ABSTRACT

Introduction Elongation of the penis has been contemplated since antiquity, 1 but only since 1971 has it been carried out as a reconstructive surgical technique for congenital and acquired shortening of the penis. 2-6 Cosmetic penile enlargement began with girth enhancements in Miami in the late 1980s, but it was the Chinese surgeon Long who in 1990 described division of the suspensory ligament and penile skin advancement as a cosmetic procedure to increase penile length. 7,8 Since then, over 10,000 men have undergone penile lengthening and girth enhancement, although no peer-reviewed paper has reported a reliable description of the techniques or results. The risks, both cosmetic and medical, have never been described by the proponents of the operations, and the complication rate is unknown. 9 Interest in the procedures remains intense, 8 despite action by the California Medical Board against one of the major proponents. 10 A full understanding of penile enlargement is therefore necessary for urologists and plastic surgeons, who may be called upon to treat the complications of these procedures. This chapter reviews the indications, techniques, risks, complications, and results of penile lengthening and girth enhancement, and discusses considerations in the reconstruction of failures.