Penoplasty in Switzerland: lengthening, thickening and realities

Penoplasty refers to procedures that change the apparent length or girth of the penis. It is a subject surrounded by much silence, insecurity and commercial promises. Every year, men of all ages wonder about the size of their penis, often since adolescence, sometimes following a remark, an illness or weight gain. For some, a procedure can bring real well-being; for many others, clear information is enough to ease an unfounded worry. This page explains how the penis is built, what the usual measurements are, which techniques exist to lengthen or thicken it, what they can really achieve, what the risks are, what Swiss insurers cover and where to consult in the 26 cantons. For an overview, see also our guide to intimate surgery.

Lengthening penoplasty most often relies on dividing the ligament that attaches the penis to the pubis, combined with skin reshaping and sometimes pubic liposuction; the gain mainly concerns flaccid length, around one to three centimetres, and requires a traction programme after the procedure. Thickening penoplasty uses the patient's fat, hyaluronic acid or tissue grafts. The procedure takes one to two hours, most often as an outpatient. Intercourse resumes after four to six weeks. Results are modest and risks real; most men who consult have anatomy within the norm. Cosmetic penoplasty is at the patient's expense; certain medical situations, such as a buried penis, may be covered. Budget guidelines in percentages are on our page on penoplasty prices in Switzerland.

The word penoplasty is used for several very different procedures. In everyday language, it mainly refers to cosmetic penis enlargement surgery. In medical language, it also covers reconstructive procedures: correction of a penis buried in pubic fat, repair after trauma, correction of webbing between the penis and scrotum, and length restoration after Peyronie's disease or prostate surgery.

All these procedures have in common that they work on the covering and attachments of the penis, not on the erectile bodies themselves, which are responsible for erection. There is no surgery capable of truly enlarging the erectile bodies of a healthy man without major risk to his sexual function. This is the first limit to understand.

One point often surprises: a significant part of the penis, sometimes up to a third of its total length, is hidden inside the body, anchored under the pubic bone and in the perineum. Surgical lengthening relies on this feature: by releasing the upper attachment, a small part of this root is allowed to move outwards, especially when flaccid.

Erection is a vascular phenomenon controlled by nerves. When stimulated, the arteries supplying the corpora cavernosa dilate and the erectile tissue fills with blood. The tunica albuginea, the fibrous sheath of the corpora cavernosa, tightens and compresses the veins, which retains the blood and makes the penis rigid. After ejaculation or the end of stimulation, the process reverses.

This mechanism explains several important points. Erect length is limited by the tunica albuginea, which does not stretch beyond a certain limit; that is why the erectile bodies cannot be enlarged. Erection quality depends on the health of blood vessels and nerves, hence the link between erectile dysfunction, smoking, diabetes and cardiovascular disease. Finally, a penoplasty that touches neither the vessels nor the erectile bodies does not normally impair erection.

Many studies have measured penis size, and their results converge. A large-scale review, combining measurements of several thousand men taken by health professionals, established average values often cited by urologists.

These figures show that the vast majority of men fall within a narrow range around the average. A flaccid penis smaller than average says almost nothing about its erect size: some penises grow a great deal when erect, others little. Micropenis, medically defined by a stretched length far below average, is rare and requires specific care, often from childhood.

When flaccid, the penis changes size throughout the day. Cold, cold water in a pool or lake, stress, fatigue or intense physical exertion cause the blood vessels and smooth muscle to contract, shortening it considerably. Warmth, relaxation or slight arousal lengthen it. These perfectly normal variations can reach several centimetres in some men.

That is why flaccid size, observed for example in a changing room after sport or a swim, is not a good indicator. Urologists measure stretched length, which varies much less and better reflects erect length.

If you would like an idea before a consultation, a simple, standardised measurement avoids errors. When erect, standing, place a rigid ruler on the top of the penis, pressing gently against the pubic bone to go through the fat, and measure to the tip of the glans. When flaccid, measure by gently stretching the penis, held by the glans, until you feel resistance, using the same technique.

Do not measure along the underside, or from the pubic skin without pressing, which considerably underestimates length in men with a bit of a belly. Then compare with the reference values. This measurement does not replace the doctor's examination, but it is often reassuring.

Most men who consult because they think their penis is too small are of normal size. Several mechanisms explain this gap. Seen from above, your own penis always looks shorter than it really is, whereas you see other men's from the front or side. Comparison is often made with pornographic images that select exceptional anatomies and use flattering camera angles. In changing rooms, flaccid penises are compared, whereas flaccid size varies enormously from one moment to the next.

These observations in no way diminish the reality of the distress felt. But they explain why the first step of a serious consultation is to measure, compare with reference values and explain. For some men, this information profoundly changes how they see themselves.

Pornography is often the main source of comparison for men worried about their size. Yet it selects performers with exceptional anatomies and uses framing, lenses and positions that accentuate size, and sometimes editing. Comparing your body with these images is like comparing your height with that of professional basketball players.

Social media and forums also spread fanciful figures, often self-reported and exaggerated. Studies based on measurements taken by professionals give a much more realistic picture. Becoming aware of these biases is often an important step in easing a worry, and many sex therapists work on these perceptions.

The penis grows mainly during puberty, under the effect of testosterone, and generally reaches adult size at around seventeen or eighteen, sometimes a little later. During adolescence, differences in pace between boys of the same age are considerable, which fuels many passing worries. Once growth is complete, size remains stable for many years.

With age, several factors can reduce apparent length: weight gain, which hides the base of the penis, reduced tissue elasticity, less frequent and less firm erections, and certain diseases or surgeries. This shortening, often of a centimetre or two, is not inevitable: regular physical activity, a stable weight and maintaining regular erections, including with treatment if needed, help preserve the tissues.

Penile surgery first developed in a reconstructive setting: reconstructions after trauma or malformations, procedures for Peyronie's disease, then implants for erectile dysfunction from the 1970s. Cosmetic lengthening by division of the suspensory ligament spread from the 1990s, at first with much enthusiasm, then with more caution when long-term results proved modest and complications not negligible.

Thickening techniques have had dark episodes, with injections of non-absorbable substances such as paraffin or liquid silicone, causing serious complications that still require reconstruction today. Current methods rely on absorbable materials or the patient's own tissues. Urology and andrology societies recommend a cautious approach, focused on information and psychological assessment before any cosmetic surgery.

Studies on cosmetic penoplasty are often small and of uneven quality, which calls for caution in interpreting them. They do, however, converge on several points. Measured gains are modest and variable. Satisfaction is higher among men who had a specific anatomical reason, such as a fatty pubis or webbing, than among those whose anatomy was normal. A non-negligible proportion of men remain dissatisfied, even when a gain is measurable.

Conversely, several studies show that information about normal measurements and psychological support considerably reduce anxiety and demand for surgery in men with normal anatomy. These findings explain why reputable urologists insist on prior assessment and do not offer surgery straight away.

Urology and sexual medicine societies have published recommendations on penile enlargement surgery. They consider that these procedures should be reserved for particular situations, after full information on normal measurements, realistic gains and risks, and after assessment of the psychological dimension of the request. They warn against injections of non-absorbable products and call for caution regarding cosmetic implants.

These recommendations are not intended to prohibit, but to protect patients from avoidable disappointment and complications. A practitioner who follows them will not necessarily refuse you the procedure, but will take time to make sure it suits your situation.

These situations do not have the same answers. The specialist's first task is to determine which applies to you, which requires an examination and honest dialogue.

Awareness

Often in adolescence, a comparison or a remark gives rise to a worry that takes hold. Many men talk to nobody about it for years.

Looking for information

Forums, advertising, videos: information found online is often contradictory, sometimes alarming, sometimes commercial.

First contact

A question asked discreetly to a referral service, a GP or a urologist, often after long hesitation.

The consultation

Measurement, examination, explanations. For many, this is when the worry is put into perspective.

Support or decision

Depending on the situation: sex therapy, weight loss, erection treatment, or a targeted surgical plan with a reflection period.

Procedure and follow-up

When decided on, an outpatient procedure, then several months of traction and check-ups.

Review

At six months, final measurement and discussion of the result, in terms of centimetres and quality of life.

Every journey is unique, but this outline shows a constant: the earlier and more reliable the information, the calmer the decisions, whether or not they lead to a procedure.

In some men, concern about penis size becomes intrusive: repeated thoughts, frequent checking, comparisons, avoiding relationships, changing rooms or swimming pools, even though anatomy is normal. Specialists sometimes speak of penile size anxiety or, in severe forms, body dysmorphic disorder.

These men are often those who most request surgery, and those least satisfied with it: even a measurable gain does not change perception, and the concern can shift or worsen. Studies show that psychological or sexological support, sometimes short-term, considerably reduces this anxiety. A reputable urologist will suggest it before any procedure, to check with you that the procedure will really relieve what is causing you distress.

Many worries arise during adolescence and persist into early adulthood. If you are between eighteen and twenty-five and the size of your penis worries you, a few pointers can help. Growth can continue until about eighteen, sometimes a little longer. Comparisons with pornography and changing rooms are misleading. Correct measurement, stretched or erect from the pubis, often gives a reassuring result.

Talking about this concern to a doctor, a sexual health centre or a sex therapist is a common step that invites no judgement. Before any surgical decision, take time for this information and support: a procedure at twenty is a commitment for life, with real risks for modest gains.

Studies that have asked partners what matters to them in their sex life place penis size far behind other factors: the quality of the relationship, attentiveness, communication and tenderness. The vast majority of partners say they are satisfied with the size of their partner's penis, whereas a significant proportion of men say they are dissatisfied with their own size.

