How can I straighten out the curvature in my penis? And is there anything that actually makes it bigger besides surgery?

–SMJ, via the Internet

You’re saying you’re curved and short? Man. Here’s hoping you’ve got a nice personality.

In 1983 I said there was no reliable means of permanently enlarging the penis–true at the time. But science marches on, and new surgical techniques offer the prospect of additional length and girth. As of 1996, 10,000 men reportedly had undergone “elective penile lengthening.” But be forewarned: complications are common, and some people wind up worse off than when they started.

Although there’s no standard surgical technique for penis enlargement, a typical operation may include:

(1) Release of the penis’s suspensory ligament. This allows the portion of the penis normally concealed within the body to protrude more.

(2) An inverted “V-Y advancement flap” sliced into the pubic skin above the penis, theoretically permitting it to hang out farther.

(3) Fat transfer for penile girth enhancement. I have mixed feelings about mentioning this, but women I’ve consulted say that while penis length isn’t all that important, they do appreciate a certain amount of circumference. Judging from the photos, fat transfer will make you look thicker in the detumescent state, but you don’t want to get carried away. In one “after” shot the guy’s got such a pipe he can’t get his hand around it. One woman’s reaction: “No way am I getting on the receiving end of that.”

(4) If appropriate, “turkey neck” removal to increase apparent length. In some men the scrotal skin attaches far forward on the penis, making it seem shorter than it is. The surgery trims this back.

Afterward one commonly applies stretching devices or weights. Length gains of as much as two inches have been claimed, although one journal report states a range of 1.1 to 2.1 centimeters–in other words, a maximum of not quite seven-eighths of an inch.

We now turn to the medical literature–always interesting, if only for the article titles, e.g., “Penile Duplication.” (What, the guy needed a spare?) More relevant to the present discussion is “Reconstruction of Deformities Resulting From Penile Enlargement Surgery” (Alter, Journal of Urology, December 1997). It tells of several dozen men whose operations went awry, ranging from lumps, hollows, scar tissue, etc (fat tissue distribution is a problem, it appears), to actual shortening of the penis, sometimes accompanied by pain, impotence, and incontinence. A 1996 account by Wessells et al in the same journal says much the same thing. If the photos are any indication, you could get an equally attractive result ladling sand into a sock–and mind you, these guys paid for this.

Moving on to your other complaint, slight curvature of the penis is fairly common and not something to be concerned about–it didn’t seem to bother Bill Clinton, anyway. Extreme curvature is called Peyronie’s disease, a condition involving a stricture of the sheathing tissue that causes the penis to pull to one side (or up or down), as with tape on a balloon. It’s uncertain what causes Peyronie’s disease, although a popular theory at the moment is damage to the penis during sex. Treatment can include vitamin E, drugs, and, as a last resort, surgery. One surgical technique, I note with a shudder, is “partial penile disassembly,” although this seems to have fallen out of favor now, presumably for obvious reasons. (“Doctor, we seem to have a part left over.”) In extreme cases of Peyronie’s disease, the victims are incapable of sexual intercourse–some of their penises look like those animal shapes you make with balloons. In such cases the knife is the only recourse.

It’s the vanity cases you have to wonder about, which brings us back to the general issue of cosmetic surgery on a part of the body that isn’t normally in public view. “Although [the patient] may have a normal or even large phallus, a perceived deficiency diminishes self-esteem,” Alter writes in the article cited above. God forbid we should have people walking around with diminished self-esteem, although it seems to me a cheaper course would be to volunteer at a soup kitchen. If that won’t do it, look up “Lymphedema Due to Chronic Penile Strangulation” (Journal of Dermatology, September 1996). The strangulation in question was “due to long-term use of a penis enlarging ring.” Sure, the guy was a little obsessed. You ain’t?

Art accompanying story in printed newspaper (not available in this archive): illustration/Slug Signorino.