A Package Deal: Cosmetic Surgery and Your Genitals

Cosmetic surgeries are much more commonplace than they once were, especially as medical advances make such procedures safer. Male body issues are fairly common, especially those pertaining to concerns about penis and testicle size, or appearance in other ways. They're not simply concerns of vanity to be dismissed.

As a trained surgeon, researcher and advocate in the field of men's health and general urology, Marah Hehemann, M.D., has targeted expertise in sexual health issues such as erectile dysfunction (ED). She said cosmetic genital procedures for men have grown in popularity.

"In terms of penile augmentation procedures, they're increasingly common, and that can range from things like injections of hyaluronic acid, which is fillers, to things like implantation of girth-augmenting sleeves to other more experimental things like fat transfer into the penis, release of the suspensory ligament and others," explained Hehemann, a urologist and assistant professor at the University of Washington in Seattle.

"Then there are really advanced lengthening procedures by sexual medicine urologists worldwide that are less common but definitely gained some popularity in kind of the mid- to late 20-teens," she added.

Sizing up options

Concerns about penis size might not be too overwhelming for some men, but for others, these worries can manifest in the form of legitimate medical disorders with real consequences on the psyche and well-being of the person experiencing them.

"It's basically a form of body dysmorphic disorder where [some] may have, by measurement, objectively normal-sized penises, but consider themselves to be too small and have shame around it and desire a larger penis," Hehemann explained.

Performed by the right professional and in the right context—that is, with a relatively complete understanding of the patient's circumstances and medical goals and history—most of these procedures are fairly safe and can deliver measurable (literally) results in line with the goals of the patient. Those goals may involve increasing girth or length, or might be about the surface aesthetics of the genitals with a desire to make them smoother, tighter or altered.

Another piece of information likely to arise if you're investigating cosmetic male genital procedures is an implant called Penuma. A Penuma is basically a silicone sleeve that runs under the skin of the penis to add length and girth in both the flaccid and erect states.

"So it's not a functional device in the sense that it's not a penile implant, where we put in penile implants to help guys with erectile dysfunction restore their erections and sexual capability," Hehemann explained. "This implant is purely a cosmetic implant, so it's not functional at all."

Defying age and gravity

Matthew Mutter, M.D., a urologist in the New Orleans area, said he doesn't have a high number of patients bring up cosmetic surgery options for their genitals. But there are certain procedures he performs somewhat regularly in that area.

"On occasion, there are guys who we do scrotoplasties for, and what that is, is basically reducing the size of the scrotum, particularly for older guys," Mutter said. "It's a very quick surgical procedure."

These procedures tend to be conducted in coordination with other, more imminently necessary actions around the same time.

"It's usually done in combination with something else, such as a hydrocelectomy, which is [removing] fluid around the testicle, or some sort of, you know, spermatocelectomy, which is a cyst on the epidermis that we remove," he added. "So it's not something that we typically do just straightforward. Now, is that different from a plastic surgeon's perspective? I don't know."

Making your own choice

It's important to realize body image issues can represent a potentially real problem with various medical solutions that might include the above surgical options. But those issues could also be addressed through other means, such as therapy.

Perhaps equally as important is understanding some choices might be quite expensive. They could also carry additional risk or fall short of your desired outcome.

Ultimately, you'll have to do your own research to determine what, if any, procedure is right for you.