Do penis enlargement devices actually work?

Illustration by Slug Signorino

Cecil replies:

I have checked into the situation thoroughly, John, and the sad fact is that if nature has equipped us with a ding instead of a dong, well, we must just learn to live with it, and that is all there is to it. A consulting urologist at the sexual behavior consultation unit at Johns Hopkins Hospital in Baltimore tells me that there are no known methods, surgical or otherwise, of permanently increasing penis size for what we might call “cosmetic purposes.”

There is such a thing as reconstructive surgery, for men who have suffered some sort of injury to their privy members, but that is another matter. For instance, a recent article in the medical literature described the unfortunate case of a Saudi Arabian lad who at age two was the unfortunate victim of an inept practitioner of a ghastly home medical technique known as “guillotine-type circumcision,” the details of which I leave to the imagination.

Having been left with a three-quarter-inch “micropenis,” as one doctor rather tactlessly put it, the poor fellow underwent reconstructive surgery in his 20s using skin grafts from his thigh. This gave him a penis that was about three inches long when fully erect, which I guess must be considered an improvement. However, the results, judging from the photos helpfully supplied with the article, leave something to be desired from an aesthetic standpoint.

There is also something called “implant” surgery, which is widely used to help impotent males achieve an erection. There are two basic techniques: semirigid rods and inflatable implants (we will have no snickering about this, if you don’t mind).

The simplest and consequently most widely used technique consists of a pair of silicone rods that are inserted into the penis via a surgical incision. The chief drawback of this method is that you are left with a permanent erection, which can be something of an embarrassment in public restrooms and whatnot. To get around this problem, an improved type of rod, which I regard as a splendid example of Yankee ingenuity, comes with a hinge in the middle.

Yet another type consists of a silicone shell with a flexible silver braid inside, giving us what is basically a giant pipe cleaner, which can be bent to suit the occasion. Many interesting and artistic effects can be achieved with this device.

Finally, there is the inflatable implant, whose advantage, according to its fans, is “a natural-appearing erection with increased penile girth,” not to mention the fact that you only get an erection when you want one. What happens is that a pair of inflatable cylinders are installed in the penis, connected by tubing to a squeeze pump in the scrotum and a reservoir near the bladder filled with the penile equivalent of brake fluid. When you feel the situation demands an erection, you give the old scrotum a squeeze or two, and there you go, just like magic. Later you can use a release valve to get things back to normal.

The disadvantage here is that the cylinders sometimes leak, resulting in a mortifying loss of pressure that all of us menfolk can readily identify with. Fortunately, the medical wizards at Johns Hopkins and elsewhere are experimenting with a new, improved implant which it is hoped will reduce this problem.

I should point out that none of these techniques is meant to increase the size of the penis beyond its natural length. In fact, oftentimes finding the right size implant is the touchiest part of the surgery (one manufacturer offers rods in something like eight sizes, ranging up to an awesome nine inches). So don’t get your hopes up.

Finally, I ought to mention the fascinating art of phalloplasty, which is medicine’s polite term for the procedure by which a woman undergoing a sex-change operation is outfitted with a surgically-constructed crank. The “neophallus” — medical terminology is a stitch sometimes — is usually fashioned out of abdominal fat; the scrotum, complete with plastic testes, is made from the patient’s labia.

In bygone days, a piece of rib was used to make the appendage sexually serviceable, but now the job is usually done with a synthetic prosthesis along the lines described above. The artificial erection is usually imbedded permanently in the penis, but I understand in current practice it’s more often fitted into a handy slip-in pouch that is cut into the underside of the organ.

Now, you may think to yourself, hey, this wazoo I’ve got now is such an embarrassment, I might as well just bag it and have somebody phalloplast me a new one. OK, but I should warn you that phalloplasty is a particularly vexing surgical undertaking, primarily because of the penis’s duality of function. Many sex-change counselors try to discourage it, and in fact most female-to-male transsexuals content themselves with less drastic measures (typically mastectomy, hysterectomy, and hormone treatments, in case you’re interested). According to at least one educated guess, only about ten phalloplasties are performed yearly in this country.

In short, your best bet is to reconcile yourself to your present equipment. Remember, it ain’t the meat, it’s the motion.

Cecil Adams

Send questions to Cecil via cecil@straightdope.com.