Ads for penis-enlargement products and procedures are everywhere. A plethora of pumps, pills, weights, exercises and surgeries claim to increase the length and width of your penis.

However, there's little scientific support for nonsurgical methods to enlarge the penis. And no reputable medical organization endorses penis surgery for purely cosmetic reasons.

Most of the techniques you see advertised are ineffective, and some can damage your penis. Think twice before trying any of them.

Penis size: What's normal, what's not?

The fear that your penis looks too small or is too small to satisfy your partner during sex is common. But studies have shown that most men who think their penises are too small actually have normal-sized penises.

Similarly, studies suggest that many men have an exaggerated idea of what constitutes "normal" penis size.

The length of a non-erect penis doesn't consistently predict length when the penis is erect. If your penis is about 13 cm (5 inches) or longer when erect, it's of normal size.

A penis is considered abnormally small only if it measures less than 3 inches (about 7.5 centimeters) when erect, a condition called micropenis.

How partners view penis size

Advertisers would have you believe that your partner cares deeply about penis size. If you're concerned, talk to your partner.

Keep in mind that understanding your partner's needs and desires is more likely to improve your sexual relationship than changing the size of your penis.

Don't believe the hype

Companies offer many types of nonsurgical penis-enlargement treatments, and often promote them with serious-looking advertisements that include endorsements from "scientific" researchers.

Look closely — you'll see that claims of safety and effectiveness haven't been proved.

Marketers rely on testimonials, skewed data and questionable before-and-after photos. Dietary supplements don't require approval by the Food and Drug Administration, so manufacturers don't have to prove safety or effectiveness.

Penis-enlargement products

Most advertised penis-enlargement methods are ineffective, and some can cause permanent damage to your penis. Here are some of the most widely promoted products and techniques:

• Pills and lotions. These usually contain vitamins, minerals, herbs or hormones that manufacturers claim enlarge the penis. None of these products has been proved to work, and some may be harmful.

• Vacuum pumps. Because pumps draw blood into the penis, making it swell, they're sometimes used to treat erectile dysfunction.

  A vacuum pump can make a penis look larger temporarily. But using one too often or too long can damage elastic tissue in the penis, leading to less firm erections.

• Exercises. Sometimes called jelqing, these exercises use a hand-over-hand motion to push blood from the base to the head of the penis.

  Although this technique appears safer than other methods, there's no scientific proof it works, and it can lead to scar formation, pain and disfigurement.

• Stretching. Stretching involves attaching a stretcher or extender device — also referred to as a penile traction device — to the penis to exert gentle tension.

  A few small studies have reported length increases of half an inch to almost 2 inches (about 1 to 3 centimeters) with these devices.

  Larger, more-rigorous research is needed to establish safety and effectiveness.

Surgery is risky and may not work

Studies of available surgical techniques to lengthen the penis have found mixed results in safety, effectiveness and patient satisfaction.

At best, surgery such as division of the suspensory ligament may add half an inch (1 centimeter) to the appearance of the flaccid penis but does not change actual length of the penis. At worst, surgery can result in complications such as infection, scarring, and loss of sensation or function.

Surgical methods of penis enlargement — Not for cosmetic use

The need for penis-enlargement surgery is rare. Surgery is typically reserved for men whose penises don't function normally because of a birth defect or injury.

Although some surgeons offer cosmetic penis enlargement using various techniques, it's controversial and considered by many to be unnecessary and in some cases permanently harmful. These surgeries should be considered experimental. There aren't enough studies of penis-enlargement surgery to give an accurate picture of risks and benefits.

The most widely used surgical procedure to lengthen the penis involves severing the suspensory ligament that attaches the penis to the pubic bone and moving skin from the abdomen to the penile shaft. When this ligament is cut, the penis appears longer because more of it hangs down.

But cutting the suspensory ligament can cause an erect penis to be unstable. Severing the suspensory ligament is sometimes combined with other procedures, such as removing excess fat over the pubic bone.

A procedure to make the penis thicker involves taking fat from a fleshy part of the body and injecting it into the penis shaft. Results may be disappointing, however, because some of the injected fat may be reabsorbed by the body. This can lead to penile curvature or asymmetry and an irregular looking penis.

Another technique for increasing width is grafting tissue onto the shaft of the penis. None of these procedures has been proved safe or effective and can even affect potency and your ability to obtain an erection.

A few things that might actually help

Although there's no guaranteed safe and effective way to enlarge your penis, there are a few things you can do if you're concerned about your penis size.

• Communicate with your partner. It may be hard to break old habits or to discuss sexual preferences with your partner. But you'll be glad you did — and you may be surprised at the spark it ignites in your sex life.

• Get in shape and lose the belly fat. If you're overweight and have a "beer gut," your penis might appear shorter than it is.

  Regular exercise can make a big difference. Better physical conditioning may not only make you look better, but also can improve strength and endurance during sex.

• Talk to your doctor or a counselor. Feeling unhappy about the size of your penis is common. A certified counselor, psychologist, psychiatrist or your family doctor can help.

Many men feel better with reassurance that they are "normal" or with advice about how to better satisfy their partner without resorting to cosmetic penis enlargement.

The bottom line

Many men believe that increasing the size of their penis will make them a better lover or make them more attractive. But chances are your penis is within the normal size range.

Even if your penis is smaller than average, it may not matter to your partner. In addition, there's no proven way to make a penis larger.

The solution to your concerns about penis size may be as easy as talking with your partner or getting in shape. If those steps don't help, try talking with a professional counselor about your concerns.

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June 22, 2017 See more In-depth