This gap does not mean the concern is illegitimate, but it is an invitation to talk about it together where possible. Some couples see a sex therapist together, which often helps put a worry into perspective and strengthen closeness. A reputable urologist always takes an interest in the relationship context of the request.

For many men, discomfort shows mainly in changing rooms, communal showers, saunas or at the swimming pool. That is where comparisons arise, always skewed: flaccid penises, often retracted by cold or exertion, seen from different angles. Some men give up sports they love, or change in secret, from adolescence onwards.

Becoming aware of these biases helps, as do simple strategies: changing without rushing, not staring at others and remembering that most men around you have the same worries. A sex therapist can support this work. For men whose penis is genuinely hidden by the pubis or webbing, a targeted procedure often brings lasting relief in these situations.

Teasing at school, a remark from a former partner or a joke in a changing room can leave a lasting mark. Years later, some men still think about it every time they have sex, even though their anatomy is perfectly normal. These memories feed an anxiety that can hold back emotional and sexual life. Recognising them and talking about them, with a professional if needed, is often more liberating than changing the body.

It can be useful to write down the memory, gauge its influence on your current life, then confront it with the facts: the real measurement, the reference values and your partner's opinion. This work, sometimes done with a psychologist or sex therapist in a few sessions, separates the old wound from present reality. Many men say they wish they had done it much sooner, before spending years hiding their body or looking for a surgical solution.

A buried penis is a situation in which the penis, of normal size, is partly or completely hidden under the skin and fat of the pubis. It mainly concerns men with significant excess weight, but also some men after surgery, an overly radical circumcision or chronic skin infection. It can interfere with urination, encourage infections and irritation, make hygiene difficult and complicate sexual life.

Treatment often combines weight loss, liposuction or excision of pubic fatty tissue, fixing the skin to the base of the penis and sometimes skin grafts. This is reconstructive surgery, performed by experienced urologists or plastic surgeons, which may be covered by insurance when functional discomfort is documented. Our guide to obesity surgery covers weight loss.

In an overweight man, pubic fat is often the main reason the penis looks small. In this situation, the most effective strategy begins with weight loss, if possible: every kilo lost reveals a little more of the base of the penis and often improves erectile function, fitness and general health.

Operating before weight loss risks a less lasting result, as fat can return. When weight loss is significant, after obesity surgery for example, pubic reshaping can be combined with other reconstructive body-contouring surgery. See our page on abdominoplasty in Switzerland.

In some men, the skin of the scrotum extends up the underside of the penis, forming a sort of membrane. This webbing, congenital or acquired, gives the impression of a shorter penis, particularly when erect, and can be uncomfortable during intercourse. Correcting it is a simple procedure: the surgeon releases the skin and redistributes it with a Z or V-Y plasty, which frees the lower base of the penis. The visual gain is often appreciable, with few risks, and the procedure is frequently combined with lengthening.

Some men are born with a curved penis, often downwards, which becomes visible at puberty. Significant curvature can interfere with intercourse and make the penis look shorter when erect. It is corrected by a urological procedure that slightly shortens the side opposite the curvature, at the cost of a small loss of length, visually compensated for by the straightening. This surgery is covered as medical care when the curvature interferes with intercourse. It is not cosmetic penoplasty, but the two questions are often linked in patients' minds.

If your penis has had marked curvature since puberty, mention it at the consultation: correcting it can improve comfort during intercourse and the impression of length much more than cosmetic penoplasty, with possible insurance coverage.

Certain skin diseases change the appearance and comfort of the penis. Lichen sclerosus makes the skin of the foreskin and glans white, fragile and contracted, which can cause phimosis and a partly buried penis. Repeated balanitis, inflammation of the glans often encouraged by diabetes or unsuitable hygiene, interferes with intercourse. Genital eczema or psoriasis can also cause irritation and fissures.

These situations call for medical treatment, sometimes circumcision. They must be treated before any penoplasty, as they compromise healing and may on their own explain part of the discomfort felt.

A very low, bulky scrotum, particularly with age or heat, can make the penis look smaller by contrast. Conversely, webbing in which scrotal skin extends up the penis visually shortens its underside. The surgeon therefore always examines the whole genital area. Webbing correction or scrotal reduction, sometimes combined, can improve overall harmony without touching the penile attachments.

Several medical situations cause a real loss of length. After radical prostatectomy for cancer, many men notice shortening of the penis, linked to healing and the absence of erections for several months. Peyronie's disease, through contraction of its fibrous plaque, often shortens the penis as well as curving it. Prolonged erectile dysfunction, with no erections for months, is also accompanied by loss of tissue elasticity.

In these situations, prevention and treatment go first through erectile rehabilitation, with medicines, injections or a vacuum pump, and through traction devices. When the length lost is significant and associated with erectile dysfunction, certain surgical techniques carried out when a penile implant is placed can restore some of the length. These procedures fall within specialist urology and medical care.

After removal of the prostate for cancer, many men notice reduced penile length in the following months. Several mechanisms contribute: healing at the base of the penis, damage to the erectile nerves and above all a prolonged absence of erections, which makes the erectile tissue lose elasticity.

Erectile rehabilitation, started early after the procedure with medicines, injections or a vacuum pump, aims to maintain tissue oxygenation and suppleness. Some urologists add traction. These measures limit loss of length and encourage the return of erections. If erectile dysfunction persists, a penile implant may be offered, possibly with length-restoration procedures. Talk to your urologist about it from the pre-operative consultation.

A penile implant is a treatment for erectile dysfunction: cylinders placed in the erectile bodies provide rigidity when other treatments have failed. It is not intended to enlarge the penis, although certain associated techniques can restore lost length. Cosmetic penoplasty, on the other hand, is for men whose erection is normal and does not touch the erectile bodies. The two approaches have different indications, risks and coverage. Our guide to intimate surgery presents penile implants.

Micropenis is a rare abnormality, generally of hormonal origin, most often detected at birth or in childhood. It is defined by a stretched length well below reference values for age, with otherwise normal anatomy. It is treated in childhood with hormones in paediatric endocrinology centres. In adulthood, when size remains very small and causes difficulty, specialised reconstructive procedures can be discussed. This situation has nothing to do with the common worries of men with normal anatomy and is managed in university centres.

Phalloplasty is reconstructive surgery that creates a penis from other tissues, for example from the forearm or thigh. It is intended notably for trans men in a gender-affirmation pathway, or for men who have lost their penis following cancer or trauma. It is performed by specialist teams, in several stages, and has nothing to do with the cosmetic penoplasty described on this page. Our guide to intimate surgery mentions these procedures.

Anabolic steroids and testosterone used without a prescription to build muscle do not enlarge the penis in adulthood. On the contrary, they can cause reduced testicular volume, lower fertility, and erection and libido problems, particularly when stopped. Very developed muscles in the trunk and thighs can also make the penis look smaller by contrast.

If you have used these products and notice changes, see a urologist or endocrinologist without fear of judgement: a hormone assessment and support often restore normal function.

Testosterone plays a major role in penile growth during foetal life, early childhood and puberty. Once growth is complete, giving testosterone to an adult man does not enlarge the penis, even when his level is low. In adults, a hormone deficiency shows instead as reduced libido, less frequent erections, fatigue and loss of muscle mass.

A hormone assessment can be useful in the case of micropenis, very small testicles, incomplete puberty or symptoms suggesting a deficiency. Hormonal treatments for micropenis are effective in childhood, much less so in adulthood. Be wary of products presented as boosting testosterone for growth: they are ineffective on size and sometimes dangerous.

The best candidates are healthy adult men with an identifiable anatomical reason for discomfort: a significant fatty pad, webbing, a partly buried penis, loss of length after an illness, or size genuinely below the norm. They have realistic expectations, understand that the gain will be modest and are prepared to follow the constraints of recovery, notably traction.

Conversely, a procedure is not advised for a man with normal anatomy who has severe size-related anxiety, a man hoping for a significant change when erect, a smoker who cannot stop, or a man whose diabetes or skin infection is not under control. It is never offered to a minor for cosmetic purposes.

Information

Knowing the reference measurements and understanding the effect of perspective is often enough to ease a long-standing worry.

Weight loss

In an overweight man, every kilo lost around the abdomen and pubis reveals more of the base of the penis. It is one of the most effective measures.

Trimming pubic hair

Simply trimming pubic hair gives a visual impression of extra length, without any risk.

Sex therapy

Support helps overcome performance anxiety, improve communication in the couple and regain confidence.

Traction devices

Worn regularly for months, they bring a modest gain in stretched length.

Treating erectile dysfunction

Firmer, more regular erections often improve the perception of size.

Simple, risk-free solutions change everyday appearance: fitted underwear with a support pouch enhances the genital area, trimming pubic hair visually reveals the base of the penis, and suitable swimwear limits discomfort at the pool. These measures do not change anatomy, but they help many men feel more at ease in the situations where their concern is strongest.

These steps may seem trivial, but they act on the concrete moments when discomfort arises: changing in front of others, swimming, looking in the mirror. Combined with accurate information about normal measurements, they are often enough to make the concern much lighter day to day, with no risk and no recovery period.

The sex therapist — a doctor, psychologist or trained therapist — is often the most useful person for a man concerned about penis size. They begin by listening: the history of the concern, its triggers and its impact on relationships and sexual life. They provide precise information about anatomy and what matters in sexuality.

