Medically reviewed by Kristin Hall, FNP
Written by Our Editorial Team
Last updated 7/28/2022
For decades, men have searched in vain for a reliable, safe means of growing a longer, girthier penis. The problem is that the penis is, to put it simply, quite anatomically complex, and adding an extra inch or two isn’t quite as easy as it may initially seem.
One popular method of penis enhancement is jelqing, which has spread like wildfire on online message boards in spite of an almost total lack of scientific evidence that it produces any real long-term changes in penis size.
More recently, the Penuma® implant -- an FDA-cleared penile implant that’s designed to offer cosmetic enhancement of the penis -- has started to attract attention as a potentially safe way for men to gain some extra size down below.
In short, the penile implant for size and shape is here -- in fact, it’s been around for upwards of one decade. But before you go rushing off to remake your member in the “ideal” image, this is not necessarily a sudden windfall for your weiner.
Unlike most “penis enhancement” surgical devices on the market, the Penuma implant doesn’t promise the world, and it also appears to be backed up by some fairly solid scientific principles, at least at first glance.
Below, we’ve explained everything you need to know about the Penuma implant, from how it’s made to how it’s fitted into the penis. We’ve also talked about what you can expect if you make the decision to get a cosmetic implant similar to the Penuma implant fitted.
We’ve also talked about the potential risks that can come with this type of device, as well as the surgical procedure that’s carried out to insert the implant.
Finally, we’ve shared a few alternatives that you may want to consider if you’re dissatisfied with your penis size and want to do something about it.
Penuma is a soft silicone implant that’s surgically inserted into your penis to provide extra girth, fix indentation deformities or increase the perceived size of a retractile penis (a penis that partly sits below the surface of the skin).
The Penuma implant is made from medical-grade silicone similar to the materials used to make buttock and chin implants. The device is inserted subcutaneously, meaning below your skin but above the tissue that allows your penis to function.
Unlike some other products on the market, Penuma isn’t designed to be a penile prosthesis or inflatable device for treating ED -- it’s not actually intended to treat erectile dysfunction or give your penis extra functionality.
Instead, it’s a cosmetic product. Since 2004, Penuma has offered this type of silicone implant for your penis to increase both length and girth. According to Penuma, it was designed by a team of “world-renowned” urologists and scientists and has been used in tens of thousands of men.
So, how exactly does Penuma work? The penile implant, which is made of silicone, is contoured to suit your individual penis shape, then carefully inserted under the skin of your penis through a small incision that’s made near your scrotum.
By creating a small incision for the implant, there’s little to no visible scarring left behind after the procedure, which is performed under general anesthesia.
The silicone implant essentially “wraps” around the tissue of your penis, creating extra girth that is typically visible when flaccid or erect. It’s essentially a cosmetic procedure for your penis.
According to Penuma, men who have the procedure performed typically see an increase of one to two inches in girth when flaccid and when erect. Many men also report that the implant helps to increase the length of their flaccid penis.
The FDA-cleared impact has no significant impact on your fertility as a man or your ability to use your penis for non-sex activities, such as urinating. It’s also discreet -- most patients who get the procedure report that it’s undetectable to their partners.
Currently, Penuma is only available in the United States, and only a few surgeons offer this type of procedure. Penuma lists physicians in Beverly Hills, Chicago, Washington D.C., Phoenix, the Bay Area, New York, Louisiana and Miami as specializing in this type of cosmetic surgery.
The Penuma implant essentially “wraps around” the internal tissue of your penis, acting similar to a sleeve that increases your penis’s girth. Because of its design, it can also make your penis longer when it’s flaccid (meaning when it’s not erect).
However, the Penuma implant doesn’t actually make your erect penis longer, meaning it’s not a true genital enlargement surgery that’s going to give you any extra inches.
The major reasons for this come down to the design of the implant and the physiology of your penis. You see, your penis contains chambers of spongy tissue called the corpora cavernosa, which expand when you get an erection.
These chambers expand when blood flows into your penis, resulting in the extra firmness and penile size that you get when you’re sexually aroused.
In most cosmetic procedures for increasing the size of a part of the body (for example, breast implants), a surgeon dissects tissue, then places a silicone implant inside this space to create extra size. The implant provides the extra width or projection.
However, this process doesn’t really work for adding length to your penis, largely because the spongy tissue relies on a network of blood vessels to become engorged, large and hard in the first place. Aim for a cosmetic improvement and you can easily disrupt your penis’s function.
Because the Penuma implant only increases girth, it’s able to fit inside your penis without any disruption to the complex erectile tissue and vasculature that’s inside your penis.
However, the downside of this is that while it works as a cosmetic treatment for girth, it doesn’t add any significant amount of length to your penis when it’s erect.
So, is penile implant surgery like Penuma worth getting if you don’t feel totally satisfied with your penis size? Well, here’s the thing: it really depends on why you want a penile implant procedure in the first place.
