Techniques for cosmetic lengthening were first described in 1990. More than 20,000 men have had such surgery (largely in America) , but reliable information about results and complications have not been published in a peer-reviewed journal (a journal where the quality and content of the research is checked by independent experts). Given the number of operations performed, this fact is both astounding and worrying.
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.”

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In 10 years as a sex therapist and 20 years as a marital therapist, I've had gobs of complaints from women whose partners were too big for comfortable sex. I've only had 2 in 20 years about her partner being too small. The first woman had a vaginal laxity after childbirth (previously, he had been "just right" and the second woman had marvelous orgasms with the small man but had a mental block.
The resistance to refunds reached comic extremes. The dry description of Sixth Circuit Appeals Court Judge Danny Boggs illustrated the lengths to which Berkeley would go to avoid returning cash: "At one point, Enzyte customers seeking a refund were told they needed to obtain a notarized document indicating that they had experienced 'no size increase.' The admittedly ingenious idea behind the policy was that nobody 'would actually go and have anything notarized that said that they had a small penis.'
Penis length surgery involves cutting the ligament with which the penis is attached to the pubic bone and grafting added skin to the base to increase length. This will increase the size of the flaccid penis by up to 2cm, but it doesn’t affect the size of the erect penis. The cut ligament may also not provide the support it originally did, which means that you might find your erections less satisfactory as a result. There is also a risk that this type of surgery may cause the side effect of pain during sex.
While many woman claim that penis size isn’t important for them and it’s all about the right technique and a loving partner treating them well, that’s only half the truth. In totally anonymous surveys, the number of women claiming that penis size is important for them, at least from a aesthetic viewpoint, is significantly higher than in face to face surveys. This fact doesn’t mean a smaller penis can’t satisfy a women, it doesn’t mean you can’t have a perfect sex life with a small penis, but the the harsh truth is: Size matters – at least for some women.

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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