Surgical methods of penis enlargement — Not for cosmetic use

The need for penis-enlargement surgery is rare. Surgery is typically reserved for men whose penises don't work because of a problem present at birth or an injury.

Some surgeons offer cosmetic penis enlargement using many techniques. But it's controversial and considered by many experts to be unnecessary. And in some cases, it can be permanently harmful. These surgeries should be considered experimental. There aren't enough studies of penis-enlargement surgery to give an accurate picture of risks and benefits.

Examples of surgery done to increase the length or thickness of the penis include:

• Cutting the suspensory ligament. The most widely used surgical procedure to lengthen the penis involves cutting the suspensory ligament that attaches the penis to the pubic bone. Also, skin is moved from the abdomen to the penis shaft. When this ligament is cut, the penis appears longer because more of it hangs down. But it doesn't change the actual length of the penis.

  But cutting the suspensory ligament can cause an erect penis to be unstable. This lack of support during an erection could result in injury to the penis during sexual activity. Also, the ligament can grow back together, causing a shortened appearance of the penis. Cutting the suspensory ligament is sometimes combined with other procedures, such as removing extra fat over the pubic bone.

• Fat injection. A procedure to make the penis thicker involves taking fat from a fleshy part of the body and injecting it into the penis shaft. Results may be disappointing. Some of the injected fat may spread unevenly or be reabsorbed by the body. This can lead to a penis that is curved, unevenly shaped and irregular looking. Scarring and problems with sensation and firmness of erections can also happen. Several other products have been used for injection, but with similar poor results.
• Tissue grafting. Another technique for increasing width or length is tissue grafting. This involves taking a piece of skin and fat layer, called a graft, from another place on the body. This graft is sewn onto the shaft of the penis. Sometimes other graft material is used. None of these procedures has been proved to be safe or to work. The procedures may cause infection and scarring that can deform the penis' shape. They also can affect your ability to get an erection.
• Penis implants. These surgeries involve placing material under the skin of the penis to give it a thicker appearance. Infections and problems with the graft may require another surgery to remove the graft. Shortening, scarring and curving of the penis can happen. The surgery also can affect your ability to get an erection.