They then offer suitable exercises and approaches: work on automatic thoughts, reducing checking and comparing behaviours, improving communication with the partner and managing performance anxiety. A few sessions are often enough to reduce distress considerably. When surgery remains under consideration, this work allows the procedure to be approached with realistic expectations. Some sessions, conducted by a doctor or by a psychologist on prescription, are reimbursable; your insurer will confirm.

• Is my concern common, and how can it be explained?
• Which exercises can reduce my anxiety?
• How should I talk to my partner about it?
• How can I tell whether surgery would really help me?
• How many sessions should I plan, and are they reimbursed?

Advertisements for pills, creams, sprays, patches or programmes promising penis enlargement are everywhere. None of these products has been shown to work. Some contain undeclared substances, such as erectile dysfunction medicines in uncontrolled doses, dangerous for people with heart problems or taking certain treatments.

Also be wary of clinics promising spectacular, guaranteed or permanent gains, techniques presented as revolutionary, and before-and-after photos taken from different angles. A reputable specialist announces modest gains, discusses risks and alternatives, and does not rush you into deciding.

Division of the suspensory ligament

Through an incision at the base of the penis, at the pubis, the surgeon divides the ligament that attaches the penis to the bone. Once released, part of the root of the penis can move outwards. To prevent the ligament from reattaching, they may place fat or tissue between the bone and the penis. The gain concerns flaccid and stretched length; when erect, it is small or nil.

V-Y skin plasty

Ligament division is often accompanied by reshaping of the pubic skin, drawn in a V and closed in a Y, which advances the skin towards the penis. This plasty improves the visual result but leaves a scar on the pubis, generally hidden by hair.

Pubic liposuction

In men with a fatty pad above the penis, removing this fat reveals the base of the penis. It is often the procedure that brings the largest visible gain, without touching the penile attachments.

Pubic lift

When the pubic skin is loose, after weight loss for example, a lift removes excess skin and raises the area, revealing the penis. It is often combined with an abdominoplasty.

Webbing correction

It frees the underside of the penis and can be combined with lengthening.

These gains are averages, with significant variation. Part of the gain obtained in theatre can be lost during healing if the traction programme is not followed. It is essential to measure stretched length before the procedure in order to judge the result objectively afterwards.

When several procedures are planned, such as pubic liposuction, webbing correction, ligament division and thickening, the question arises of doing them together or separately. Combining them limits the number of anaesthetics and recovery periods, but increases the length of the procedure, swelling and the risk of complications, particularly when lengthening is combined with thickening by fat or graft.

Many surgeons prefer to start with the procedures that reveal the penis — liposuction and webbing correction, possibly with lengthening — then assess the result before offering thickening several months later. This step-by-step approach often shows that the first stage is enough.

The suspensory ligament does not only attach the penis: it also stabilises the erection and contributes to its upward angle. After division, the erection may be lower, sometimes less stable, which troubles some men during intercourse. This effect varies from patient to patient and is generally moderate, but it must be known. It is one of the reasons why ligament division is not offered lightly, particularly to young men whose sexual function is perfectly normal.

Sensation in the glans and penile skin is provided by the dorsal nerves, which run along the top of the penis with the dorsal arteries and veins. They pass just under the suspensory ligament, which explains the caution required when dividing it. The surgeon cuts the ligament against the bone, away from this neurovascular bundle.

After the procedure, stretching and swelling of the tissues can cause a temporary reduction in sensation, tingling or, conversely, hypersensitivity of the glans. These sensations generally resolve within a few weeks. Lasting damage to the dorsal nerves is rare in experienced hands, but it is one of the most feared risks of penoplasty.

After ligament division, the tissues tend to retract and the penis can shorten again during healing. To prevent this, surgeons almost always prescribe a traction programme: a device that keeps the penis stretched, worn several hours a day for several months, or repeated manual stretching exercises. This programme is demanding and requires discipline.

Traction devices are also offered without surgery. Studies show that prolonged, regular wear, several hours a day for months, can bring a modest gain in stretched length. They are also used to limit shortening linked to Peyronie's disease. Vacuum pumps, useful in erectile dysfunction, do not lastingly lengthen the penis when used alone.

Traction devices generally consist of a ring that rests at the base of the penis, two adjustable rods and a holding system near the glans, made of silicone or a soft strap. The tension is increased gradually over the weeks. Other models use a vacuum sleeve. All work on the principle of gentle, prolonged traction that stimulates tissue lengthening.

The main difficulties are discipline and skin discomfort at the contact point. Regular breaks, good hygiene and changing the pads prevent irritation. Skin that turns blue, numbness of the glans or pain mean the tension must be released. Traction is ineffective if worn for only a few minutes a day.

Fat transfer

The surgeon harvests fat from the abdomen or thighs, purifies it and reinjects it in fine layers under the penile skin. The result feels natural, but some of the fat is reabsorbed, often unevenly, which can create irregularities or small lumps. Several sessions are sometimes needed.

Hyaluronic acid

An absorbable gel is injected under the penile skin, sometimes also into the glans. The effect is immediate and reversible with an enzyme, but temporary: it decreases over one to two years. Nodules, migration of the product or asymmetry are possible. The treated glans may become less sensitive in some men, or more comfortable when ejaculation was rapid.

Tissue grafts

Dermal grafts taken from the patient, or tissue matrices of biological origin, are placed around the shaft. They give more lasting thickening, at the cost of a more major procedure and a risk of retraction or infection.

Subcutaneous implants

Silicone implants designed to be placed under the penile skin exist. They give significant, lasting thickening, but carry a risk of serious complications, such as infection, exposure through the skin, retraction or altered sensation, which sometimes require their removal. They remain controversial and are rarely offered.

Harvesting

Under local anaesthesia with sedation or general anaesthesia, the surgeon harvests fat from the abdomen, flanks or thighs using small cannulas.

Preparation

The fat is decanted, centrifuged or filtered to keep only viable cells.

Injection

It is reinjected in fine threads between the skin and the sheath of the erectile bodies, evenly around the whole circumference, avoiding the underside where the urethra runs.

Moulding

The surgeon gently moulds the penis to distribute the fat, then applies a slightly compressive dressing.

Recovery

Swelling is significant for two to three weeks. Volume then decreases as some of the fat is reabsorbed. The result is judged at around six months.

The session lasts about an hour. An anaesthetic cream is applied, then a nerve block is given at the base of the penis. The doctor injects the gel through a fine cannula, in several passes, between the skin and the sheath of the erectile bodies, then massages gently to distribute the product. A light dressing is applied. Swelling and a feeling of tension last a few days.

It is advisable to avoid intercourse, masturbation and sport for a few days to two weeks, according to instructions, so that the product settles. A check-up is planned after a few weeks, with a possible touch-up. The effect decreases gradually over one to two years. In the event of a complication, an enzyme can dissolve the product.

Cosmetic subcutaneous implants are crescent-shaped pieces of soft silicone, made in several sizes or custom-made, placed through an incision above the scrotum, under the skin and around the erectile bodies without entering them. They immediately and significantly increase girth and apparent flaccid length.

However, they carry a risk of complications whose frequency is not negligible in published series: infection, displacement, exposure of the implant through the skin, contraction of the capsule that forms around it, discomfort during intercourse and altered sensation. These complications sometimes require removal of the implant, with a risk of loss of length. Medical societies call for caution and detailed information before this option is chosen.

Dermal grafts are taken from the patient, often from the groin crease or buttock, stripped of their surface layer, then wrapped around the shaft under the skin. Acellular dermal matrices are tissues of biological origin, treated to keep only their framework, which serve as a scaffold for the growth of the patient's own tissue.

These grafts give more lasting thickening than hyaluronic acid, with a natural appearance when they take well. Their main drawback is possible retraction, which can shorten or deform the penis, as well as infection and hardening. The procedure is more major, with a longer recovery. They are offered by a few specialist teams.

Some requests concern the volume of the glans, considered small in relation to the shaft, particularly after the shaft has been thickened. Hyaluronic acid is the most widely used method, with a temporary effect. Injection must be done cautiously, as the glans is richly supplied with nerves and blood vessels; an injection that is too superficial creates irregularities, and an excessive one can cause discomfort. Glans sensitivity may be temporarily altered.

Some practitioners offer hyaluronic acid injections into the glans to reduce its sensitivity and delay ejaculation. Available studies are limited, and this use is not recommended by urology societies, which favour sex therapy, behavioural techniques, certain medicines and local treatments. Glans injections also carry a risk of irregularities and altered sensation. If rapid ejaculation is your main concern, see a urologist or sex therapist before any procedure.

Injections of paraffin, oils, petroleum jelly or liquid silicone have been carried out, sometimes outside any medical setting, to increase penile volume. They cause chronic inflammatory reactions, deformities, skin necrosis and sometimes serious complications requiring major reconstruction, often with skin grafts. These products must never be injected. If you have had an injection and do not know what it contained, see a urologist, even if you have no symptoms.

Injections of paraffin, petroleum jelly, oils or liquid silicone cause, over time, a chronic inflammatory reaction called a granuloma or paraffinoma. The penis becomes hard and deformed, sometimes painful, the skin thickens and can ulcerate, and intercourse becomes difficult. These complications can appear years after the injection.

Treatment consists of surgically removing all the infiltrated tissue, which often leaves the penis without skin. Coverage is provided either by a skin graft or by a two-stage technique in which the penis is temporarily buried under the scrotal skin, then freed a few weeks later with its new covering. These reconstructions are carried out by specialist urologists or plastic surgeons, often in university centres, and may be covered depending on the situation.

