From fillers and implants to the rise of ‘scrotox’, we discover what drives men to resort to intimate cosmetic procedures – and meet the medic who repairs the damage when things go very wrong.
Everyone knows the Covid lockdowns were hard for our mental health. So much soul-searching and rumination. Where is my life going? Is this the person I want to spend the rest of my life with? But consultant urologist, Dr Gordon Muir, noticed something else: a lot of men examining themselves in the bathroom mirror and asking, “Is this the penis I want to spend the rest of my life with?”
“During Covid, a lot of young men were watching hours and hours of porn and, at the same time, not being properly socialised,” says Muir. “As a result, they were comparing themselves with porn stars who, statistically, are outliers. It’s like watching basketball all day and then deciding, ‘I should be six foot and six inches tall.’ Next thing, they’re booking themselves in for penis-enlargement surgery.
Of course, with the recovery time afforded by ‘working from home’, it led to a lot of misguided butchery.” The International Society of Aesthetic Plastic Surgery reports a significant rise in both surgical and non-surgical procedures globally since the pandemic. More breast implants and more butt lifts. More surgical and non-surgical penile enlargement, too. Most days, London-based Muir is helping men with serious post-cancer or erectile dysfunction treatments. But his other job is flying all over the world fixing disastrous cosmetic penis work.
“The tragedy is there is usually nothing unusual about their genitalia in the first place,” says Muir. “13.2 centimetres erect; 9.2 centimetres when flaccid. That’s average. But lockdown convinced a lot of men – young men especially – that they had a problem.”
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Muir knows how big a penis should be, because in 2016 he helped measure more than 15,000 men in one of the biggest studies ever conducted. He also discovered that only 15 per cent of women are dissatisfied with their partner’s size. The problem is that 80 per cent of men aren’t listening. “Lots of men want to be bigger,” he says. “But usually, after hearing the facts, they walk away.” In extreme cases of ‘penile dysmorphophobia’ (an inability to accept the size and shape of one’s penis is normal), men end up in front of Professor David Veale, consultant psychiatrist at Nightingale Hospital, London. Veale and Muir worked together on the penis-length study.
“We sometimes see perfectly normal-sized men obsessed with their penis length. They’ve been teased at school or by a partner and, as a result, they are stuffing wadding down their trousers and they are very unhappy,” he says. Long periods of lockdown rumination and our increasingly porno-adjacent culture haven’t helped. TV shows like Love Island, websites like OnlyFans and the normalisation of ‘dick pics’ have played their part, too.
When I was a boy, Sue Townsend’s character Adrian Mole measuring his ‘thing’ at 4.3 inches was one of the few cultural reference points. And now I know how big the actor Orlando Bloom’s organ is, even if I don’t want to (in 2016 Bloom was pictured paddleboarding naked across an Italian lake – one surgeon I spoke to cited this as the “year zero” of the current enhancement boom).
The penis-enlargement industry has become very clever about exploiting this anxiety. On the Moorgate Andrology website they claim to have polled 180 women, 90 per cent of whom said they would prefer “a bigger penis than their current partner had”. Another clinic showed me a video. The man who had undergone enlargement surgery wasn’t even in it. His wife did all the talking. She said: “Sexually, it’s the best thing that’s ever happened to us. We do it more and more, always wanting more.” It’s a slick strategy.
Whether they are average-sized or not, men suspect they are being judged by women. There are myriad reasons to dislike Donald Trump, but was it right for porn star Stormy Daniels to compare his penis to the “mushroom character in Mario Kart”? Even Greta Thunberg is not averse to delivering a kick to the gonads when riled. Last December the former kickboxer and social media personality, Andrew Tate, asked for Thunberg’s email address so he could send details of his sports car collection and their “enormous emissions”. She replied, “Yes please, do enlighten me. Email me at email@example.com.”
Author and The Times columnist, Caitlin Moran, has just published a book called What About Men?. Like everyone else, she laughed about Trump’s mushroom, but later wondered whether the link between penis size and personal inadequacy needs another look.
“On reflection, the idea that penis size and shape is a reflection of personality is a bit mediaeval. I don’t care about Trump, but I’d hate it if any teenage boy got the impression they were being judged in that way,” says Moran. “These days women refuse to be shamed over having, say, a baggy vagina. We have owned it; we’ve had a healthy conversation about it. That hasn’t yet happened with the penis. Where are the comedians telling other men or boys that being average-sized is OK? Where are the role models going public about being five inches? Who will be the Average-Sized-Penis Pioneer who first speaks out on this taboo?”
