Penile implants are prosthetic devices developed to address significant functional issues, primarily concerning erectile capability. The question of whether these medical devices can also increase the physical size of the penis is a common point of confusion for many patients seeking treatment. This discussion clarifies the true purpose of penile implants, examines their actual impact on size, and contrasts them with procedures specifically designed for cosmetic enlargement.
The Primary Role of Penile Implants
The primary function of a penile implant is therapeutic: to restore the ability to achieve and maintain an erection suitable for sexual activity when other, less invasive treatments have failed. These devices are a long-term solution for men experiencing severe, chronic erectile dysfunction (ED). They are typically recommended after initial treatments, such as oral medications or injections, prove unsuccessful.
Implants are also frequently used to manage complex conditions like Peyronie’s disease, where scar tissue causes painful curvature and significant shortening. By addressing the underlying inability to achieve rigidity, the implants restore the structural integrity necessary for intercourse. The goal is functional restoration, not cosmetic alteration.
The devices fall into two main categories: inflatable and malleable (semi-rigid) implants. Inflatable implants, the most common, consist of cylinders placed within the penis, a pump in the scrotum, and a fluid reservoir in the lower abdomen. Activating the pump transfers sterile fluid into the cylinders, creating a firm erection that mimics the natural engorgement process. Malleable implants consist of a pair of rods that are always firm but can be manually bent into position for sexual activity or concealed when flaccid.
Do Penile Implants Increase Length?
The medically accurate answer to whether a penile implant increases anatomical length is no. Implants are sized to fit the existing internal structures of the penis, specifically the corpora cavernosa, the two chambers that normally fill with blood during an erection. The implant’s design utilizes the maximum available space within these chambers to provide optimal rigidity.
A common misconception arises because many patients requiring an implant have already experienced significant length loss due to underlying conditions like severe ED or corporal fibrosis. The lack of healthy, frequent erections causes tissue atrophy and scarring, leading to shrinkage. When the implant is placed, it restores the penis to its pre-disease, stretched length by fully extending the fibrotic tissue.
This functional restoration can lead to a perceived increase in size because the erect penis is now fully firm and rigid, a state that was impossible prior to the surgery. Objective data shows that while not designed for enlargement, the inflatable prosthesis can result in a small mean objective increase in length and girth compared to the pre-operative stretched measurement. This minor gain, sometimes reported around 0.36 cm, is primarily attributed to the hydraulic pressure of the inflatable cylinders fully expanding the corporal tissue.
Maximizing Existing Length During Surgery
Surgeons employ specific techniques to maximize the patient’s native penile dimensions during the procedure and prevent the common complaint of perceived shortening. The process begins with meticulous preoperative measurement of the stretched flaccid penis, establishing a baseline for the target implant length. Experienced surgeons perform aggressive sizing, selecting the longest possible cylinder size that can be safely placed within the corpora cavernosa.
During the operation, specialized surgical instruments are used to carefully stretch the fibrotic corporal tissue, accommodating the largest possible cylinders. This intraoperative stretching is a deliberate action to counteract the tissue atrophy that has occurred from chronic ED. Post-surgery, patients are instructed to begin a regimen of early and frequent cycling—inflating and deflating the device—which acts like an internal tissue expander.
In cases where significant length loss has occurred, particularly with severe Peyronie’s disease, surgeons may use advanced techniques like the Modified Sliding Technique (MoST). This specialized procedure involves making small, controlled incisions in the tunica albuginea, the sheath surrounding the corpora, to allow for tissue expansion and significant lengthening at the time of implant insertion. These specialized maneuvers are aimed at restoring and preserving the patient’s maximum potential length, rather than adding new anatomical tissue.
Procedures Designed for Size Enhancement
When a patient’s primary goal is to increase penile size beyond its original dimensions, they are seeking cosmetic enhancement, which is distinct from the functional restoration provided by a penile implant. Several procedures are marketed for this purpose, focusing on increasing either length or girth.
Lengthening procedures often involve surgically cutting the suspensory ligament that anchors the penis internally to the pubic bone. Releasing this ligament allows the penis to hang further forward, resulting in an increase in flaccid length, but it does not change the actual erect length. This procedure is sometimes combined with a ventral phalloplasty to enhance external projection.
For girth enhancement, procedures include injecting dermal fillers, such as hyaluronic acid, or performing fat grafting. These injectable materials are placed beneath the skin of the penile shaft to increase circumference. Fat grafting can be unpredictable, however, due to variable reabsorption rates and the potential for a lumpy or irregular appearance. These size enhancement procedures carry different risks and are not covered by insurance, as they are not medically necessary to restore erectile function.