Lucas, 24

Self-conscious since secondary school, he avoids changing rooms. His measurements are average. After a few sessions with a sex therapist, his anxiety decreases considerably and he decides against the procedure.

David, 45

He has put on twenty kilos in ten years and feels his penis has shrunk. Weight loss, then pubic liposuction, reveal the base of the penis; he is satisfied without ligament division.

Karim, 33

Significant webbing visually shortens his penis when erect. A simple webbing plasty under local anaesthesia gives him the change he wanted.

Jean-Pierre, 61

After a prostatectomy, he has lost length and suffers from erectile dysfunction. Erectile rehabilitation, then a penile implant with a length-restoration procedure, are carried out by a specialist urologist.

Marco, 38

He wants thickening. He starts with hyaluronic acid to judge the effect, then decides not to go on to a permanent technique.

Stefan, 52

Liquid silicone injections received twenty years earlier have caused a painful deformity. A two-stage reconstruction is carried out in a university centre.

"Surgery can double the size of the penis"

False. Gains are of the order of a few centimetres when flaccid, and small when erect.

"Lengthening works mainly when erect"

False. Ligament division works mainly on flaccid and stretched length.

"Pills and creams make the penis grow"

False. No product sold online lastingly increases size; some are dangerous.

"A small flaccid penis is small when erect"

Not necessarily. Flaccid size is a poor predictor of erect size.

"Hyaluronic acid is permanent"

False. It is reabsorbed within one to two years.

"Partners attach great importance to size"

Studies show the opposite for the vast majority of partners.

Circumcision changes neither the length nor the girth of the penis. When flaccid, a circumcised penis may look slightly longer because the glans is uncovered, but this is an impression. When erect, length is the same. Conversely, a circumcision that removes too much skin can, rarely, interfere with erection or contribute to a partly buried penis. Circumcision should therefore never be considered as a way of changing size.

Penoplasty can reveal a hidden penis, correct webbing, bring a modest gain when flaccid or visible thickening. It does not turn normal anatomy into exceptional anatomy, barely changes erect length and does not, on its own, improve sexual life. The most satisfied men are those who had a specific anatomical reason and measured expectations.

It is useful to set with the surgeon what you would consider a good result, in centimetres and in terms of daily life: no longer feeling uncomfortable in changing rooms, regaining a visible base of the penis, correcting webbing. This concrete goal allows the result to be judged fairly.

• It does not enlarge the erectile bodies.
• It barely increases erect length.
• It does not improve erection quality.
• It does not treat rapid ejaculation or low desire.
• It does not remove deep anxiety linked to body image.
• It does not guarantee a partner's satisfaction.

A significant number of men who consult for penoplasty eventually decide not to have surgery. This is not a failure. Often, the consultation, measurement and explanations have eased a long-standing worry; sometimes sex therapy has changed how they see their body; sometimes weight loss or treating erectile dysfunction has been enough.

If the concern returns, nothing prevents you from consulting again later. Meanwhile, a few habits help: limiting comparisons, particularly with pornographic images, maintaining good general and vascular health, and not hesitating to talk about your doubts with your partner or a professional.

1. Measure

Know your stretched measurement and compare it with reference values.

2. Identify the cause of the discomfort

Pubic fat, webbing, loss of length, anxiety, comparison.

3. Try the alternatives

Weight loss, sex therapy, traction, treatment of erectile dysfunction.

4. Understand the techniques

Realistic gains, risks, recovery and traction constraints.

5. Decide without pressure

Reflection period, second opinion if needed, suitable timing.

• Is my size genuinely below the norm?
• What exactly bothers me, and in which situations?
• What exactly do I expect from the procedure?
• Am I prepared to wear a traction device for months?
• Have I tried talking about this concern with a professional?
• Does the request come from me?

The interview

The urologist or surgeon asks how long the size of your penis has concerned you, in which situations, what you have already tried and what you expect from a procedure. They also take an interest in your sexual and relationship life, without judgement.

Medical history

Illnesses, treatments, surgery, erection problems, Peyronie's disease, previous product injections.

The examination

They examine the penis, pubis, scrotum and skin, and measure flaccid and stretched length, sometimes girth. These measurements serve as a reference for judging the result.

The explanations

They compare your measurements with reference values and tell you clearly whether your anatomy is within the norm. They present the possible options, surgical or not, with their realistic gains, risks and constraints.

Direction

If the concern seems disproportionate, they suggest a session with a psychologist or sex therapist. For a cosmetic procedure, a reflection period and a second consultation are usual.

Note exactly what bothers you and since when, in which situations the concern is strongest, what you have already tried and what you hope for. If you have measured yourself, note the method used. List your treatments and medical history, in particular any previous injection in the genital area, and any erection problems.

Prepare your questions in writing: in front of the doctor, emotion often makes you forget the essentials. If you are afraid you will not dare to speak, simply hand over your sheet. You can come alone or with your partner.

Some men choose to come to the consultation with their partner. This allows information to be shared, the options and recovery constraints to be understood together, and often reveals that the concern is not shared. The doctor may nevertheless wish to speak with the patient alone for a few minutes to make sure the request is his own. This is common practice and does not call the other person's presence into question.

For recovery, the presence of an informed partner makes organising the first few days, moral support and a gradual return to intimacy easier. In practice, couples who address these questions together generally cope better with the period after the procedure.

If you prefer to come alone, that is just as legitimate. You can then share the information received at your own pace, using the written documents given by the surgeon, which describe the technique, recovery and precautions.

Some urologists use validated questionnaires to assess penile size anxiety, sexual satisfaction or the presence of body dysmorphia. These tools help understand the request better and measure, after any procedure, whether well-being has really improved. They are not a test to pass, but an aid to decision-making.

The psychological assessment, when offered, is a time for listening. It distinguishes a specific discomfort, which may respond to a procedure, from wider distress that requires other responses. Many men say it allowed them, for the first time, to talk about an insecurity they had carried for years.

• Are you a urologist or plastic surgeon, and how many penoplasties do you perform each year?
• Are my measurements within the norm?
• Which technique do you propose, and why?
• What gain can I reasonably expect, flaccid and erect?
• What are the risks to sensation and erection?
• Will traction be needed, and for how long?
• Which product will be injected, and is it absorbable?
• How do you handle an unsatisfactory result?

A good specialist will tell you clearly if a procedure does not seem useful and will not hesitate to suggest alternatives first. Be wary of promises of large or guaranteed gains.

Before cosmetic penoplasty, a second opinion is strongly advised, notably if you are promised a large gain, are offered several procedures at the first consultation, or have not been measured. Bring your measurements and questions. If two specialists announce very different gains, ask them what data they are based on.

Before the procedure, you sign a document setting out the technique, expected gains, alternatives, risks and constraints, notably traction. For penoplasty, it mentions in particular the risk of a gain considered insufficient, change in the angle of erection, altered sensation, irregularities and scars. Read it at home, ask your questions and keep a copy. You remain free to withdraw up to the last moment.

• Exactly which product will be injected, with which brand and traceability?
• Is the product absorbable, and can it be dissolved if there is a problem?
• Who provides anaesthesia and monitoring?
• How are infections prevented?
• What complications have you encountered in your practice, and how did you treat them?
• Who will follow me up if a problem arises in a year's time?

A practitioner who cannot answer precisely about the product being injected must not carry out the injection.

Injections are carried out in an equipped practice; surgical procedures in a clinic or outpatient centre with an operating theatre. Make sure the clinic is authorised by the canton, that an anaesthetist will be present for sedation or general anaesthesia, check the nature and traceability of injected products, and the out-of-hours emergency arrangements.

Penoplasty is performed by urologists, particularly those dedicated to andrology and genital reconstructive surgery, and by plastic surgeons. Urologists are best placed to assess erectile function, penile diseases and reconstructive situations. Plastic surgeons are involved notably in pubic liposuction, skin reshaping and skin reconstruction. Complex cases, such as after-effects of permanent product injections, micropenis or significant buried penis, are managed in university centres.

Check the practitioner's specialist title in the federal MedReg register. Ask how many penoplasties they perform each year, which techniques they use, what gains they observe in their patients and how they handle dissatisfaction.

The essential thing is to choose a practitioner who regularly performs the planned procedure and knows how to assess sexual function as a whole.

The GP is often the first person one dares to talk to about an intimate concern. They can reassure you, measure, look for a medical cause such as diabetes or a hormonal problem, and refer you to a urologist or sex therapist. After a procedure, they can carry out a first examination if a problem arises and the clinic is far away. Medical confidentiality fully applies.

Stop smoking

Healing of the penile and pubic skin depends on good circulation. Stopping smoking four to six weeks before and after is strongly advised.

Medicines

Report any treatment that thins the blood; whether to suspend it is decided with the doctor. Also report erectile dysfunction treatments.

The skin

A skin infection, ingrown hairs or fungal infection must be treated beforehand. Do not shave the pubis yourself in the preceding days; clipping is done according to instructions.

Supplies

Cotton supportive briefs, compresses, an ice pack, and the prescribed traction device, which you will be shown how to use.

Organisation

Plan a few days of rest, someone to accompany you home, and a period of four to six weeks without intercourse or intense sport.

• Reference measurements noted.
• Quote signed and touch-up conditions known.
• Informed consent read and signed.
• Smoking stopped for several weeks.
• Painkiller prescription and traction device ready.
• Supportive briefs, compresses, ice pack.
• Someone to accompany you home.
• A few days of rest arranged.