As a college student, I remember being directed to a girlfriend’s bedside drawer to retrieve a condom but pulling out a purple, XL-sized vibrator. It looked more like a law-enforcement tool than something that might give pleasure. It also felt like a personal rebuke from both her and the hard-plastics industry. If women are so relaxed about size, why are their vibrators so big?
“I think that men fundamentally misunderstand the different ways women engage with vibrators as opposed to actual penises,” asserts Moran. “A vibrator is for use by a woman when she is enjoying herself alone… but it’s totally different from sex with a man. Men are very penis-based during sex while, for women, actual sex is a full-body experience; we are aware of your touch, your smell, your weight. It really isn’t about size. Comparing vibrator pleasure with real sex is like comparing playing FIFA online and an actual game of football in the park.”
Brotherly camaraderie online fuelling the fire
There is certainly a big-game atmosphere on the online penis-enlargement community, PhalloBoards. Men with names like ‘Joytoy’ or ‘Girthquest’ openly discuss their meatus (the opening of the penis) or shaft issues. Good and bad surgeons are recommended and there is brotherly camaraderie in sign-offs like, “Good luck, bro!” or, “Send pics!”
I haven’t really thought about my penis very much. Maybe I should. Do I need ‘scrotox’ (botox for the scrotum which can give the scrotal sac a smoother and tighter appearance)? Should I add length using weights or should I go chunky using a pump or synthetic fillers? Ligament cutting also seems very popular (a procedure in which the penile ligament attaching the penis to the pelvic bone is severed – the penis then drops and this can add length to its flaccid appearance, although it won’t increase erect length).
For the budget-conscious there are exercises like ‘jelqing’ (placing two fingers around the base of the shaft then stretching the penis upwards), followed by ‘clamping’ (placing a clamp around the base of an engorged member to stop blood escaping – some claim this will grow the head or glans). There is a lot of suspicion around the Penuma (which stands for ‘penis new man’), a silicone implant shaped like a hot dog bun inserted just under the foreskin. Your penis sits inside it like a frankfurter, but several recipients have had nightmarish experiences.
Muir has been called upon to remove them. “They’re awful. Don’t do it,” he warns me. “As for fillers, getting silicone out of your penis is a nightmare because it sticks to everything.” But I want to know more about this world so I sign up to PhalloBoards. However, under my own name no-one talks to me. I think it’s too personal. The etiquette is to use a comedy name that creates distance in such a sensitive environment. So I re-enter as ‘Boner Contention’ and am warmly welcomed (“Hey, Boner!”). A lot of new friends ask me about my “journey”.
To be honest, I felt like I might find a lot of incel chatter– the aggression of the involuntary celibate community. But the mood isn’t angry at all; instead, it’s determined. “My girlfriend has given me two beautiful babies, but now she can’t feel me as good as she did before,” says ‘DonkeyBoy’. “I’m widening my girth so we can love like we used to.”
The hot new thing seems to be a penile-elongation protocol called P-Long. It was invented by an American doctor called Dr Judson Brandeis in California. First you have injections of platelet-rich blood into your penis to promote tissue growth. Then you take some nitric oxide tablets which make sure these growth nutrients circulate (I can’t help notice the bottles are labelled ‘Spunk’). Later you put your penis in a RestoreX traction device which stretches it (you can even wear it to the office under your trousers) and then stick it in Dr Joel Kaplan’s vacuum device to add girth. If you do the whole protocol, it costs thousands of dollars, though it sounds like something you’d have got for free in mediaeval England.
‘Phalloguy100’ has tried P-Long and seems pleased. “I’m a grower [in the penis-enlargement community, a ‘grower’ is someone who is gradually aroused to full length; a ‘shower’ already hangs at full length] and smaller than average, so my penis usually sticks straight out when flaccid. With the pump, it started to feel thicker and started to point down towards the testicles. It’s definitely worth using.”
The testimonies worth reading
More often than not, though, the penis-enlargement testimonies remind me of watching Elon Musk’s early SpaceX launches. There is initial excitement, soon followed by frantic neck clutching and groans of despair. ‘Magic Johnson’ lives in Germany. He is in his early 30s and has a wife and child. In the autumn of 2021, he decided to have fillers. “Covid was tough for me and our sex life faded. As a present to both me and my wife, I thought that I’d do something about it.” He attended a surgery in Hamburg (Germany, Mexico and Turkey are penile-surgery honeypots), where he had his penile ligament cut. Initially he was happy. “I was the owner of a pretty enviable tool,” he says.
