Here’s What Happens When You Get a Penis Enlargement Surgery

VICE spoke to surgeons about some of the ways people with penises can become people with bigger penises, and the risks involved in the process.
Penis enlargement surgery implant fat transfer elongation
Photo: Charles Deluvio / Unsplash  

For one reason or another, a lot of people long for bigger penises.

Dick size is the subject of brotherly banter as well as bullying, a source of pride and shame, and the inspiration behind cultural phenomena, with phrases like “big dick energy” and “gray sweatpants thirst” swung around a lot.


And like it has for lips and butts, modern medicine has erected a number of ways for members to become bigger—by length and girth—through surgery. According to cosmetic surgeon Niro Sivathasan, surgical penile enlargement remains an open secret. 

“[Penile enlargement surgeries have] always remained one of those things that not many men would discuss, but it was available information,” he said. 

Sivathasan is based in Sydney, Australia, and has a background in reconstructive surgery. He now focuses on aesthetic surgery and medicine. Sivathasan said he has performed multiple penile enhancement surgeries as well as related procedures, like scrotal lifts. He compared these surgeries to a more popular and now less taboo cosmetic procedure: breast implants.

“It wasn’t long ago that women would never speak about breast implants. It’s just not something you’d talk about. Now, they discuss it everywhere. They talk about it freely. It’s very much been accepted into mainstream culture,” Sivathasan told VICE.

James Elist, a urologist based in Beverly Hills, California, made the same comparison. Elist has been a urologist for over 40 years, originally working to treat male sexual dysfunction and infertility in his patients. In the early 2000s, he developed an implant to increase girth in penises.


Elist estimated that about a third of his penile enlargement implant patients have partners who have had breast implants. The women, Elist told VICE, talk to the men about how happy they are with their breasts, prompting the men to think it’s time for them to have something made bigger, too.

The profile of people who get penile enlargement surgery, “covers the length and breadth of men,” said Sivathasan. He has seen people in their 20s to those in their late 50s, manual laborers and CEOs, and straight as well as gay men.

The impact of surgical penile enlargement is, well, larger, for some people—like those who have micropenises or buried penises—but for others, the surgeries are more of a lifestyle choice.

Elist said some of his patients want the surgery to make their penises look more even or to better satisfy their partners in bed. Meanwhile, Sivathasan said some of his patients look to the surgeries to resolve feelings of inadequacy. He added that by removing the stigma around talking about penile enlargement surgeries, “we are going to help address the feelings, albeit misguided, of inadequacy that men have associated with the size of their penis.”

Penile enlargement surgeries are highly specialized procedures that come with the risk of complications. According to one study, these could include penile deformity, non-healing wounds, and sexual dysfunction.


Sivathasan acknowledged that patients may lose sensation in their penis temporarily after certain types of surgeries, but it is likely to return with recovery. Other possible side effects include infections, bruising, and damaged nerves. He said that while there are risks, penis enlargement surgeries do not normally have adverse effects on penile function, fertility, or sensation. 

Doctors like Sivathasan and Elist screen their patients to make sure their heads—the one on top of their shoulders—are in the right place. This often includes careful consultation and sometimes even counseling. They need to make sure that the patients choose the right surgeries for what they want to achieve, have reasonable expectations of the surgeries they pick, and can make the commitment to post-surgery downtime and recovery, as well as other considerations for both doctor and patient to confidently proceed with the surgeries.

Sivathasan warned that doctors need to be careful when performing these procedures, lest they damage the nerves, and patients end up with what he called a “wooden woody,” or a penis unable to feel or function. 

People with penises who are interested in taking a shot at becoming people with bigger penises must think long, deep, and hard before undergoing a penis enlargement procedure. When successful, however, these surgeries have the potential for life-changing effects.


Elist said that his patients report having more sex with their partners after getting their penises enlarged. Sivathasan, on the other hand, said penile enlargement procedures can give people more confidence, be it to enter the dating world or to wear shorts at the beach. One guy told GQ that he experienced “this crazy amount of stamina” after a penis enlargement procedure, adding that he “can go for two hours.”

“As with anything in the cosmetics industry—whether it’s right or wrong in terms of the way others perceive it—when an individual feels that they look better, that positively reinforces their mindset, [and] they engage better with other people as a result. That then positively reinforces their [behavior], and it just improves the quality of their life,” said Sivathasan.