Choose a period when you can take a few days' rest, then wear the traction device regularly for several months and abstain from intercourse and sport for four to six weeks. Winter is often preferred: loose clothing is easier to wear, and swimming is not on the agenda. Avoid scheduling the procedure just before a holiday, a sports trip or an important event in your life as a couple.

Between the first consultation and the final result, allow six to nine months: a few weeks of reflection and possibly sex therapy, the procedure, several months of traction and healing, then the review at six months. For thickening with hyaluronic acid, the timeframe is much shorter, but the effect is temporary. Knowing this timeline avoids impatience and helps choose the right time to go ahead.

This interval is also a protection: it allows time to check that the plan holds, compare several opinions and organise yourself without rushing. Men who have given themselves this time generally approach the procedure more calmly, follow traction better and judge their result with more perspective. Conversely, a decision taken in a hurry, after a hurtful remark or a difficult period, deserves to be postponed for a few weeks.

Hyaluronic acid injections are done under local anaesthesia, often with a cream followed by a nerve block at the base of the penis. Fat transfer, webbing correction and ligament division can be done under local anaesthesia with sedation or brief general anaesthesia; combined procedures or grafts are more often done under general anaesthesia. The choice is discussed with the anaesthetist according to your health and preferences.

For injections and short procedures, local anaesthesia often relies on a dorsal nerve block: a few injections at the base of the penis, after an anaesthetic cream has been applied, numb the whole penis within a few minutes. The initial injection causes a brief stinging and burning sensation, then nothing. The anaesthesia lasts several hours. Light sedation can be added for anxious patients.

The anaesthetics used for penoplasty are short and well controlled. Local anaesthesia can cause a rare reaction to the product or brief faintness. Sedation and general anaesthesia carry the usual risks, very low in a healthy person: nausea, a temporary sore throat and an exceptional allergic reaction. The anaesthesia consultation allows the technique to be adapted to your health and treatments.

You are welcomed in the morning, discreetly. The surgeon reviews the plan, repeats the measurements and draws the incisions. After anaesthesia, the procedure takes one to two hours for lengthening, thirty minutes for an injection or webbing correction. On waking, a dressing and sometimes light compression are in place. Urination is checked, then you go home accompanied, with written instructions and the number to call.

Arrival

You arrive in the morning, having fasted if general anaesthesia or sedation is planned. The surgeon reviews the plan with you and repeats the measurements.

The incision

They make an incision at the base of the penis, on the pubis, drawn as a V if a skin plasty is planned.

Release

They divide the suspensory ligament against the bone, protecting the nerves and vessels on the top of the penis.

Interposition

They place fat or tissue between the bone and the penis to limit reattachment of the ligament.

Associated procedures

Pubic liposuction, webbing correction or fat transfer if planned.

Closure

They close the skin in a Y, apply a dressing and often light compression. The procedure takes one to two hours.

Night-time erections can be uncomfortable in the first few days, pulling on the scars; they are normal and do not endanger the result. Swelling of the penis can be impressive, especially after fat transfer, and decreases over several weeks.

Healing of the skin and deeper tissues goes through several stages. During the first week, inflammation dominates: swelling, redness, tenderness. Between the second and sixth weeks, new tissue forms and the scar becomes stronger, hence permission to resume intercourse at around four to six weeks. Beyond that, for several months, the tissues remodel: the scar softens and whitens, and hardening decreases.

It is also during this remodelling phase that the tissues tend to retract, hence the importance of traction after lengthening. Smoking, poorly controlled diabetes and repeated rubbing slow these stages.

Hygiene

Shower from the next day or the day after, according to instructions, patting dry carefully. No baths, swimming pools or saunas for three to four weeks.

Urinating

Urination is normal; slight swelling can deflect the stream in the first few days.

Dressing

Cotton supportive briefs, then soft underwear. Avoid very tight trousers.

Sitting

Sitting is possible quickly; the pubic scar can pull when bending in the first few days.

Cycling

Wait four to six weeks, until the scar and tissues at the base of the penis are strong.

The skin plasty scar is on the pubis, at the base of the penis. In the first few weeks, keep it clean and dry, without applying any cream that has not been prescribed. Once the skin has closed, gentle massage with a neutral cream for a few minutes a day softens it. A silicone gel may be advised if you tend to form thick scars.

Avoid shaving or waxing the area for several weeks, so as not to irritate the scar or encourage ingrown hairs. Protect it from the sun for six months. A scar that becomes red, thick and itchy beyond two months should be shown to the surgeon.

After penoplasty, gentle, regular hygiene prevents infection. In uncircumcised men, gently retract the foreskin when washing, if swelling allows, rinse with lukewarm water and dry before returning the foreskin. A very swollen foreskin must not be forced; if it remains stuck behind the glans and the glans swells, seek help promptly. Change underwear every day and wash the traction device according to instructions.

Intercourse and masturbation generally resume after four to six weeks, once the scars are strong and swelling has decreased, with the surgeon's approval. After hyaluronic acid injections, the wait is often shorter, from a few days to two weeks. First intercourse may be accompanied by different sensations: slightly reduced sensitivity, a feeling of tension at the base of the penis or a changed angle of erection. These sensations generally ease over the weeks.

After thickening, it is useful to have a lubricant and approach resumption gently, communicating with your partner. Condoms remain recommended depending on the situation; their size may need to be adapted after significant thickening.

The weeks without intercourse, daily traction and sometimes a swollen or bruised penis can weigh on the relationship. Talking about it in advance with your partner and explaining the stages and timescales avoids misunderstandings. Tenderness and intimacy do not stop during recovery. When intercourse resumes, new sensations, a changed angle of erection or performance anxiety may appear; patience and communication are then the best allies. Some couples see a sex therapist together at this point, to good effect.

Cyclists who ride a lot sometimes experience penile numbness or temporary erection problems, linked to compression of the perineal nerves and arteries by the saddle. These symptoms, generally reversible, are prevented by a suitable saddle with a central cut-out, a well-adjusted position, good-quality cycling shorts and regular breaks. They have nothing to do with penis size, but it is important to report them to the urologist if they persist, and to return to cycling gradually after penoplasty.

For office work, a return is often possible after three to seven days. Physical jobs, those involving lifting or sitting for long periods on a vibrating seat need one to two weeks more. Your employer will not know which procedure it was: the certificate says nothing on this point. After simple injections, a return is possible the next day.

Day 0

Ligament division, V-Y plasty and pubic liposuction under general anaesthesia, one and a half hours. Home in the evening, accompanied.

Days 1 to 3

Swelling and bruising of the penis and pubis. Cold through a cloth, painkillers. Night-time erections wake him with a feeling of tension.

Day 7

Check-up: healing well. Traction started, thirty minutes twice a day.

Week 3

Back to work. The traction device is worn three hours a day, in the evening.

Week 6

Check-up and approval to resume intercourse. The erection is slightly lower than before.

Month 6

Stretched measurement: a gain of just over two centimetres. The base of the penis is much more visible thanks to liposuction.

Day 0

One-hour session under local anaesthesia. Slight tension and swelling in the evening.

Days 2 to 5

Swelling decreasing. No intercourse or sport.

Week 2

Intercourse resumed. A small nodule is felt on one side.

Week 4

Check-up: the nodule is massaged and disappears. Girth has visibly increased.

Month 12

The effect is starting to fade. He is hesitating between a maintenance session and stopping.

For an outpatient penoplasty, living alone is not a major difficulty, provided someone takes you home and, ideally, you do not spend the first night alone. Prepare simple meals, an ice pack, supportive briefs, your medicines and the traction device. Keep your phone within reach with the team's number.

Complications of penoplasty are not rare, and some can have lasting consequences for appearance or function. This is the main reason for urologists' caution.

Haematoma and infection

They are possible after any procedure. Sudden, painful swelling, spreading redness or fever require consultation.

Altered sensation

The nerves that give sensation to the glans run along the top of the penis. A temporary reduction is common; lasting loss is rare but possible.

A disappointing result

This is the most common complication: a gain the patient considers insufficient, or partly lost during healing. Measurement before and after the procedure allows it to be judged objectively.

Erectile dysfunction

It is rare after a well-conducted penoplasty, but anxiety about the procedure or its result can temporarily disrupt erections.

If pain intensifies, temperature rises, the penile skin darkens or urinating becomes difficult, call the surgeon without delay; at night or at the weekend, call 144.

Penile fracture is a rupture of the sheath of the erectile bodies during an erection, most often during intercourse. It shows as a cracking sound, sudden loss of erection, pain and rapid swelling with a haematoma. It is a surgical emergency: prompt repair limits the risk of later curvature, shortening and erectile dysfunction. If in doubt, go to A&E immediately.

• Are healing and swelling progressing normally?
• Is my traction properly adjusted and sufficient?
• When can I resume intercourse, cycling and swimming?
• Does the measured gain match what was expected?
• Will the change in the angle of my erection evolve?
• Is a touch-up possible, and when?

To judge a penoplasty, compare measurements taken before the procedure and at six months, under the same conditions and with the same technique. Also look at the concrete goals set at the outset: is the base of the penis revealed, the webbing corrected, the discomfort in changing rooms reduced? Impressions in the mirror, seen from above, remain misleading. If anxiety persists despite a measurable gain, it is a sign that psychological or sexological support may be useful.

To know objectively what a penoplasty has achieved, you need to compare measurements taken in the same way before and after the procedure. Urologists generally measure stretched flaccid length from the pubis, pressing the ruler against the bone, to the tip of the glans, stretching the penis with constant force. Some also measure when erect, after an injection that induces an erection, or request standardised photos.