A month later he had a ‘glans enlargement’, a procedure in which fillers are injected into the head, and things were so good (and so big), he decided on a third procedure, this time aimed at girth. His surgeon opened a drawer, produced a selection of tin cylinders and placed them on the desk. These represented the girth that extra fillers might achieve. Some of them were 18 centimetres in circumference.
“I wanted to take that step from a big penis to a monster one,” says Johnson. But two weeks after this final op the problems began. An open wound appeared on the rim of his meatus. The fillers began to coagulate and bumps and dents appeared in his shaft. After a month he was left with a member that was soft but with hard bulges in it and, despite being circumcised, the damaged glans was now covered in loose foreskin.
“My doctor said I needed to ventilate the wound, so I sat in my car at night with the windows open,” he says. “The wound is better, but my penis still doesn’t look right. If I wasn’t married to someone very understanding I think my sex life would be over, because I would never show this deformed thing to another person.” Extraordinarily, Johnson doesn’t regret all his penile surgery. He just wishes he had stopped earlier. “I flew too close to the sun, bro,” he says. If anything, ‘Chopper’ is an even more tragic case. Based in the north of England, he’s in his mid-20s and a virgin despite the fact his penis is, by standard measurements, average in length.
“I know that logically I am average-sized, but I cannot accept this,” he says. “I’m 188 centimetres tall and well built, so it appears small in comparison with the rest of me. I decided to fix it.” He started his journey with PMMA fillers at a surgery in Prague (PMMA or polymethyl methacrylate is a synthetic polymer used in aircraft windows).
“My girth increased and that improved my confidence. But when the fillers started to form lumps it began to look like something out of a horror movie. Worst of all, I’ve lost sensation at the tip. It sounds crazy, but I was so focused on the aesthetic side, I forgot about sensation. Without any feeling sex is pointless. The penis is a living thing and I feel like I’ve killed it.”
All enlargement procedures are fraught with danger. But there’s another more obvious reason men should not try to supersize their reproductive organ. “Few women want a 10-inch penis,” says Muir. “If you’re too big, the glans touches the cervix and that’s going to hurt.”
Moran agrees. “Depending on the sensitivity and position of your cervix, the state of your pelvis and the frangibility of your urethra, you would actively be seeking something that isn’t, to paraphrase Robert Oppenheimer, a ‘girth destroyer of wombs’.”
Stepping into the belly of the beast
I’m about to find out where I stand. I have a phone consultation with Moorgate Andrology in London. In 2016, its surgeons featured in a BBC series, The Penis Extension Clinic. I remember it; a lorry driver called Leon paid thousands to have over an inch added (he had his penile ligament cut).
“I asked for a monster and they’ve given me a monster. I can’t get my hand round it,” he said. In 2019, Moorgate even offered a special package, the ‘Moorgate Mega Penis’, but it’s off the market now. After sending an email I receive a number to call. It’s a mobile number for David Mills, the surgeon from the TV series. I like the fact I’m getting the clinic’s top guy, but his mobile goes through to a young female receptionist. “How may I help you?”
“I want to know if you can make my penis bigger,” I reply.
Just saying that to a woman makes me feel like I could soon be going to jail. Later Mills’ brother Michael calls me back. He says he’s a “logistics guy” and puts me at ease. Then he says a Moorgate surgeon would be happy to take a look at me, but they are still dealing with a post-pandemic rush.
“During Covid, a lot of men relaid the lawn or fixed the window frames and then thought, ‘What can I do for me?’” he tells me. “And they realised that lockdown meant they could get the penis they always wanted.” Mills says a ligament cut will add two to four centimetres to my length. If I also want to improve my girth, fat taken from my thigh can be injected into my shaft. That could make me 20 per cent thicker. “Then, after six weeks without sex, we’ll start you on an extender. That will combat fibrosis [scarring] and get elasticity back,” he adds.
Is there counselling, I ask, someone who can advise me whether I actually need this surgery? “Let’s see you trousers-off and assess if you’re at the full potential of all you can be,” he says. The whole chat is very relaxed, a bit like being at the barber’s, except Mills’ team are planning to put an inch on the top. But of course it’s not a haircut and the implications don’t just affect me. I’m married. What are the protocols? Do men tell their wives or just turn up in the bedroom with their new member?
“That’s a very good question,” says Mills. “Some men discuss it with their partners first. Others literally ask their wives to pick them up in the Tesco car park round the corner and say, ‘I’ve just invested in a bigger penis.’”
A few days later I am booked for the trousers-off Zoom call. It costs $280 and I sense a hint of the new casual culture around penis enhancement in a note confirming my appointment: “Make sure that you are not driving during the consultation.”