Here are some of the ways penises are surgically enlarged.


True to the adage, people in search of something need not look further than inside themselves—even if what they’re searching for is some extra penis length.

“Twenty-five to 30 percent of the penis is buried, which means it is below the skin,” Sivathasan said. He explained that in elongation surgery, doctors “exteriorize” the buried portion of the penis by releasing the ligament that holds it close to the body. In doing so, Sivathasan said that the penis will hang lower, and therefore look longer. 


The question, of course, is what that ligament was for to begin with. According to Sivathasan, the ligament is what makes erections point upward, so when it’s cut, patients lose about 15 degrees from the angle of their erections. “That is the compromise that one has to make,” he said. 

Postoperative stretches and exercises are critical in this procedure, as Sivathasan warned that patients who do not follow them may find that their penis retracts, and they may end up with an even shorter penis.

“Patients may expect the penis to typically be about 25 to 30 percent longer, as this is the amount that is buried,” Sivathasan said. “Postoperative stretching may give up to 50 percent longer than pre-surgery baseline, but certainly not double, as per the marketing promises by some.”

He stressed that no new length is created in this procedure, but “[the penis is allowed] to come out a bit more.” 

Fat transfer

Length, however, is literally only one dimension of penis size. Another dimension, which some would argue is more important in sexual pleasure, is girth. 

One way to increase penis girth is to take fat from somewhere else in the body and inject it into the penis. Sivathasan said the fat for this procedure is usually taken from the lower abdominal area or the pubic area just above the penis. Taking fat from the latter will make the penis look bigger anyway, Sivathasan said, because there’s less mass surrounding it.


He said surgeons then inject that fat into the shaft of the penis, thereby increasing the girth by around 1.5 inches immediately after the operation. This increase then stabilizes at around an inch after six weeks. That gain in girth gradually decreases over time, with around 30 percent of the fat surviving after 12 months, and an eventual return to the original girth in 18 to 24 months.

“Of course, numbers are variable and depend on lifestyle factors such as smoking and how the penis is used,” added Sivathasan.

Harvesting the fat is a relatively safe procedure since surgeons don’t need a big amount, he said. Patients should be warned, however, of possible lumpiness and “a cobblestone” appearance in the penis after the procedure. 


Penuma, shorthand for Penis New Man, is a penile implant Elist developed in the early 2000s. It’s made of soft medical-grade silicone and comes in multiple sizes, including large, extra large, and extra-extra large. According to Elist, it covers the penis from under the head to the base, and then goes around one inch into the body. He said it’s like a jacket for the penis, adding one to two inches of girth.

The procedure takes 45 to 60 minutes, and patients should be able to go back to daily activities, except sex and exercise, in two to four days. Elist said the body forms a capsule of tissue around the implant over time, and that the silicone feels natural and undetectable for sexual partners who have not seen the penis before surgery.


The Penuma implant is designed to last a lifetime, but it can be taken out. This may become necessary if patients do not comply with postoperative care guidelines, which could cause infections in the implant. 

Dermal fat graft

One of the most invasive of procedures is called a dermal fat graft, which Sivathasan said has been used in reconstructive surgery all over the body for years.

When done to enlarge the penis, which Sivathasan said is an extraordinarily

specialized procedure, surgeons “deglove” the penis, or pull it out of its skin. They then open the penis up to get to a deep layer, and sew the dermal fat graft (normally taken from the buttocks or abdomen) into place. The surgeons then put the penis, which is now thicker, back into its skin. Once done, it’s up to patients’ bodies to form blood vessels around the dermal fat graft, allowing it to settle.

If not done properly, the procedure can cause damage in deep structures of the penis, resulting in pain and swelling. Sivathasan said the probability of this happening is not high, but it is nonetheless a possibility.

The payoff of the procedure is that the results are permanent, giving patients one to two inches of extra girth, “and most of it shall survive,” said Sivathasan, comparing the results of the dermal fat graft to those of fat transfers, which decrease over time.

“However, this depends on available fat, [which is] less in fitness fanatics, and ability to accommodate the firmer structure by the skin when the enlarged penis is returned back into [it],” added Sivathasan. 

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