The final measurement is taken at around six months, once swelling has gone and the traction programme is well advanced. Also note how you feel on a simple scale before and after: discomfort in changing rooms, confidence during intercourse. These indicators count as much as the centimetres.

After penoplasty, the way you see your own body changes in several stages. In the first few weeks, swelling often gives the impression of a spectacular result, then the reduction in swelling can be disappointing. At around three to six months, the result stabilises and most satisfied men feel more at ease.

In some, attention shifts to another detail, or the concern persists despite a measurable gain. This is a sign that a psychological component plays an important role and that support may help more than another procedure. The surgeon is best placed to talk about it with you at check-ups.

Penoplasty does not always give the hoped-for result: a smaller gain than expected, slight asymmetry, a small irregularity or a changed angle of erection. In most cases, these imperfections are discreet and do not prevent a fulfilling sex life. Before considering a touch-up, wait for stabilisation at six months, compare measurements and discuss it with the surgeon. Some imperfections are simply corrected; others, such as a slight lowering of the angle of erection, do not justify a new procedure. Sex therapy often helps restore confidence, whatever the result.

Some complications can be corrected: fat transfer irregularities with a new injection or aspiration, hyaluronic acid nodules with an enzyme that dissolves them, a scar with revision, and ligament reattachment with a new release. Others are more difficult: loss of sensation, deformity after a permanent product injection or graft loss sometimes require complex reconstructions, with uncertain results.

These revisions are carried out by urologists or plastic surgeons specialising in genital reconstructive surgery. It is advisable to wait for the tissues to stabilise, generally six months, except in emergencies such as infection. Bring all the documents from the initial procedure: nature of the products, techniques and reports.

A touch-up can be useful when a specific defect persists after six months: ligament reattachment with loss of the gain, insufficiently corrected webbing, a clear irregularity after fat transfer, a troublesome hyaluronic acid nodule or a thick scar on the pubis. It is discussed with the surgeon, with measurements and photos, distinguishing what can be improved from what reflects the limits of the technique.

Conversely, a touch-up to obtain a few extra millimetres in a man whose result matches his initial expectations rarely brings satisfaction and carries new risks. The financial conditions of a touch-up — free, partial contribution or full charge — must be known before the first procedure and set out in writing on the quote.

• Having a product injected without knowing what it is.
• Buying miracle products online.
• Neglecting traction after lengthening.
• Resuming intercourse too soon.
• Choosing a practitioner on the promise of a spectacular gain.
• Having surgery in response to a partner's remark.
• Judging the result in the first few weeks.

In Switzerland, compulsory insurance only covers treatment of a disease or its consequences. Penoplasty requested for cosmetic reasons by a man with normal anatomy is therefore at his expense. Certain medical situations may, however, be covered, following a prior cost approval request.

Do not schedule a procedure whose coverage is uncertain before receiving your insurer's written response. Supplementary insurance rarely covers cosmetic procedures.

Urologists are present in every canton and are the first point of contact. Cosmetic penoplasty is mainly offered in cities; complex reconstructions are carried out in university centres.

Geneva

Andrology urologists, plastic surgeons and a university department for reconstructions. Base for price comparison.

Vaud

Lausanne brings together a university centre and private practitioners; Nyon, Morges, Vevey and Yverdon have urologists for a first consultation.

Neuchâtel and Jura

Urologists locally for assessment; cosmetic procedures and reconstructions tend to take place in Lausanne, Bern or Basel.

Fribourg

Urologists and a few plastic surgeons, bilingual consultations; Bern and Lausanne for complex cases.

Valais

Urologists in Sion, Martigny, Monthey and Visp; Lausanne or Bern for specialised cosmetic procedures.

Bern

University centre with reconstructive urology, many private urologists; Biel/Bienne for bilingual consultations.

Basel

University hospital and urologists practising in the city, within reach of patients from Jura and Aargau.

Zurich

The largest number of andrology urologists in German-speaking Switzerland, and teams experienced in reconstruction after paraffin or silicone injections.

Central and eastern Switzerland

Urologists in Lucerne, Zug and St. Gallen; Zurich for specialised procedures.

Graubünden and Ticino

Urologists in Chur, Lugano and Bellinzona; Zurich for complex cases. Consultations in Italian in Ticino.

For such an intimate subject, being able to express yourself without searching for words is important. In French-speaking Switzerland, consultations are in French. In Zurich, Basel or Bern, many urologists see patients in French or English; ask when booking. In Ticino, consultations are in Italian.

This table shows, for 41 cities, the availability of cosmetic penoplasty, access to complex reconstructions and the price difference usually observed with Geneva. Discretion leads some men to consult in a neighbouring city; as procedures are often outpatient, this choice remains easy to arrange.

Discretion matters a great deal to men considering penoplasty. Medical confidentiality covers the consultation and procedure; the sick note never mentions the nature of the procedure. Invoices are sent to the patient. A young adult still insured by his parents can ask his insurer to send documents to his own address, if coverage is involved.

Many men prefer to consult in a city other than their own. As procedures are generally outpatient, a train journey of thirty minutes to an hour remains easy. Plan for someone to accompany you or a taxi home, and a few quiet days at home. For traction, organise times when you can wear the device undisturbed.

Choosing a urologist in another city, for discretion or for their experience, is common. For an outpatient procedure, plan for someone to accompany you or a taxi home, and possibly a night on site if the journey exceeds an hour. Group your check-ups, ask whether some can be done from photos, and identify an emergency department near home for the first few days.

Keep the operative report and written instructions with you: if you need to be seen at another facility, they allow the team to understand immediately what was done and adapt care.

We express prices as relative indices, which are more useful for comparison than amounts that vary between practitioners and facilities.

Details by city are on our page on penoplasty prices in Switzerland.

A deposit is often requested to reserve the date, expressed as a percentage of the quote. Ask about the conditions for postponement in the event of infection, a herpes outbreak or another medical problem that would require the procedure to be moved, and about cancellation conditions. Ask for them in writing, along with the conditions for any touch-up.

Additional costs often include the traction device, medicines, supportive underwear, travel to check-ups and, for hyaluronic acid, renewal sessions. Over several years, repeated injections can cost more than a lasting technique, but they keep the advantage of reversibility.

For thickening, the choice between hyaluronic acid and a lasting technique also has a financial dimension. Hyaluronic acid costs less per session but must be renewed every one to two years; over ten years, the cumulative cost can exceed that of fat transfer or a graft. In return, it remains reversible and can be stopped at any time. For lengthening, the traction device and possibly a touch-up must be added to the quote. Thinking over several years helps make an informed choice.

Suspensory ligament: A fibrous attachment between the penis and the pubic bone.

V-Y plasty: Reshaping of the pubic skin drawn as a V and closed as a Y.

Penoscrotal webbing: Scrotal skin extending up the underside of the penis.

Buried penis: A penis hidden under the skin and fat of the pubis.

Micropenis: A penis of a size far below reference values, of medical origin.

Stretched length: Length measured by gently stretching the flaccid penis.

Fat transfer: Transfer of the patient's own fat.

Traction: Prolonged stretching of the penis using a device.

Flaccid length: Length at rest, highly variable.

Stretched length: The reference measurement in consultation.

Girth: The circumference of the penis, measured at mid-shaft.

Ligamentolysis: Another name for division of the suspensory ligament.

Anchoring: Fixing the skin to the base of the penis to prevent it from riding up.

Retraction: The tendency of tissues to shorten during healing.

Granuloma: A chronic inflammatory reaction around an injected product.

Penile block: Local anaesthesia of the penile nerves.

• Most men who worry about their size have normal anatomy.
• Lengthening works mainly when flaccid and requires prolonged traction.
• Pubic liposuction and webbing correction often bring the largest visible gain.
• Hyaluronic acid is temporary but reversible.
• Injected permanent products must be avoided.
• Psychological or sexological support is often more useful than surgery.
• Cosmetic penoplasty is at the patient's expense.

With Medespoir Suisse, you can ask your questions without exposing yourself, understand what each technique can really achieve, and meet a urologist or plastic surgeon experienced in these procedures near you. We also help you decipher a quote.

Penoplasty can respond to specific situations: buried penis, webbing, a fatty pubic pad, loss of length after an illness. For a size worry in a man with normal anatomy, information and support often bring more than a procedure with modest gains. Taking time to measure, understand and talk with a reputable specialist is the best way to decide. For the budget, see our page on penoplasty prices in Switzerland.

Budget

Price differences between cities and cantons, the quote breakdown and ways to save are detailed on our page Penoplasty: prices in Switzerland.

Related procedures

• Vaginoplasty in Switzerland

Our guides

• Guide to intimate surgery for men and women in Switzerland
• Cosmetic surgery in Switzerland

Answers to the most frequent questions about penoplasty in Switzerland.

Understanding penoplasty

What is penoplasty? The term refers to procedures that change the apparent length or girth of the penis: division of the suspensory ligament, pubic skin plasty, pubic liposuction, correction of webbing, fat or hyaluronic acid injections, and grafts. It also includes reconstructive procedures, such as correction of a buried penis.

Can a penis really be enlarged? A hidden part of the shaft can be released, whatever masks it can be corrected and girth can be increased with injections or grafts. The erectile bodies themselves cannot be enlarged without major risk to erection. Gains are therefore real but modest, especially when flaccid.

What is the difference between penoplasty and phalloplasty? In everyday language, the two terms are sometimes confused. In medicine, phalloplasty mainly refers to creating a penis from other tissues, for example in trans men or after amputation. Penoplasty refers to changes to an existing penis.

