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Alternative Methods of Penis Enlargement
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Many different methods have been developed over the years in an attempt to increase penis size. Whilst some are based on age-old principles, others such as penis enhancement surgery use pioneering ideas and techniques.
Below we've outlined these different methods and have attempted to answer the key questions regarding the effectiveness and safety of each one. We have omitted certain products currently available such as the lotions, creams and magnets that claim to enlarge the penis. It is doubtful such products have any effectiveness and we are not aware of any evidence to the contrary.
The enlargement methods outlined below include the use of penis pumps, penis enhancement surgery and the use of weights and stretching devices. We have also included a section discussing the possible effects of  penis enlargement pills. Whilst it is highly debatable as to whether these actually promote permanent gains in penile size, it is clear that they have provoked a great deal of interest in recent months.  For information regarding natural penis enlargement exercise techniques please visit the FAQ page.

Penis Pumps
Penis pumps work by creating a vacuum around the penis. They consist of an acrylic cylinder, into which the erect penis is placed. At the base of the cylinder an airtight seal ensures the vacuum created is maintained. Through the use or either an electric or hand pump, the air within the cylinder is then extracted and the resulting vacuum forces increased volumes of blood to be drawn into the penis. This increased volume of blood in turn causes the erect penis to temporarily swell in size.
The results achieved in erection size are often similar to those experienced during extreme sexual arousal, when the penis is engorged with blood to its full capacity.
Although pumps certainly engorge the penis to capacity and result in immediate gains, the effects as mentioned above are in the main only temporary and are lost within a few hours.
Unfortunately, the use of a penis pump does not result in sustained long-term improvements in penile size. They have no effect in increasing the natural capacity of the erectile chambers, which is a necessity if permanent gains are to be achieved.
There are no well-documented scientific studies of the long-term effects of pumping. However, excessive pumping or the use of a too intense vacuum can have detrimental side effects. Lymph blisters are common and men often notice a reduction in sensitivity and problems achieving firm erections. Moreover, burst or ruptured blood vessels can lead to bruising and at worst even hemorrhaging.
For these reasons, only pumps with an accurate and reliable pressure gauge should ever be used and instructions should always be followed carefully.
Many penis pumps of varying quality are available at present. One of the most popular, Dr. Kaplan's Penis Enlargement Pump can be found at drjoelkaplan.com

Penis Enhancement Surgery
Although penis enhancement surgery has been available for several years, the techniques as yet do not seem to have been perfected. Fortunately however, as surgeons have gained in experience and techniques have been further researched, the procedure does now seem to be less hazardous and less prone to the nightmarish consequences of earlier attempts.
Surgical lengthening of the penis is achieved by cutting the suspensory ligaments that support the penis. Once these ligaments have been cut, part of the large section of penile shaft usually held within the body drops forwards and extends out, thus creating the illusion of a longer penis. After surgery, part of the postoperative treatment includes stretching of the penis to prevent the severed suspensory ligament from healing shorter than it was previously. Without continuous stretching the gains achieved through surgery are often lost.
Gains in flaccid length are by far the most noticeable. Unfortunately gains in erect length are often less dramatic. In fact some men do not gain any length or experience a shortening due to fibrosis (shrinkage and toughening of tissues). In an extremely comprehensive study into penile augmentation surgery published by the Electronic Journal of Human Sexuality, out of a research sample of 58 men ranging in age from 22 to 67, average penile length following surgery increased from 5.4 to only 5.7 inches. Moreover, 69 percent of this research sample stated that the gains in length had not lived up to their expectations. Furthermore, apart from the apparent lack of significant gains in erect penile length, the severing of the suspensory ligament has further detrimental consequences. These include a significant reduction in the angle of erection as well as increased susceptibility to injury.