If you’re looking for something to prop up your wilting willy and give you stronger erections, this isn’t the product for you. Penuma implants are strictly for visual and functional size -- they don’t actually impact your performance in any meaningful way.
The only way this type of procedure could impact your performance (specifically, your ability to get and maintain an erection) is if you currently have a psychologically induced form of erectile dysfunction, such as sexual performance anxiety brought on by feelings of inadequacy.
In that specific case, a little extra girth may be a good confidence boost. But it’s by no means a medically recommended solution for confidence issues, nor is it the type of procedure that you should consider undergoing lightly.
It’s also not a procedure that’s backed up by a lot of high quality scientific research yet, largely because it’s relatively uncommon.
Currently, there are no truly large-scale scientific studies of Penuma available. However, in an interesting single-surgeon study published in the Journal of Sexual Medicine, researchers did find promising results.
From 2009 to 2014, more than 520 patients underwent surgery with the Penuma soft silicone penile implant. Of these patients, more than 400 agreed to take part in a study to assess their results and levels of satisfaction.
The researchers found that the study participants displayed an average increase in midshaft circumference (the measurement around the middle of the penis) of 56.7 percent.
They also found that 72 percent of the men who underwent the surgery had improvements in self-esteem two to six years after the procedure, with 81 percent claiming “high” or “very high” levels of satisfaction.
In short, most men who underwent surgery to receive the Penuma implant showed a reasonably large increase in penile girth and reported feeling satisfied with the results of the procedure.
With this said, the study mentioned above has some limitations, the biggest of which is that the surgeon that performed the procedures was the inventor of the device.
This doesn’t necessarily mean that the results aren’t accurate, but it may play a role in some of the patients’ assessments of the Penuma implant’s effectiveness.
It’s also worth noting that not all of the patients that underwent the surgery took part in the study afterwards, with more than 120 abstaining from participation.
This is far from abnormal for a scientific study (it’s common for people to drop out of research or opt not to participate), but it may mean that the true patient satisfaction rate from this procedure can’t be accurately measured based on this study’s findings alone.
So, is the Penuma implant worth it? Although it might not provide true penile enlargement in the sense of extra length, the Penuma implant appears to produce a noticeable increase in the girth of the penis, with most men who undergo the procedure reporting good results.
Long-term follow-up research also suggests that many men view getting the Penuma procedure as a positive decision.
Ultimately, it’s a personal decision that you’ll have to make based on your own priorities. Are you satisfied with the girth and shape of your penis, or would you consider surgery to get some extra girth and potentially correct any indentation deformities or other concerns?
Surgery that’s performed solely for cosmetic reasons is rarely cheap, and the Penuma implant is no exception.
According to the Penuma website, the cost of undergoing surgery with a Penuma implant varies based on your location, choice of healthcare provider and other factors. However, it’s normal for the Penuma implant procedure “usually costs around $16,000 to $18,000” in total.
The website also notes that the precise cost of surgery can vary, as the implant is customized to match each patient’s anatomy and meet their needs.
One detail to keep in mind is that you need to be circumcised to receive the Penuma implant. If you’re not circumcised, you’ll need to undergo a surgical circumcision procedure in order for the implant to be safely fitted inside your penis.
The cost of adult circumcision can vary based on a range of factors, but it typically costs $1,500 to $5,000. As an elective procedure, circumcision typically isn’t covered by health insurance.
Also, it should go without saying that the Penuma penile implant is also almost always seen as an elective surgery, and as such, isn’t covered by insurance.
Some financing companies may offer payment plans for penile enhancement surgery, but this is something you’ll need to discuss with your provider if you’re considering this type of procedure.
In order to get a Penuma implant, you’ll need to be 21 years of age or older. You’ll also need to meet certain other safety criteria, which your surgeon will discuss with you prior to approving as a candidate for the procedure:
If you aren’t circumcised, you’ll need to undergo an adult circumcision prior to having the Penuma implant inserted into your penis.
If you’ve previously had a penis enhancement procedure (for example, fat transfer, filler injections, silicone gel or a related procedure), you may not be able to undergo surgery to have the Penuma implant inserted.
In order to insert the Penuma implant, your surgeon will create a small surgical incision close to your scrotum. The implant will be inserted and the incision will be closed, creating a tiny, hidden scar that will be concealed from your sexual partners.
The entire procedure is performed under general anesthesia, meaning you will be in a sleep-like state during the procedure and unaware of the surgery as it’s being performed.
According to Penuma, the company that makes the implant, most men are able to walk after the surgery. You can usually go home the same day as the procedure before taking part in several follow-up sessions with your surgeon to assess your results and recovery.
It’s normal for your penis to swell following the procedure. You’ll need to abstain from sex and/or masturbation for several weeks after the procedure (typically six weeks) before your healthcare provider clears you for sexual activity.
All surgical procedures have some risks, and the Penuma implant surgery is no exception to this rule. However, complications are generally uncommon, and the risks of most complications from this type of procedure can be mitigated with the right pre-op and post-op care.