Which part of the penis is hidden inside the body? The root of the penis, anchored under the pubic bone and in the perineum, can account for up to a third of its total length. Dividing the suspensory ligament allows a small part of this root to move outwards, especially when flaccid.

How is the penis measured in a consultation? The doctor generally measures stretched flaccid length, from the pubis to the tip of the glans, pressing the ruler against the bone to neutralise fat and gently stretching the penis. This measurement correlates well with erect length. They may also measure girth.

What is the average penis size? Major studies put average erect length at around thirteen centimetres and girth at around twelve centimetres, with most men grouped in a narrow range around these values. Flaccid length is highly variable and not very predictive.

My penis looks small when flaccid: is that a problem? No. Flaccid size varies with temperature, stress and physical activity, and from one man to another. Some penises that are small when flaccid grow a great deal when erect. It is stretched or erect length that matters, and it is most often normal.

Why does my penis seem smaller than other men's? Because you look at it from above, which foreshortens the perspective, whereas you see others from the front. Comparisons in changing rooms concern flaccid penises, which vary greatly, and pornographic images select exceptional anatomies.

What is a micropenis? It is a rare abnormality of hormonal or genetic origin, defined by a stretched length well below reference values for age. It is generally identified in childhood and treated by specialists. It does not concern men whose size is simply a little below average.

Does penis size affect fertility? No. Fertility depends on sperm production by the testicles and proper functioning of the seminal ducts, not on penis size. Penoplasty does not change fertility either.

Lengthening

How is surgical lengthening performed? Through an incision at the base of the penis, the surgeon divides the ligament that attaches it to the pubis. Part of the root moves outwards. They often add pubic skin reshaping and place fat or tissue to limit reattachment of the ligament.

How many centimetres can be gained? On average one to three centimetres in flaccid and stretched length, with significant variation. The gain in erection is small or nil. Part of the gain can be lost if traction is not followed after the procedure.

Does lengthening change erection? It can make the erection lower or slightly less stable, as the ligament contributes to its angle and stability. This effect is generally moderate but should be known. The rigidity of the erection is not changed.

Is an extender needed after the procedure? Yes, in most cases. A traction device worn several hours a day for several months, or manual stretching, limits tissue retraction and reattachment of the ligament. This programme largely determines the result.

Can an extender alone lengthen the penis? Studies show that regular, prolonged wear, several hours a day for several months, can provide a modest gain in stretched length of around one to two centimetres. It is a significant constraint, but without surgical risk.

Does a vacuum pump lengthen the penis? No, not lastingly when used alone. It causes a temporary influx of blood and is mainly used to treat erectile dysfunction or to maintain tissue elasticity after prostate surgery. Excessive use can damage the skin.

What is a V-Y plasty? It is a reshaping of the pubic skin: the skin is incised in a V shape and closed in a Y shape, which advances the skin towards the penis and improves the visual result of lengthening. The scar is on the pubis, generally hidden by hair.

Does pubic liposuction lengthen the penis? It does not change real length, but it reveals the base of the penis hidden by fat. In a man with a significant fatty pad, the visible gain can be greater than that of ligament division, with fewer risks.

What is penoscrotal webbing? It is scrotal skin that extends up the underside of the penis, forming a sort of membrane that visually shortens the penis, especially when erect. Correcting it with a skin plasty is simple, low-risk and often gives an appreciable visual gain.

Is the lengthening result permanent? The gain obtained after healing and the traction programme is generally stable. Partial retraction can occur in the first few months if traction is not followed or the ligament reattaches. Weight gain can also mask the base of the penis again.

Thickening

How can the penis be thickened? By injecting the patient's own fat or hyaluronic acid, by tissue grafts placed around the shaft or, more rarely, by a subcutaneous implant. Each method has its advantages and risks in terms of duration, evenness and complications.

Is hyaluronic acid safe in the penis? It is the most reversible method: the product is reabsorbed and can be dissolved with an enzyme if there is a problem. It can nevertheless cause nodules, asymmetry or migration of the gel. It must be injected by an experienced doctor, using a suitable product.

How long does hyaluronic acid last? Generally one to two years, depending on the product, the amount and activity. The effect decreases gradually. Maintenance injections are needed to keep the result.

Is penile fat transfer permanent? The portion of fat that takes is lasting, but some is reabsorbed, often unevenly, which can create irregularities or small lumps. Several sessions are sometimes needed. The result is less predictable than with hyaluronic acid.

What is a cosmetic penile implant? It is a silicone implant placed under the skin of the penis to increase its girth. It must not be confused with the penile implant used to treat erectile dysfunction. It carries a risk of serious complications, such as infection or exposure through the skin, and remains controversial.

Can the glans be enlarged? Yes, by hyaluronic acid injection, with a temporary effect. As the glans is richly supplied with nerves and blood vessels, injection requires great caution. Sensitivity may be temporarily altered.

Are liquid silicone injections dangerous? Yes, very. Injections of liquid silicone, paraffin or oils cause chronic inflammation, deformities and skin necrosis requiring major reconstruction. They must never be performed.

I have had an injection and do not know what it contained: what should I do? See a urologist, even if you have no symptoms. They will examine the area, request imaging if needed and tell you whether to monitor or intervene. Bring any documents you have.

Does thickening change sensitivity? A temporary change is common, especially after an injection into the glans. Sensitivity generally returns within a few weeks. Some men report persistently reduced glans sensitivity after injection.

Do I need a different condom size after thickening? Sometimes. A condom that is too tight can be uncomfortable and break more easily. Wider condoms are available in pharmacies. Condoms remain recommended for infection prevention depending on the situation.

Decision and consultation

Which specialist should I see? A urologist, preferably with experience in andrology, is the first point of contact. They assess anatomy, erectile function and reconstructive situations. A plastic surgeon may be involved for pubic liposuction or skin reshaping. A sex therapist can support the whole process.

Does the consultation include an examination? Yes, examination and measurement are essential. They are carried out with respect for your modesty, with explanations at each step. They allow you to be told whether your anatomy is within the norm and what options exist.

Should I see a psychologist before penoplasty? It is not always compulsory, but it is often offered, notably if your anatomy is normal or the concern is very intrusive. The aim is to check that surgery will really address your distress.

What is penile size anxiety? It is a persistent, distressing concern about the size of one's penis, often in men with normal anatomy. It can lead to avoiding relationships or changing rooms. Psychological or sexological support reduces it effectively.

When should penoplasty be ruled out? When anatomy is normal and the request is based mainly on anxiety or comparison, when expectations are unrealistic, when a significant change in erection is hoped for, or when the request comes from outside pressure. An honest specialist will tell you so.

Should I talk to my partner about it? It is not an obligation, but it is often useful. Partners generally attach much less importance to size than men think. Talking about it, or even seeing a sex therapist together, sometimes helps put a long-standing worry into perspective.

How long between consultation and procedure? Allow several weeks: most urologists require a reflection period and see the patient a second time. This interval is also used to plan rest days and obtain the traction device.

Can I ask for a second opinion? Yes, it is recommended before a cosmetic procedure of this type. Bring your measurements and reports. If one practitioner promises much greater gains than another, ask what data they are based on.

Can I have surgery before 18? No, cosmetic penoplasty is not performed on minors. Anatomy continues to develop during adolescence, and worry about size is very common at that age. A young person who is worried can talk to their doctor, who will inform and reassure them.

Procedure and recovery

Is the procedure done under general anaesthesia? Not always. Injections are done under local anaesthesia; ligament division, webbing correction or fat transfer can be done under local anaesthesia with sedation or brief general anaesthesia. Combined procedures are more often done under general anaesthesia.

How long does the procedure take? From thirty minutes for an injection or webbing correction to one or two hours for lengthening with skin plasty, longer if several procedures are combined. Patients generally go home the same day.

Is penoplasty painful? Pain is generally moderate and well controlled by painkillers. Night-time erections can be uncomfortable in the first few days, pulling on the scars. Swelling is often more troublesome than pain.

How long does the swelling last? Swelling of the penis and pubis is marked in the first week and decreases over three to six weeks. After fat transfer, it can be significant and last longer. Supportive briefs and cold applied through a cloth help.

When can I shower? Generally from the next day or the day after, according to instructions, patting dry carefully. Baths, swimming pools and saunas wait three to four weeks.

When can I resume intercourse? After four to six weeks for a surgical procedure, once the scars are strong and with the surgeon's approval. After a hyaluronic acid injection, the wait is shorter, from a few days to two weeks.

When can I return to work? After three to seven days for office work, one to two weeks more for a physical job. After a simple injection, the next day. The sick note does not mention the nature of the procedure.

When can I resume sport? Walking from the first few days, fitness and running after two to three weeks, swimming after three to four weeks, cycling and horse riding after four to six weeks, and contact sports later, with protection.

Are night-time erections dangerous for the result? No. They are normal and can be uncomfortable in the first few days, but they do not endanger the result. Some surgeons prescribe a light treatment if they are very painful.

When will I see the final result? After three to six months, once swelling has gone, scars have softened and traction has been continued. With fat transfer, some fat is reabsorbed in the first few months. Compare measurements taken before and after.

Is treatment needed after the procedure? Painkillers are prescribed for a few days, sometimes an antibiotic and local scar care. For lengthening, the traction programme is a genuine treatment to be followed for several months.

How do I urinate after the procedure? Normally, in the vast majority of cases. Swelling can deflect the stream in the first few days; simply sit down to urinate if that is easier. Inability to urinate requires prompt consultation.

