Professor Ralph at UCL believes that some clinics are feeding patients’ unrealistic expectations. “Initially, they don’t see doctors, they see sales people. It’s a hard sell: ‘We can get you an extra inch or two.’ I’ve been practising in the NHS for 30 years: if it was that easy to increase the length of a normal penis, I’d be in the Mediterranean on my cruise liner now.”
A three-judge panel of Sixth Circuit appellate judges took up the question in a lengthy opinion handed down on December 14, 2010. To address the Fourth Amendment issue, the judges first had to decide if taking the e-mails from NuVox constituted a "search" at all—with "search" in this case defined as the government infringing upon "an expectation of privacy" that "society is prepared to consider reasonable."

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O’Connor says he had no concerns beforehand (“My main worry was having the anaesthetic – I’m scared of needles”) and no regrets afterwards. The pain was manageable and there were no complications. He views the procedure as akin to working out. “I’m not obsessed by my body – I have too many other things going on in my life,” O’Connor says. “But I’m proud of it and I like that it’s in good shape – every part of it.”
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Atherosclerosis, a condition in which fatty deposits build up inside arteries, may restrict blood flow to the penis and cause erection difficulties. "The small blood vessels that go to the penis can become diseased much earlier than the [larger] vessels that go to the heart," Karen Boyle, MD, a urologist at Johns Hopkins School of Medicine, tells WebMD. "In younger or younger middle-aged men, ED is often the first sign of atherosclerosis."
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