Jamin Brahmbhatt, MD, is board-certified in urology. He is an assistant professor at UCF College of Medicine and chief of surgery at Orlando Health South Lake Hospital.

The first thing people will typically ask about penis enlargement techniques, also known as penile augmentation, is do they work? And, arguably more important, are they safe and worth the price?

The answer to these questions varies by the technique used, which ranges from supplements, vacuum pumps, and traction devices to various injectable fillers to a wide range of surgeries and penile implants.

Also factoring in is your reason for pursuing penile augmentation. Is it that you think your penis is "too small" or feel insecure about the size or shape of your penis? Or, is there a medical reason, such as penile trauma or a medical condition that affects your fertility and/or function of the penis?

This article explores the various reasons for pursuing penis enlargement and the different techniques used, some of which can be performed at home and others which require specialist treatment. It also weighs the benefits and risks as well as how effective—or ineffective—the various treatments are.

There are many reasons why a person might seek penile augmentation. There may be medical, such as problems with fertility or the ability to urinate, and/or psychological reasons that directly impact a person's self-esteem or quality of life.

In some cases, a person's penis might be genuinely smaller due to a genetic or hormonal disorder that causes micropenis. Micropenis is defined as a stretched penis length of under 3 inches.

Having a penis this size may interfere with a person's ability to direct a urine stream. It can also make sexual intercourse difficult and decrease the odds of conceiving.

There are other conditions associated with reduced penis size:

Other people seek penis enlargement out of the belief that they are "smaller than average." Many of these individuals fail to realize that the typical erect penis is around 5 to 6 inches long with a circumference of 4 to 5 inches.

There are even some people with above-average penises who have an abnormal preoccupation with their penis size. When the preoccupation interferes with their quality of life, it is typically diagnosed as penile dysmorphic disorder (PDD). It is a condition that may benefit more from psychological counseling than penile enlargement.

According to a 2019 review in Sexual Medicine Review, counseling was effective for the majority of people who felt inferior about their penis size, with most coming to understand that their penis size was normal and in no need of augmentation.

There are numerous websites that recommend penis exercises to increase the length or girth of the penis. The rationale behind these exercises is that repetitively rubbing the penis creates "micro-tears" in tissues that make the penis seem bigger or thicker when healed.

There is one popular technique called jelqing in which the thumb and forefinger are wrapped around the penis to repetitively stretch the shaft from the base to the tip for 20 minutes every day.

Despite claims to the contrary, there has never been any evidence that physical exercise of any sort, including jelqing, can increase penis size. In fact, the persistent rough handling of the penis can cause injury or scarring that can interfere with the erectile function of the penis.

If you want to enhance the appearance of your penis because it makes you feel more confident, there are simpler ways to do so:

There are several options advertised to people who are dissatisfied with the size of their penis. While these may be tempting, don't be misled by false claims. Speak with a urologist for insights on what may work for you and what won't.

There are many companies that claim their supplements can enhance penis size. At best, they will do nothing more than waste your money. At worst, they may contain traces of Viagra (sildenafil) or other drugs dangerous to individuals with heart disease.

Supplements like L-citrulline or L-arginine are said to increase nitric oxide levels in the blood, which may improve circulation to the penis. Although some people claim this helps improve erections, there is no evidence that doing so increases penis size.

While there has never been an FDA-approved device for a penile extension, there has been growing interest in products that may help increase penis length using traction. With penile traction, a weighted device is connected to the shaft of the penis and worn for a specific amount of time each day to gradually stretch the penis.

A small study in Translational Andrology and Urology suggests that a device called "The Extender" may increase the length of the penis in people with Peyronie's disease by breaking down scar tissues that caused the abnormal curvature. There is no evidence that it can do the same in people without Peyronie's.

These devices marketed for penis enlargement wrap around the shaft and provide a gentle squeezing pressure to "stretch out" the penis. Some are suggested for use during an erection, while others are used while the penis is flaccid.

There is no evidence that wrapping anything around the penis will lengthen it. In fact, this can cut off the blood flow, causing bruising, hematomas, and nerve damage.

Lotions, creams, and oils advertised as being able to increase penis size by being applied directly to the organ often contain hormones, vasodilating medications that increase blood flow, and essential oils said to promote cell proliferation. There is no evidence that any of these works; some may even cause skin irritation or allergy.

Penis pumps and vacuums are popularly used as sexual aids to promote erections in men. They are also used by some with the intent of increasing penis size. These devices are placed over the penis (and sometimes the scrotum) and use suction to engorge the penis with blood.

If used consistently over a long period of time, they can cause the skin of the penis to become "spongy" and have a thicker appearance. Despite their popularity, there is no evidence that vacuums or pumps can increase the length of a penis.

Vacuum pumps can cause injury if the suction is too extreme or the device is worn for too long. Urethra bleeding and bruising can occur as superficial veins in the penis are ruptured. This can reduce penis sensitivity and impair erections.

There is no evidence that any over-the-counter device can significantly increase the length of a penis. Some devices, like penis pumps, may increase the girth of the penis if overused but can also damage nerves and blood vessels and impair erections.

Some people with penises seek the injection of natural and synthetic fillers to increase the girth of the penis. Others seek surgery if a smaller penis size or penile abnormality is interfering with the ability to urinate.

Small penis size usually is not an indication for surgery to treat infertility. In such cases, assisted fertility procedures may be the better option.

Penile injections have been around since the early 1900s, often performed by non-medical professionals and often with disastrous results. In recent years, three injectables have been used by aesthetic physicians to increase penile girth, each of which has its pros and cons:

The use of injectable penile fillers is still considered experimental.

Some people have been known to self-inject synthetic materials, like silicone and paraffin, in an attempt to increase the girth of their penis. Practices like these are dangerous and can lead to infection, abscesses, induration (tissue hardening), tissue necrosis (death), and even penis loss.

There are no FDA-approved surgical treatments for penis enlargement, but that has not stopped some people from aggressively seeking them. The construction, reconstruction, or modification of the penis is referred to as phalloplasty .

These are the most common:

Penile augmentation is often pursued by people who think that their penis is too small or have a medical condition that affects the penis size. This includes people with congenital disorders like micropenis or microphallus, who have experienced a loss of penis length due to surgery or Peyronie's disease, or have a "buried penis." Psychological reasons are often better addressed with counseling.

No home remedy, exercise, supplement, cream, or device has ever proven effective in significantly increasing penis size. Some devices, like vacuum pumps, may increase girth by creating scar tissue but can also permanently injure the penis if overused.

Specialist treatments used to increase penile girth include injectable fillers and fat-grafting surgery. Penile length may be increased with more invasive surgeries such as V-Y plasty and penile disassembly, although they come with significant risks

If you think that your penis is too small, be sure to measure it accurately. Even if it is shorter than average, it's important to place the size of your penis in context and ask yourself why it is causing you such distress. It sometimes helps to speak with a psychologist who can help you sort through your feelings and provide the perspective you need.

If you decide to pursue penile augmentation, meet with a specialist known as a urologist to discuss the benefits and risks of the procedure. Ask about the response rate and possible complications. If you're concerned about infertility, speak with a fertility specialist first to get an accurate picture of your sperm count and sperm motility.

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