The manhood makeover: The rise of the penis enlargement

A vast painting covers the wall above a marble mantelpiece on which rests a human skull. It depicts Maurizio and Roberto Viel, who are twin plastic surgeons, and a nude woman whose breasts they have augmented. The imposing work, called Creation, greets patients at the brothers clinic on Harley Street in London. Increasingly these patients are men and, increasingly, they come in search of a larger penis.

Achieve massive girth; Get your giant tool now: These are genuine subject lines from spam emails that invade our inboxes, offering quack solutions to men who feel small. As the prevalence of porn as well as the increasing exposure of crotches and more on billboards (think David Beckhams pants ads) helps to fuel a rising sense of inadequacy among many men, penis enlargement has become a growth business.

The problem for those who would make penises larger, however, is that, much more than breasts, for example, they have evolved to withstand great stress and changes in size. They resist almost all attempts to make them permanently bigger.

Roberto Viel says he has overcome these challenges, and performs about 200 penoplasty operations a year. Sitting at his desk, he pulls out a gold-nibbed pen and draws a penis. It includes the suspensory ligament, which holds up the erect penis. By partially severing it, having accessed it by cutting away a flap of flesh covering the pubic bone, Viel causes the penis to drop, and hang lower by as many as two inches. The length of the erection is not increased, however, and its angle is lower. If I cut too much it will be like that, Viel says, overlaying his drawing with a drooping outline, and thats not the best for sex.

Viel also extracts fat, usually from the patients stomach, and injects it under the skin on the top side of the penis, increasing its circumference by more than an inch, whatever its state. Viel keeps some of the fat in his fridge for top-ups, in case it is reabsorbed. The whole procedure, which takes about 90 minutes and is performed under local anaesthetic, costs around 5,000.

Viel studied medicine in Milan and trained in France and America alongside his brother. They have worked for more than 20 years at their richly-decorated London Centre for Aesthetic Surgery. Maurizio is now based at the clinics other branch, in Dubai. In 1991, Roberto gave Maurizio a nose job, which made the twins look more alike. Ten years later, Roberto injected fat from Maurizios tummy into his brothers face, with similar results.

Penis enlargements now make up half the Vielss work, bringing in a around million pounds a year in revenue. The twins are accomplished self-publicists, and have appeared in dozens of magazines and newspapers. The Independent learned about the growing demand for their procedure in a press release sent by his clinics public relations agent. She and Viel shift slightly in their seats when questioning turns to concerns about his work.

Viel estimates he has performed 3,000 penis enlargements since 1991. He is fully licensed to carry out his procedure, inspired in part by the pioneering work in the 1980s of Dr Long Daochao, a Chinese surgeon. But it remains a niche technique. None of the 230 surgeons represented by the British Association of Aesthetic Plastic Surgeons (Baaps), which accounts for about 40 per cent of the industry, offers penoplasty. The Viels are not members. Nigel Mercer, a consultant plastic surgeon and former president of Baaps, says, Its not something we say every surgeon should offer because there have been lots of unhappy patients.

Marcus Drake, a senior lecturer in urology who specialises in reconstruction surgery at the University of Bristol, says, there is always a reason for a ligament and if you cut it the associated joint or structure wobbles around. A bit of introspection on any mans part will soon make him recognise this is borderline risky. Drake goes further, pointing out the lack of full clinical trials of penoplasty. In the absence of evidence, most people would be sceptical as to the robustness of the procedure and the justification for doing it, he says. Wed also regard it as potentially unethical without that justification.

Viel says the limited availability of penis surgery is not due to risk but because there is no formal training for it. He adds: I have developed and improved the technique using surgical techniques from different surgeries to put together a procedure I think is reliable and gives good results in a safe way. Nobody wants to take any risks, and I would not be so naive or stupid to put my name to a procedure that was not safe.

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The manhood makeover: The rise of the penis enlargement