Practical questions

Should I shave the pubis before the procedure? No, do not shave yourself in the preceding days, to avoid micro-cuts. If clipping is needed, it is done according to the team's instructions, with clippers, on the day or the day before.

What should I wear on the day of the procedure? Loose clothing, soft trousers and cotton underwear or supportive briefs. Avoid tight jeans on the way home, as they would press on the dressing.

Can I drive after the procedure? Do not drive on the day of the procedure, especially after sedation. You can drive again when braking and sitting no longer cause pubic pain, which generally takes a few days.

Should I apply cold? It is recommended for the first three or four days. An ice pack wrapped in cloth, placed on the pubis for a quarter of an hour at regular intervals, limits swelling and eases pain. Ice must not touch the skin directly.

How long should I wear supportive briefs? Generally two to four weeks, day and night at first, then during the day. They limit swelling and support the penis and scrotum. Follow your surgeon's instructions.

How do I use the traction device? The team shows you how to fit it, adjust the tension and protect the skin. You start with short periods, then gradually increase to several hours a day. Pain, skin that changes colour or numbness mean you should release it and ask for advice.

Can I wear the traction device at work? Some devices are discreet enough to be worn under loose clothing; others are mainly used at home, in the evening or, for some models, at night. Organise yourself to reach the recommended daily duration.

Do the stitches need removing? In most cases, the threads dissolve on their own within fifteen days to three weeks. If a few non-dissolvable stitches have been placed on the pubis, they are removed at the check-up.

Is the pubic scar visible? It is often hidden by hair once it has grown back. It remains pink for a few months, then fades to white. In men who remove pubic hair, it may remain visible close up.

Can pubic hair move up onto the penis? After a V-Y plasty, some of the hairy pubic skin can move towards the base of the penis. This is a known effect that can be treated with laser hair removal if needed.

Can I resume masturbation? Yes, following the same timetable as for intercourse: about four to six weeks after surgery, a few days after an injection. If in doubt, ask at the check-up.

Can I drink alcohol after the procedure? Avoid it in the first few days, as it encourages swelling and bleeding and interacts with certain medicines. After that, in moderation.

Should I stop smoking for good? Ideally, stop for at least four to six weeks before and after the procedure. Smoking also damages the blood vessels responsible for erection; stopping for good benefits sexual health in general.

How many check-ups should I plan for? Generally one check-up after a week, another at around four to six weeks, then a review at around three to six months with a new measurement. The schedule depends on the procedure and the surgeon.

Can I sunbathe after the procedure? Protect the pubic scars from the sun for several months to prevent them from darkening. Swimming waits until healing is complete, generally three to four weeks.

Can I cycle to work? Not before four to six weeks after surgery on the pubis or base of the penis. Saddle pressure could interfere with healing. Plan to use public transport or walk during this period.

Can pills sold online replace surgery? No. No pill, cream or supplement lastingly increases penis size. Some products sold online contain undeclared substances that are dangerous for the heart. Do not take anything without medical advice.

Are manual exercises effective? The stretching exercises prescribed after lengthening help limit retraction. However, exercises promoted online for enlarging the penis without surgery have not been shown to work and can cause injuries if done forcefully.

Should I inform my GP? It is useful if you are on treatment or have health problems. They can also carry out a first examination if a problem arises during recovery. Medical confidentiality applies.

Can I use a sauna or steam room? Not before healing is complete, generally three to four weeks, because of the risk of infection and increased swelling with heat.

Are the injections painful? An anaesthetic cream and local anaesthesia at the base of the penis make the injection only mildly painful. A feeling of tension and slight swelling follow for a few days.

Can I wear tight underwear after an injection? In the first few days, prefer soft underwear, so as not to displace the product and to limit swelling. Also avoid massaging the area firmly, unless instructed by the doctor.

What should I do if a lump appears after an injection? Do not handle it vigorously. Contact the doctor who carried out the injection. They may suggest massage, a dissolving enzyme for hyaluronic acid, or a further examination.

Whom should I call at night if there is a problem? Before the operation, save in your phone the on-call number given by the surgeon. If you are bleeding heavily, in severe pain or can no longer urinate, go straight to A&E or call 144.

Risks

What are the main risks of penoplasty? Haematoma, infection, visible scarring, altered sensation, a lower erection after ligament division, irregularities or nodules after injection, fat reabsorption, retraction, and a result considered insufficient. Serious complications are rare but possible.

Can penoplasty cause impotence? This is very rare, as the erectile bodies are not touched. A temporary reduction in erections can occur, often linked to anxiety or pain. Lasting erectile dysfunction directly caused by a well-performed penoplasty is exceptional.

Can sensitivity be lost? A temporary reduction in sensitivity is common and generally resolves within a few weeks. Lasting loss is rare but possible, as the nerves of the glans run along the top of the penis, close to the operated area.

What happens if the ligament reattaches? Partial reattachment can lose part of the gain. A new release is possible, but trickier. Rigorous traction and placing tissue in between at the first procedure reduce this risk.

Can irregularities after fat transfer be corrected? Often yes, with a new injection to fill a hollow or aspiration to reduce a lump. You need to wait for things to settle, generally six months. Oil cysts may require minor excision.

Is a hyaluronic acid nodule serious? Most often not. It can be massaged or dissolved with an injection of a specific enzyme. A nodule that is painful, red or growing requires consultation, as it may be inflammation.

Can I be disappointed with the result? Yes, it is even the most common complication, particularly in men who hoped for a significant gain or whose anatomy was normal. That is why measurement, information and assessment of expectations before the procedure are essential.

Which signs require emergency consultation? Sudden, painful swelling, fever, spreading redness, skin that becomes dark or cold, heavy bleeding, inability to urinate. Contact the team without delay, or call 144 in an emergency.

Particular situations

Can a buried penis be treated? Yes. Treatment often combines weight loss, liposuction or excision of pubic fat, fixing the skin to the base of the penis and sometimes skin grafts. When functional discomfort is documented, coverage can be requested from the insurer.

Does the penis shorten after prostatectomy? Shortening is often observed, linked to healing and the absence of erections for months. Erectile rehabilitation and traction limit this loss. When a penile implant is placed, certain techniques can restore some of the length.

What about Peyronie's disease? The disease often shortens the penis as well as curving it. During the active phase, traction can limit the loss. After stabilisation, surgery corrects the curvature and, in some cases, restores length. Cosmetic penoplasty is not offered during the active phase.

Does excess weight make the penis smaller? It does not change real size, but pubic fat hides the base of the penis. It is often considered that significant weight loss can reveal a visible part of the shaft again. It is one of the most effective measures.

Can an older man have penoplasty? Yes, if he is in good health. In older men, requests often concern a buried penis, loss of length linked to erectile dysfunction or loose skin. Assessment of erectile function and general health is then particularly important.

Can penoplasty be combined with a penile implant? A penile implant treats erectile dysfunction. When it is placed, additional procedures such as ligament release, webbing correction or length-restoration techniques can be combined by an experienced urologist. The risk of infection increases with complexity.

Can people with diabetes have surgery? Yes, if diabetes is well controlled. Poorly controlled diabetes increases the risk of infection and poor healing and can contribute to a buried penis. Diabetes control is checked before the procedure.

Can I have surgery if I have erectile dysfunction? Yes, but the dysfunction must first be assessed and treated. Cosmetic penoplasty does not improve erections. When dysfunction is severe, a penile implant is the appropriate solution, possibly with associated procedures.

Prices and insurance

How much does penoplasty cost in Switzerland? In relative indices, on a base of 100 for ligament division with skin plasty, a hyaluronic acid injection is around 30 to 55, pubic liposuction around 45 to 75, fat transfer around 55 to 85, and combined lengthening and thickening around 140 to 200. Differences between cities are on our prices page.

Is penoplasty reimbursed? Not when it is cosmetic in a man with normal anatomy. Certain medical situations, such as a buried penis with functional discomfort, after-effects of permanent product injections or a micropenis, may be covered, following a prior cost approval request.

Are traction devices reimbursed? As a rule, no. They are bought or sometimes rented by the patient. In certain medical situations, such as Peyronie's disease, a contribution may be discussed; ask your insurer.

Is Geneva more expensive than other cities? In our comparisons, Geneva serves as the base; together with Zurich, it is where prices are highest. Depending on the city, the difference reaches 5 to 20%. It is better, however, to favour the urologist's experience over a few per cent of savings.

What does a penoplasty quote include? The surgeon's fees, anaesthesia, the facility, injected or grafted products, check-ups and sometimes the traction device. Check the nature and quantity of products, as well as the conditions for a touch-up.

Where to consult in Switzerland

Where can I have penoplasty in Switzerland? With experienced urologists or plastic surgeons, in the major cities — Geneva, Lausanne, Bern, Basel, Zurich — but also Lucerne, St. Gallen, Lugano and other medium-sized cities. Complex reconstructions are carried out in university centres.

Can I consult in French in German-speaking Switzerland? In the major German-speaking centres, many urologists speak French. State your language when booking: on such a personal subject, it is better to leave nothing to the vagaries of translation.

How can I stay discreet? Everything said and done is protected by medical confidentiality. Your employer receives a certificate that says nothing about the procedure, and invoices are sent to you. Many men also choose a urologist in another city.

Can Medespoir direct me? Yes. Write us a few lines about your concern, without a photo. A urologist reads it confidentially, then we put you in touch with a practitioner who regularly performs penoplasty near you and speaks your language. This service costs nothing and does not commit you to anything.

Tell us in a few lines what concerns you; no photo is needed. A urologist reads your message in confidence and tells you the suitable options. Free service, no obligation.