Penis enlargement surgery: bigger is better?

by: Winnie Allingham

September 29, 1999

I WANT A BIGGER PENIS

Bigger is better, and in North America that goes for sex organs too. We’ve all heard about breast implants, and now penis enlargement, a relatively new procedure, is the latest growth industry. Some doctors advertise that they can lengthen a penis by 1/2 to 2 inches (1.25 to 5 cm), and enlarge its girth by up to 50%. Yet the practice is hugely controversial. The American Urological Association’s statement is that penis enlargement surgery “has not been shown to be safe or efficacious.”

“99 percent of these people who come to me and say ‘I want my penis bigger’ are nuts,” says Dr. Sidney Radomski, a Toronto urologist. “They really have a psychological problem. I’m amazed people would have this surgery. It looks awful.”

Keith Schulner is a Camarillo, California attorney, whose firm has handled 58 lawsuits against a urologist who practiced penis enlargement surgery. He says, “The top five problems in order of severity were: impotence, incontinence, pain, numbness, and disfigurement. A minority are impotent still....One didn’t even look like a penis. You’d have to look twice. It was round, kinda coneshaped.” When asked if he’d ever consider penis enlargement after seeing what he has, Schulner laughs: “Not a chance.”

So why, then, are men paying from $4500 to $13000 Cdn to have their penises enlarged?

I DIDN’T WANT TO BE A PORN STAR

“I did not do it to show off my penis in the gym when I work out or to be a porn star,” says an anonymous penis enlargement patient who was operated on by Dr. Robert Stubbs, a plastic surgeon based in Toronto. This patient had the operation two and a half months ago and is currently undergoing the extensive post-operative procedures. “The inspiration, and this is the explanation I gave my wife, was that having a longer penis allows the individual to enjoy the sexual relationship better. ...It allows the couple to have various positions during sexual intercourse that makes the relationship more valuable, more enjoyable, more interesting and more satisfying.”

“A lot of men just want to feel better about themselves, they want to feel more comfortable in the locker room,” says Dr. Gary Rheinschild, an Anaheim, California urologist when asked what motivated his patients to have penis enlargement surgery. Dr. Stubbs agrees. “The penis is symbolic of manhood. Men who feel shortchanged in that area have sometimes had crippling experiences in the locker room, with other men, or in the bedroom with women.”

The operation itself is straightforward.

The penis is a lot longer than it looks. About half of the penis is tucked away inside the abdomen, and it is anchored to the pubic bone by two ligaments. When these ligaments are surgically severed, the penis slumps forward. The actual size of the penis is not changed. There is just more of it outside the body after the surgery.

“Lengthening, in a sense, is a misnomer. Penis exposure would be a better term,” writes Dr. Stubbs in the Canadian Journal of Plastic Surgery. He learned about penis enlargement in China. Dr. Long, a surgeon in China, fixed a patient whose penis had been bitten off by a dog. After that success, Dr. Long continued to do the operation as cosmetic surgery, teaching Dr. Stubbs along the way. Since China, Dr. Stubbs estimates that he has done more than 460 penis-lengthening operations.

A few weeks after the lengthening operation, once the incisions are healed, weights are attached to the penis. “The skin scar alone can be so retractile (tending to retract)…that unless I apply force in the opposite direction...we might end up with a shorter penis because of the pullback,” says Dr. Stubbs. “One of my early patients said ‘why don’t you use truck wheel balancing weights, they’re adhesive’. I believe we are the biggest consumer in all of North America now for those weights.”

Dr. Stubbs’ patient is currently in this phase: “It’s not comfortable to walk around every day with a pound and a half of weight hanging from your penis...It is embarrassing because you have to wear loose pants but sometimes people notice things.” Traction is maintained for up to six months.

The girth of the penis is widened with fat injected by syringe, or by dermal fat grafts, which are two strips of skin with attached fat. This skin, usually two inches (5.08 cm) by six inches (15.25 cm) wide, is harvested from the crease between the buttocks and the thigh.

“We put the dermal graft in under the head of the penis to the base of the penis...it makes it appear symmetrical and even,” says Dr. Rheinschild. Both Dr. Stubbs and Dr. Rheinschild agree that the lengthening and widening procedures must be done six months to a year apart.

There are permanent side effects to the penis enlargement surgery. The angle of the erection becomes more horizontal than vertical after the lengthening operation. Also, the penis becomes floppier, and more prone to buckling and penile fracture. The pubic skin that is pulled forward to cover the extra inches can leave the shaft hairy and the gain in size in the enlarged penis’ flaccid state is more than appears in its erect state.