Potential risks and complications associated with the Penuma implant include seroma (build-up of fluid inside the body), the development of scar tissue around the implant and the possibility of infection.
Many of these, such as excess scar formation and infection, are common risks associated with many surgical procedures, not only penile surgery.
Research suggests that complications from the Penuma implant are generally uncommon. Less than five percent of participants in studies reported seroma (the most common problem), with a smaller percentage of patients reporting other complications from surgery.
Less than three percent of people who underwent surgery for the Penuma implant had to have the device removed due to complications or other adverse events.
No participants in studies of the Penuma implant reported any negative changes in ejaculation, erections or general sexual function.
Right now, the Penuma implant is the only reliable option for penile augmentation without a high risk of complications or changes in your penis’s function.
Other options include penile suspensory ligament surgery, which increases the perceived length of your penis, and pseudoscientific techniques such as jelqing, which claim to add length to the penis by stretching the tissue.
Both of these approaches have major downsides. While penile suspensory ligament surgery -- a procedure that involves dividing the penile suspensory ligament to make the penis look longer -- does create the appearance of extra length, it can affect your penis’s function.
This is because the suspensory ligament tethers the penis to your pubic arch -- the front area of your pelvis. Cutting this ligament makes the penis appear slightly longer, but it also causes it to hang at an unusual, downward-facing angle when it’s erect.
It also does nothing to extend your penis skin, meaning it may cause your pubic hair to grow on the shaft of your penis rather than on your lower torso.
Another surgical technique is fat grafting, which can add girth to the penis. However, this comes with its own set of risks, including the development of a lumpy, uneven appearance to the penis and, like with all surgical procedures, the possibility of infection.
Jelqing, on the other hand, is a do-it-yourself technique that involves stretching your penis with exercises. The process is uncomfortable, and most research suggests that the results of these at-home techniques are poor.
While these approaches all have significant downsides, there are real options for improving the way you perform in bed and potentially making your erect penis slightly larger.
Although PDE5 inhibitors won’t physically enlarge your penis when it’s flaccid, they can make it easier for you to maintain a firmer erection during sex. Essentially, you’ll be able to do more with what you’ve got instead of worrying about achieving a larger penis size.
By giving you a harder and more reliable erection, medications like sildenafil may also produce a slight increase in erect penis size, especially if you’re normally prone to erectile dysfunction.
We offer several other PDE5 inhibitors as part of our range of ED treatments, including tadalafil (the active ingredient in Cialis®) and avanafil, which is currently available under the brand name Stendra®.
You can learn more about the effects of these medications and their impact on your penis and sexual performance in our guide to the most common ED treatments and drugs.
It’s far from abnormal (or even uncommon) to desire an extra inch below your belt. However, if your penis length is in the normal range but you feel as if you need penis enlargement surgery, it’s potentially a sign that you have penile dysmorphic disorder.
Penile dysmorphic disorder is similar to body dysmorphic disorder, but specifically focused on penis length, girth or shape. It’s a real issue for some men that can cause a variety of mental health problems, including an increased risk of certain anxiety disorders.
Experts aren’t aware of precisely what causes PDD, but it’s likely that the porn industry, which tends to select for men and women with larger-than-average appendages, may play at least a part in distorting people’s idea of what is and isn’t normal.
According to a study published in the journal BJU International, the average erect penis is 5.2 inches in length. It’s also perfectly normal for a penis to be an inch smaller or larger than this, all while still fitting comfortably within the “normal” range.
Interestingly, men are far more concerned about being above the average penis size than their partners. In a 2018 survey published in the journal Psychology of Men & Masculinity, a team of experts found that 85 percent of women said they were satisfied with their partner’s penis size.
In the exact same survey, only 55 percent of men stated that they were satisfied with their own penis size.
Put simply, provided your penis is at least close to the normal size range, you’re probably more worried about it than she is.
If you feel like your penis isn’t big enough and think you could have penile dysmorphic disorder, it’s best to talk to a mental health provider about your concerns.
You can connect with a mental health provider in your local area, or from home using our online mental health services.
Currently, Penuma is the only silicone sleeve implant for improving your penis appearance that has been cleared by the FDA. As such, if you’re considering aesthetic surgery for your penis, it probably has a place near the top of your “to look into” list.
The Penuma implant doesn’t lengthen your penis, but it can provide a moderate amount of girth enhancement. If you’re unhappy with the girth of your penis and understand the risks of surgery, it could be an option worth considering.
Every guy is self-conscious about something, and thanks to the widespread availability of porn, it’s easy to feel inadequate about your penis.
However, it’s important to remember that size isn’t everything -- it’s how you use it. Most women are more than satisfied with a penis around the average size, and simple things like dealing with erectile dysfunction can often go a longer way towards improving sex than a bigger member.
Before opting for surgery, make sure you’ve tried other methods to improve your sexual function and enjoy better, more satisfying sex.
You can learn more about doing this by viewing our range of erectile dysfunction and premature ejaculation treatments online, or by reading our full list of natural ways to improve your erections and sexual function.