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There are several surgical treatments, most of which carry a risk of significant complications. Procedures by unlicensed surgeons can lead to serious complications. Risky surgical treatments include subcutaneous fat injection, division of the suspensory ligament, and the injection of dermal fillers, silicone gel, or PMMA. The American Urological Association (AUA) and the Urology Care Foundation "consider subcutaneous fat injection for increasing penile girth to be a procedure which has not been shown to be safe or efficacious. The AUA also considers the division of the suspensory ligament of the penis for increasing penile length in adults to be a procedure which has not been shown to be safe or efficacious." Dermal fillers are also not approved by the US Food and Drug Administration (FDA) for use in the penis.
Two urological researchers, Marco Ordera and Paolo Gontero of the University of Turin in Italy, examined outcomes from both surgical and nonsurgical procedures for “male enhancement” in previous studies. Half of the studies involved surgical procedures performed on 121 men; the other half involved nonsurgical enhancement techniques used by 109 men.
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Lengthening the penis. The most common procedure is to cut the ligament that connects the penis to the pelvic bone. This allows a little more of the shaft -- on average less than an inch -- to become visible outside the body. It's not really lengthening the penis so much as revealing more of what's usually hidden. To prevent the ligament from reattaching, a guy would need weights or stretching devices daily for about six months.
The vacuum pump. This is a cylinder that sucks out air. You stick your penis in and the resulting vacuum draws extra blood into it, making it erect and a little bigger. You then clamp off the penis with a tight ring -- like a tourniquet -- to keep the blood from leaking back into your body. What are the drawbacks? The effect only lasts as long as you have the ring on. Using it for more than 20 to 30 minutes can cause tissue damage. This is sometimes used as a treatment for erectile dysfunction, but has not been proven to actually increase the size of the penis.
For men with performance issues who are physically healthy, Boyle often prescribes counseling, such as marriage counseling for men with relationship issues or psychiatric help for men who are preoccupied with a problem in penile appearance. For young men with sexual performance problems and no signs of physical problems, Boyle may prescribe counseling and a low dose of Viagra as they work out issues of insecurity. "They need reassurance from a physician that everything is OK," she says.