The Fast-Growing Business of Penis Enlargement Surgery

Richard Jones, a journalist from Bromsgrove, England, is talking about his penis.

"I'm looking at it in the mirror now," he says down the phone. "It hangs almost half way to my knees. If you think of a tin of Right Guard aerosol, it's like that but a bit fatter. If I try and put my thumb and first finger round it, they don't meet."

He pauses for a moment. Then decides he hasn't quite offered enough detail.

"The first time my husband saw it, his expression was just terror. Safe to say, he very much likes it now."

Richard is one of a growing number of men who have had a penis enlargement. He paid £7,000 [€9,930] last October for a pair of London surgeons to augment him. Firstly, they sliced open the pubis and severed a ligament so that his manhood hangs an extra inch and half longer, to six inches flaccid. Secondly, they removed a quantity of fat from his stomach and injected it into the shaft of the penis to increase the girth by about five centimeters. Erect, it's worth noting, it's remained roughly the same size as before.

The whole operation lasted little more than an hour and Richard was able to have sex again within a month. Today, he says he has no visible sign of scarring.

"I was never small, but I thought it would be nice to have it done," shrugs the 39-year-old. "And it's improved my confidence so much. It's a lovely feeling, walking into a room and thinking, If we all got our cocks out here, I'd have the biggest. I see people in the gym showers checking it out. My only regret is I didn't have it done ten years earlier."

Penis enlargement is—and there's no way of avoiding the pun here—a fast-growing business. The increasing availability of pornography, the rise of advertising that features the male crotch—think David Beckham in his underwear, or Cristiano Ronaldo in his underwear, or Rafael Nadal in his underwear—and the ubiquitous spam emails telling us all we need to be bigger downstairs has, so the theory goes, created a generation of men anxious about what they're packing. One study carried out at King's College, London, found that a third of us stress over it.

All of this has led, according to the International Society of Aesthetic Plastic Surgery, to some 15,000 enlargements taking place worldwide every year, up from way under a thousand just four years ago. Which is why I am here at the London Centre for Aesthetic Surgery, the clinic of doctors Maurizio and Roberto Viel.

The twin brothers from Italy are largely acknowledged as Europe's finest penis boosters. Together, they have been performing what they term penoplasty operations since 1991. The pair—who both have medical degrees from the University of Milan—were the first surgeons to offer the service outside the US.

"It actually started with a girl coming into our clinic and asking if we could make her boyfriend's penis bigger," remembers Dr. Maurizio. "This was a request we had not heard before, but she'd read about it being done in America. So we looked into it and decided this was a service we could provide. The funny thing is the girl never came back. Maybe she split from him. Maybe he was less keen."

Today, the pair perform more than 400 such operations a year at their two clinics in Dubai and London's Harley Street. They make more than a million pounds per annum from the procedures. Men from across Europe and Asia come to them, and there is no stereotypical patient, they say. Customers include everyone from high earners to the unemployed; gay, straight, young, old, and all nationalities.

"We had an African gentlemen visit us recently," says Maurizio. "And his size… I had to say to him, 'This is not a penis that needs making any longer, this is just fine how it is.' We ended up compromising and I gave him a little more girth."

The pair won't operate on anyone under 18 and tend to turn down anyone in their late teens or early twenties. "They are so young," says Roberto. "I say to them, 'Go out and use it first.' Then, if they're still unhappy in a couple of years, come back and we'll talk more. We have a duty of care to our patients. We don't just operate on anyone. We look into the reasons why they want this done and, only when we're certain this is not a psychological issue, only then do we proceed."

Which raises the key question here: Why exactly do so many guys want their dicks enlarged?

"To feel more confident," says Maurizio. "It's the same rationale as behind a woman wanting bigger breasts. These guys feel better in themselves to know they're bigger. Some men, as soon as they finish sex and lose their erection, they cover up immediately because they don't want to show their partner the flaccid penis. They feel embarrassed. That's no way to live."

Would they have it done themselves? I ask. There's a pause.

"If I felt it was something I wanted, yes," nods Maurizio. "Personally, though, I'm not the biggest—I admit that—but what I have is enough for me. I think, with sex, quality is as important as quantity."

Another pause.

"I've had a nose job—Roberto did it. So maybe when I'm 80 years old I will do this, just to try something new. Why not?"

A penis enlargement is arguably more important for some men than others. One of the most common conditions the Viels see are guys with what's medically called a micro-penis.

"These are so small they do not hang below the scrotum," explains Roberto. "Some, they are like a button. You'd be surprised. It's not very common [about 0.6 percent of men suffer from the condition] but it happens. For these men, the surgery is really very necessary. For them, we are offering a life-changing service."

The optimum penis size, the brothers reckon, is "whatever makes you happy." But if someone came in asking for, say, a 30 centimeter upgrade, they would tell them this was impossible.

"The lengthening operation—the cutting of the ligament—allows you to only extend a penis by five centimeters at most," says Maurizio. "If a surgeon promises you more, they are misleading you. Theoretically you can keep increasing the girth, but too much will lead to the penis being too heavy, causing erectile problems in later life. It needs to be done in moderation."

There can be complications, too. The doctors say that 90 percent of their patients leave—like Richard—delighted with the results. I speak to one other guy from Leeds who asks not to be named. He tells me that having "a cock like a can of Foster's is probably the best thing about me."

Nonetheless, issues can arise. An elongated penis rarely retains the same angle of erection post-op. Scarring occasionally remains visible under the pubic hair. Infections have been known occur. The pain in the first couple of weeks can be considerable—especially if the patient becomes erect.

"This is why we prescribe a drug to stop this happening," says Roberto. "Plus, we tell the patient: 'Stay away from the wife.' Do complications happen? Very occasionally. The important thing is that we deal with them right. The key thing—the thing that men are most bothered about—is will it work properly after the operation. And yes, it will. There is no doubt of that."

Do they not worry that they are feeding on male insecurity? I ask. Did they really work through medical degrees for this?

"We don't save lives, this is true," says Maurizio. "But we do improve the quality of them. We make people feel better about themselves. We transform their confidence. You only have one life and there's no point spending it unhappily. I feel we're doing a good thing here."

As I think back to Richard and his husband and their delight at the results, there seems little arguing with that.

"It's very satisfying when you've completed an operation," nods Maurizio. "It's nice to look at a penis and know you've made it more pleasing."

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