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"I think there isn't a guy in the world who hasn't wished his penis were an inch or two longer," says Michael O'Leary, MD, professor of urologic surgery at Harvard Medical School and a urologist at Brigham and Women's Hospital in Boston.
However, after more than a century of generally dubious and sometimes lunatic penis enlargement attempts, there's still not much you can do. Sure, there are lots and lots of supposed options out there -- penis pills, creams, brutal stretching exercises, horrific-looking devices, and penis surgery. Almost none of it works. The few approaches that can work often have modest benefits and serious side effects. How serious? In some cases, erectile dysfunction-serious.
"Trust me, if I knew of a way to safely and effectively increase penis size, I'd be a billionaire," O'Leary tells WebMD. "But I don't. Nobody does."
Still, common sense doesn't stop size-obsessed guys from trying very sketchy treatments on a vital part of their anatomy -- and risking a lot in the process.
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The typical erect penis is usually 5 to 6 inches long with a circumference of 4 to 5 inches. There's more variation in the size of flaccid penises.
Some guys are genuinely smaller than that. In rare cases, genetics and hormone problems cause a condition called micropenis -- an erect penis of under 3 inches. Sometimes Peyronie's disease or prostate cancer surgery can reduce a guy's size.
But studies show that most of the guys seeking penis enlargement are average-sized. They just think they're below average.
Why? Part of it is perspective. It's very hard to gauge the size of your own penis -- looking down, you've got a bad angle.
Psychology plays a role, too. Some average-sized guys become obsessed with the idea that they're too small. There's even a psychiatric diagnosis: penile dysmorphic disorder. It's similar to the perceptual distortion of anorexics who think they're fat no matter how thin they get.
According to one study, the majority of men who get penis enlargement surgery have this condition. They're also the least satisfied with the results.
"A lot of men who think that they have a small penis are overweight," says Jennifer Berman, MD, a urologist in Beverly Hills and co-author of Secrets of the Sexually Satisfied Woman.
Losing weight will reveal more of that hidden shaft that's buried beneath belly fat. It doesn't actually increase your size, but it will look that way.
For guys who would rather have a surgical procedure than eat less, liposuction of the fat pad around the penis can work. Still, the effects aren't permanent -- if you don't change your eating habits, your penis will once again sink into your belly, like a pier at high tide.
There are no well-studied approaches. No major medical organization approves of these surgeries. Some guys opt to travel to other countries for treatments that aren't approved in the U.S. If that thought has crossed your mind, slow down -- it's time to have a frank talk with your doctor about the risks you'd be taking.
The side effects of lengthening surgeries are numerous and include infections, nerve damage, reduced sensitivity, and difficulty getting an erection. Perhaps most disturbing, scarring can leave you with a penis that's shorter than what you started with. Widening the penis is even more controversial. Side effects can be unsightly -- a lumpy, bumpy, uneven penis.
The few studies that have been done aren't encouraging. The European Urology study looked at 42 men who had procedures to lengthen their penises by cutting the suspensory ligament and found that only 35% were satisfied with the results. Half went on to get more surgery.
Talking to a doctor or a therapist can help. Research has found that when a doctor honestly reassures a guy that his penis is average-sized, he is likely to stop searching for surgery.
You also need to be on guard against phony claims for miracle penis enlargement.
"The main target for penis enlargement advertising is insecure guys who think all their power lies in their penises," says Berman. "These guys are easy victims."
Ian Kerner, a sex counselor in New York, says that the imagined glories of a gargantuan penis are not all they're cracked up to be.
"When it comes to penis size, being average is really where you want to be," says Kerner, the author of books including She Comes First. "Having a penis that's too big can be a much larger problem -- pun unintended -- than one that's too small." For guys who are too big for their partners, oral or vaginal sex can be difficult.
So consider: A quest for a bigger penis could leave you with a lumpy, bruised, discolored, thickened, painful, dysfunctional member. (Not to mention a drained bank account.) Does risking the inches you have for the hope of an extra half inch make sense?