is is far less invasive and the recovery time is much shorter.  Fat historically had its issues with fat nodule development.  However, with small cannulas and proper filtration this appears to be less of an issue.  

Penis enlargement surgery can provide modest improvements, but it comes with risks and limitations. Lengthening procedures, like suspensory ligament release, typically add up to 1 inch in flaccid length, with minimal impact on erect length. Risks include scarring and unstable erections.

Girth enhancement options include:

Fat Transfer: Increases circumference but may reabsorb unevenly over time.
Dermal Fillers: Offers smooth, natural-looking results but can be temporary.
Collagen Sleeves: Permanent but invasive, requiring longer recovery.
For safer, minimally invasive alternatives, growth factor injections (PRP) and advanced fillers can enhance girth while improving blood flow and tissue health, offering natural results with fewer risks. These non-surgical options typically achieve gains of up to 1–2 inches in length and 0.8–1.2 inches in girth.

Consult a qualified physician to discuss your goals and determine the safest and most effective approach for you.

There are also minimially invasive options so as Bo-cox for injected into the side of the penis to relax the ligaments providing and increase in length as well as dermal filler for added girth. It sounds like a combination of the two treatments might be ideal for you.

There are some REAL reasons why penis enlargement is not a mainstream surgery. It is fraught with complications and distraught men.

Adding another inch in length is not a major challenge. It can be achieved by an incision along the base of the penis with division of the penile suspensory ligament. The result is a longer penis BUT the downside is that upon erection the penis does not "rise" but elongates while pointing at the floor. If this is not a compromise you wish to take, do NOT have this done.

As regards increase in penile width, EVERYTHING you can think of has been tried with fat grafting and Alloderm sheets being the latest fads. The penile skin is very thin and the space between it and the shaft does not have a rich blood supply. As a result, fat grafting in this area is unreliable at best and often results is small clumps of fat necrosis while placing sheets of Alloderm (cadaveric human dermis) may be complicated by infection, ulceration and erosion.

Most men once they understand these REAL risks would opt for "leaving well enough alone"

Good Luck with your decision.