Presented by: Kyle T. Moore BA
Rutgers Robert Wood Johnson Medical School

Introduction

Society has long been preoccupied with penis size. As a result, penis enlargement strategies provide examples of mankind’s ingenuity in addressing the issues troubling them most. From snake bites to complex cosmetic surgery, this essay summarizes the lengthy history of penile augmentation.

Materials

Existing literature was reviewed to provide a history on penile enhancement. Beginning with a discussion on ancient attitudes and practices, landmark studies are summarized to portray the evolution of penile augmentation strategies into the techniques being investigated today. This paper also provides analysis on the effectiveness of various techniques and the quality of evidence available in the field of penile augmentation.

Results

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Weights, herbal remedies, and jelqing represent examples of ancient penile enlargement strategies. In the modern era, girth enhancement began with Robert Gersuny’s mineral injections, and now numerous injectable fillers are approved for cosmetic use and under investigation for penile girth enhancement. Fat injections and dermal fat grafts are other examples of strategies for girth enhancement. Recently, the Penuma^® implant became the first FDA-cleared penile implant for cosmetic male penile enhancement. Meanwhile, modern penile lengthening strategies can be traced back to Cantwell’s 1895 description of reconstruction of an epispadic penis. Since then, V–Y advancement and suspensory ligamentolysis have become foundational techniques for penile lengthening. Other approaches have also arisen over recent years, including suprapubic fat pad reduction, penile disassembly, and sliding elongation. However, while many techniques exist, weaknesses in the field such as unstandardized methodology and publication bias make it difficult to develop clear guidelines on penile augmentation. Furthermore, studies have found mixed psychological outcomes and patient satisfaction even if there are measurable increases in penile length or girth.

Conclusion

Penile augmentation has a history dating back thousands of years. Penis size is of great importance to many men, and advancements in this field may provide relief for those suffering from penile dysmorphophobia. However, the evidence behind these techniques is incomplete, and more research is needed before the benefits of penile augmentation can be compared to those of procedures such as breast augmentation. However, given mankind’s relentless pursuit of penile enlargement, we can expect continued advancements in the field for the foreseeable future.

Funding

None

Co-Authors

Melinda Z. Fu, MD
Rutgers Robert Wood Johnson Medical School

Benjamin J. Lichtbroun, MD
Rutgers Robert Wood Johnson Medical School

Danielle Velez, MD
Rutgers Robert Wood Johnson Medical School