When enlarging circumference, the head of the penis cannot be widened: just the shaft. The penis can end up looking like a tied balloon and distinctly unnatural.

ARE YOU MAN ENOUGH?

All genital enhancement techniques require money and an operation, but the lengthening procedure also requires the type of man willing to commit to wearing weights for an extended period of time. For these and other reasons, Dr. Stubbs only operates on 15 percent of the men who come to his clinic for penis enlargement. “(Some men) are unrealistic. They don’t have proper aftercare and they think it’s just like buying higher horsepower in a new car, pay a bit of money and get a few inches. The operation unfortunately is not just a bit of surgery, it’s the aftercare.”

Dr. Stubbs has other reasons for carefully vetting his patients. “We all know that if a man is unhappy with the outcome of surgery,... they do things, which can be terminal. There was a doctor killed in Spain for a nose that didn’t go well.”

Despite this, Dr. Stubbs reports a satisfaction rate of 80 percent for his genital enhancements. According to his patient, “Psychologically, the fact that you look at yourself in the mirror and you see that you have a longer penis - which is what you wanted from day one - it gives you a satisfaction, sure.” This patient of Dr. Stubbs says his penis has a net gain of 4 to 4.5 centimetres (1.5 to 1.7 in), and expects 1 to 1.5 cm (0.4 to 0.6 in) more when his healing is complete. Dr. Rheinschild’s best results were with a navy commander, who went from 14.5 cm (5.75 in) to 24 cm (9.5 in). So why does the American Urological Association say this surgery isn’t safe or effective?

“I can’t recommend a lot of the doctors who are doing this type of surgery because I’ve just seen too many bad things,” says Dr. Rheinschild. His practice centers on a recently developed subspecialty: fixing up botched penis enlargement operations. 50 percent of the operations he does are reconstructive. “There’s a gentleman in Beverly Hills who operated on an attorney from Hong Kong. And the attorney was very unhappy about it because the dermal grafts pulled up from the head of the penis and the base of the penis so it looked like a camel’s hump.”

Dr. Rheinschild has dealt with common and unusual complications. “The most common I’ve fixed is severe scarring at the base of the penis which gave (it) severe distortion. Another problem…is fat injections… (the patients) develop lumps and bumps. I really have to condemn all fat injections.”

Dr. Rheinschild remembers two worst case scenarios. “There was a gentleman who got an infection that wasn’t treated and so the patient got an infection of the pubic bone. (He went to hospital) and they had to cut the bone out. I did not even attempt to reconstruct because of the severe damage to his penis, the nerve sensation, and the bone. It was just too risky. The other I did attempt to repair, which was done by a doctor in Windsor, Ontario. (The patient) had lost approximately three and a half inches (8.9 cm). We were able to give him back one and a half (3.8 cm). Some of these people are done so poorly there is not a lot you can do.”

SOME MEN THINK I’M A GOD, AND OTHER OPINIONS

Dr. Radomski has seen patients with penis enlargement surgery at his Toronto erectile dysfunction clinic. “They look horrible, they are disfigured, and often the results are poor…the penis is in an odd position and there is lots of scarring.” He recommends the surgery only for children with deformed penises or micropenises, or car crash victims, and that’s it. “First of all the American Urological Association, which is the largest urological association in the world, has indicated that penis enlargement surgery is not recommended. Second of all the patients have psychological problems, the majority of them, you should not be operating on these people.”

Dr. Radomski suggests that money is at the heart of the controversy. “Whatever Dr. Stubbs says, it’s a biased view. You cannot have an unbiased opinion when you are charging patients $3000 or $4000 dollars to do surgery like that. And the same thing with the patients who have the surgery. If you’d paid $4000 to have your hair done, you’d say it looks great, doesn’t it?”

He recommends a different approach to men who want a bigger penis. “The majority of the guys who come in do not have a penile size problem. You see a guy who thinks he’s small. Well, hello, it’s not small. If you take a real honest approach, you say: look, you don’t need this type of surgery. Your penis is normal size and it shouldn’t affect your sexual performance. The problem is your mental thought about this needs to be assessed, not your penis.”

“Some men think I’m a God that cured their problem,” says Dr. Stubbs about his patient’s reactions, “and some that I’m the worst possible person that’s taken advantage of their insecurity.” He’s very aware of the controversy surrounding penis enlargement surgery. “I’m just sitting in the middle with my scalpel in my hand.”

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