Dear Dr. G,

I am a 22-year-old man who is often very shy.

The truth is, I have a dark secret that has been haunting me since my childhood.

Since I can remember, I have always noticed having a small penis.

I recalled telling my parents about my anxiety, and they took me to see a doctor.

As I was in my prepuberty state, the doctors reckoned I had a buried penis which would sort itself out when I lost my baby fat.

I tried so hard to lose weight and despite having minimal pubic fat, I still considered my penis to be smaller.

I really lived healthily throughout my youth and exercised regularly.

To my disappointment, I do not see any improvement in the penile front.

In fact, I went to see the doctors myself after the age of 18, the doctors assured me my penis is within normal range, and I should accept the way I was built.

I accept functioning. I can probably get by with no problems in the future. However, I am not going to accept the average in my life.

I went to the specialist, who told me the penile enhancement is a hoax and will not work for me.

However, on the contrary, I saw a few social media posts on how it worked for the others, and I am willing to risk it for my dream.

I am putting Dr G on the spot to make the impossible penile enhancement possible!

Can you tell me what penile enlargement operations are?

How long have they been around? How effective are they?

What are the complications of such operations?

Finally, should I take the risks and make “impossible” penile enlargement possible?

Yours truly,

Short-changed Shaun

Attempts to lengthen the penis can be traced back long before the advent of modern surgery. Various cultures practised traction, stretching, or the application of weights to the genitalia, usually beginning in adolescence, though these methods were anecdotal and culturally specific. In the 1970s and 1980s, modern surgical principles were applied to penile length restoration. Surgeons working in reconstructive urology, especially those treating trauma, severe scarring, genital malformations, or buried penises in obese patients. Only later did these reconstructive methods migrate into the cosmetic realm, promoted to men with normal genital anatomy seeking purely aesthetic enhancement.

The demand for penile enlargement has increased dramatically, driven in part by the internet, advertising, and social media. Yet systematic reviews consistently show that most men who pursue lengthening procedures have a penis within the normal range. The gap between perceived inadequacy and anatomical normality is driven less by measurable deficiency and more by anxiety, misperception, or body dysmorphic tendencies. Only specific conditions—true micropenis, severe fibrosis, traumatic shortening, Peyronie’s disease, or buried penis due to obesity or scarring are widely regarded as legitimate indications for surgical elongation.

Understanding the mechanisms of lengthening requires distinguishing between non-surgical and surgical approaches. Non-surgical interventions such as penile traction therapy represent the most evidence-supported method outside reconstructive surgery. Traction devices apply a sustained, low-intensity stretch to the penis for several hours per day over months. Multiple studies reveal modest gains, usually in the range of one to two centimetres in stretched flaccid length, with variability in erect length outcomes. Vacuum erection devices, although excellent for penile rehabilitation in men with erectile dysfunction or after prostate surgery, do not reliably produce permanent lengthening when used alone. Their role remains ancillary rather than primary.

The suspensory ligament release is the most widely known cosmetic lengthening procedure. The principle involves dividing the ligament that holds the penis close to the pubic bone, allowing a greater portion of the internal shaft to protrude externally. While the concept appears straightforward, the results often disappoint. Studies show that this operation usually increases flaccid apparent length rather than true functional erect length. The penis may project further when at rest, but the corpora bodies themselves are not lengthened. Furthermore, the procedure can destabilise the penile base, alter the angle of erection, and reduce rigidity during intercourse. Complications such as scarring, tethering, aesthetic deformities, and even worsened erectile function are not rare.

Other surgical corrections typically involve suprapubic lipectomy, skin fixation, and reconstruction of the penopubic junction. Although the corpora are not physically lengthened, the difference in functional and perceived length can be significant, and patient satisfaction rates are higher than in cosmetic procedures performed on otherwise normal anatomy. However, these operations are technically demanding and carry risks of wound complications, especially in obese or diabetic patients.

Most gains produced by surgery are improvements in flaccid appearance or restoration of length lost to disease rather than creation of a genuinely longer penis. Non-surgical traction yields modest but meaningful improvements when performed correctly, yet few men adhere to the demanding schedule required for success. Cosmetic surgical procedures, especially suspensory ligament release, offer inconsistent results that often fail to meet patient expectations. Satisfaction is closely tied to psychological factors and expectation management; men who expect dramatic increases in erect length are almost always disappointed.

Penile elongation procedures occupy a fascinating, controversial, and often misunderstood space within sexual medicine. They sit at the crossroads of reconstructive urology, cosmetic surgery, psychological well-being, and cultural expectations about masculinity. While the desire for a longer penis is neither new nor uncommon, the scientific and surgical journey toward achieving it has been far more complex, risking potential serious complications. Mohamad Ali famously said: “Impossible is just a big word thrown around by small men” When it comes to penile enhancement for normal men, Dr G’s opinion is: “Small men who refuse to accept the impossible might just be thrown around by big regrets!”