Just after 8pm London-time, Dr Nenad Djakovic appears on my screen. Last year he featured in a television documentary, My Massive Cock, on which he tried to help a man struggling to hold down a relationship because of his 27-centimetre penis. On that occasion, Djakovic suggested a partial amputation. That isn’t going to be necessary today. First, I want to know if Djakovic offers a guarantee with his enlargements.
“If I cut the penile ligament, the average gain is six to 12 centimetres in a flaccid state,” he says (more than Mills suggested). “This is what you can count on but, of course, this is medicine. There are no absolute guarantees.” Djakovic reassures me he has been performing these surgeries since 1996, and there’s a poster saying “Smile” on the wall behind him.
Is it really worth the cost?
But it’s hard to smile when he outlines the risks. Infection is rare but possible. In the case of fillers I might get lumps. Small ones you live with; big ones are sometimes broken down with a thin needle. If I have my ligament cut then I might suffer some “instability” and a change of angle in my erection, plus I’ll need roughly six weeks to recover from a swollen or sore foreskin.
Mills told me it costs around $16,000 for the length and girth procedure, and around $15,000 just for girth. But do I actually need it? I’ve been sitting patiently with my trousers off under the desk. Oddly, having been anxious all week, I actually want to show Djakovic my penis. I want to see if egregious ‘short-selling’ actually happens. “I don’t need to see it,” he says. “Only if you have warts or Peyronie’s disease [a disorder leading to unusual curvature] do I need to do an examination.”
The Moorgate website says 90 per cent of its sample of women are unhappy with their partner’s member. Djakovic seems to dismiss this. He says I should only do what feels right for me.
“If you feel you need to do it, then do it. Most women, to be honest, don’t care. Your wife married you with what you already have. I’m sure there are men with a bigger one, but also men with a smaller one. I have a big nose. Do I worry about it? No. I have self-confidence. And I’ve been married 20 years without a problem. If I wanted to change it, I wouldn’t ask my wife. I’d just do it.”
The truth is no penis enlargement, either surgical or nonsurgical, has a proven track record. There are some Medicare rebates, and some private health insurance providers cover some of the cost under specific circumstances, but nothing is guaranteed. “Basically, you can no more give someone a bigger penis than make a person with size-seven feet a size 11,” Muir tells me. In fact, there used to be a joke about this. A GP tells a patient that all penile surgery is pointless because no doctor in the world can make a vas deferens (the vas deferens is the sperm-carrying duct).
However, the surgical possibilities are changing fast. In 2018, a US navy medic who’d had both legs, his penis and scrotum blown off by a Taliban IED (improvised explosive device) while serving in Afghanistan received the world’s first transplant involving a full penis and scrotum, plus a section of thigh and abdominal wall. First he received new prosthetic legs, but then waited eight years for a penis and scrotum to be donated by the family of a dead man with military ties. The donated penis was flown by private jet to Johns Hopkins Hospital in Baltimore and transplanted by a team of 13 people over 14 hours.
At present, the dangers of having to take post-operative immunosuppressant drugs (medication taken to manage the body’s immune system to stop it rejecting new tissue, but which, in turn, can increase the chances of illness) mean penis transplants are only suitable for extreme cases. But will they ever have an aesthetic use?
“In 10 to 15 years, it’s possible we’ll solve the immunosuppressant issue,” says Dr Richard Redett, who carried out that Baltimore operation. “But then you’d need willing donors. Bereaved families are used to donating major organs like a heart or kidneys. It’s still a major consideration to donate a penis.”
Before Covid, even Muir was considering the first-ever ethical study of penile fillers. Is it possible to create ones that don’t go lumpy or move about, ones that actually work? Because of lockdown, the study was postponed. For now, he’s dubious: “It’s a con for anxious men who will likely end up with a scarred penis that looks like the dog has chewed it.”
“A lot of the men who come to Moorgate have statistically normal-sized penises,” adds Mills. “We tell them that. But they still want a cosmetic enhancement. I’ve been doing this for 40 years and, now more than ever, men are relaxed about making cosmetic changes. Sure, penis enhancement is a little left-field and they don’t talk about it much. But young men today see women with perfectly normal C-cup breasts who insist on having a DD implant. Bigger breasts. Bigger penises. It’s a simple lifestyle choice.”
Muir sees it differently: “What women actually want is men who are kind, funny and not obese. If you’re really that worried about giving your partner pleasure, buy her a Rabbit (a type of vibrator). Live your life. For God’s sake, leave your penis alone.”