Other surgical methods of penile enhancement are directed towards increasing the girth of the penis. These techniques are more successful in achieving their aims.
Until recently, penile girth was surgically increased through the use of a technique known as Fat Transfer. This involved the removal of fat cells by the use of liposuction, either from the lower abdomen or inner thighs. The fat cells were then purified and injected along the length of the penile shaft between the erectile tissue and the skin of the penis. Unfortunately, this technique often failed to produce permanent satisfactory results as over time the fat injected into the penis would be slowly reabsorbed back into the body. In fact, The American Society for Aesthetic Plastic Surgery (ASAPS) considers this technique to be of high risk and notes there is insufficient data presently available to establish its safety and effectiveness.
A more recent surgical technique, virtually replacing Fat Transfer has been the development of Dermal Graft Augmentation. This involves the removal of strips of tissue consisting of all the layers of skin and underlying subcutaneous fat from under the gluteal folds of the buttocks and then inserting these strips into each side of the penis. Because Dermal fat grafts are more securely placed and the fat transferred is far less traumatized than when injected, the results are generally considered to be far more stable and long lasting. Again however, complications can occur if segments of the grafts do not completely survive. Such complications can include the development of penile curvature and asymmetry.
The results of the study into penile augmentation surgery mentioned above confirm that surgical techniques used to thicken the penis are far more effective than those designed to increase penile length. In the research sample of men studied, flaccid circumference following the above procedure had increased from an average of 3.1 inches to an average of 4.1 inches, whilst erect penile circumference increased from an average of 4.1 inches before surgery to 4.8 inches after surgery.

It should be remembered that there are risks involved with any surgical procedure. With regard to penile augmentation surgery in particular, The American Urological Association does not presently consider the techniques involved to have been proven to be safe or effective. Whether the possible benefits out weigh the potential dangers is a question that can only be answered by the individual concerned. Whilst surgery may be considered a valid option for those with documented medical conditions, it could be seen as a rather drastic solution in any other circumstance. For this reason, it is important to discuss with a physician whether such a procedure would be warranted and to understand exactly what would be entailed.
Financially, penis enhancement surgery is an expensive option. The costs of the different types of penile augmentations available range from U.S. $3000.00 to $10000.00.

Further information: Surgeons specializing in male enhancement procedures.

Weights and Stretching Devices
The use of weights and stretchers to enlarge the penis is based on the principle of tensile force and the body's own ability to adapt and change under such influence. Through the application of sustained and continuous tension, cells within an area subjected to such force divide and multiply, resulting in an increase in tissue mass.
The practice of stretching various parts of the body through the use of tension is not a new one and has existed in several cultures throughout the centuries. Well-documented examples of such practices include the neck lengthening feats of the women of the Paduang tribe in Burma as well as the lip and earlobe stretching practices of certain African tribes.
Applying the above principle in an attempt to increase penile size can have some degree of success. In a study into the effectiveness of one particular device (the JES Extender), the results concluded that out of the 18 test subjects, erect penile length increased from an average of 11.2 cm to 13.9 cm (just under 1.25 inches) over an 18 week period. For the entire study period, the test subjects used the device for 12 hours a day, 7 days a week. Unfortunately, the study seems to have been concerned only with penile elongation and does not comment on the affects to penile girth experienced by the research sample.
Whilst there is no doubt the JES Extender is completely safe when used correctly, the use of inferior devices or home made solutions can potentially result in complications.
Long term reduction in blood circulation to the glans of the penis, for example by tying weights to the end of the penile shaft, can lead to infection and the possibility of gangrene. Ultimately, this can end in amputation. Clearly, this would be far from a positive result when such efforts had been made to enlarge the penis.
Whether penile stretching has any affect in promoting gains in penile girth is another debatable question. It seems probable that increases in length are accompanied by a slight reduction in circumference. However, according to a further study conducted into the effectiveness of another popular stretching device, The Penistretcher, nominal increases in penile girth ranging from 0.5 - 1 cm (less than 0.5 inches) are achievable through sustained use over a 3-6 month period.

Whilst it would seem that the use of such stretching devices can indeed result in increases in penile size (in particular length), it is also apparent that the process is extremely time consuming requiring use of the apparatus for periods of up to 12 hours a day over several months. Whether this is a practical solution when considering the demands of everyday life is difficult to say.
Furthermore, although far cheaper than penis enhancement surgery, well constructed devices such as the JES Extender and the Penistretcher are still relatively expensive. Expect to pay in the region of U.S. $300.00 for the Penistretcher, whilst the JES Extender will leave you with next to no change out of U.S. $1000.00.
Although worth considering, it should be remembered that a well-researched and methodical exercise program will offer similar if not greater results at a fraction of the cost and would be well worth considering before such an investment is made.
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