Nate* had never given up on his penis before. For years, the San Francisco native tried every method under the sun to enhance the size of his penis, including using a penis stretching device, but the results never lasted long-term. Tired of the setbacks and disappointment, the 45-year-old finally decided to seek outside assistance.
He opted for a solution in the form of Penuma: an FDA-cleared penile implant made from medical-grade silicone, designed by urologists to feel natural whether you’re flaccid or erect. Available in three sizes (L, XL, and XXL), the Penuma implant is contoured to your individual shape before it’s placed underneath the skin. On average, it increases patients’ flaccid length by 1-2 inches.
Nate opted for the XL model, and received his Penuma implant in late 2020. We asked him all about the procedure, including how his sex life has changed. (FYI, Men’s Health does not endorse the Penuma procedure—or any penis-enlargement technique—without first consulting a physician.)
*Subject’s name has been changed to allow him to speak freely on private matters.
So, why did you get the surgery?
All men, I guess, are concerned about penis length or performance. In the past, I’d been using a traction stretching device and made some gains—like, an inch in length—but then when I stopped using it, those gains were lost. It was impermanent gain, and I didn’t want to mess around or waste my time. So, I started to look for something that would be a more permanent solution, and that’s how I came up with Penuma.
What did you hope to get out of it?
I know a majority of Penuma patients undergo the surgery for cosmetic reasons, but I did it mainly for functional reasons. I had seen how a large, girthy dildo could efficiently stimulate a woman, and wanted that for myself. A lot of the methods men use, I don’t regard as scientifically sound or useful, but I liked what I read about Penuma.
How did you prepare for the procedure?
Preparing for the procedure, you need to do some clearances with your doctor: a complete blood count, a medical history, and physical clearance that are sent to the surgeon. I also had to do a Covid test at the surgery center. For the pre-op process, they look at your anatomy and so forth. I believe some doctors today are also requiring a psychological evaluation to make sure that you don’t have body dysmorphic disorder that might trick you into believing your 6-inch penis is actually 2 inches or if you expect a 12-inch penis at the end of the surgery. It’s been shown that those patients have a higher dissatisfaction rate with surgery in general, and will sometimes remove the Penuma before they heal.
Why did you choose the XL model?
The surgeons select the model based on the patient’s existing anatomy (size of head and girth of shaft). I actually had the XL model, which Dr. Elist custom-trimmed at the time of surgery. Before surgery, the surgeon can estimate which model can be used for the patient based on a pre-op exam, but the final decision will be made in the operating room. I would not necessarily want to be bigger [in] girth than I am now, since at my present girth with the XL model, girls (mouths and jaws) are already challenged to give extended oral sex.
Do you remember any of the surgery?
The surgery itself was quick. I woke up an hour or so later and felt like I’d been knifed in a back alley. So, I was on my knees for like four hours; they prescribed me Tramadol, which is a narcotic, but it didn’t make a difference and I was on my knees cursing.
At the end of four hours, the pain just fell off a cliff and I was fine.
Fernando Trabanco FotografíaGetty Images
Did you notice an immediate difference in the way your penis looked?
Your flaccid length and girth increase immediately after the surgery. Interestingly, there’s a retraction or loss in erect length immediately after surgery because you have a limited amount of penile skin and tissue available. They stretch out the penile skin and tissue to accommodate the implant, and they put as much of the implant in as possible, and then a portion that implant will remain in the body cavity to descend later. That’s the theory. So, after surgery, you may have an erectile retraction; I had about a 1.1-inch retraction immediately after surgery, but then around week ten, I started gaining back length. I’m positive 0.875 inches at 14 months now [when erect], and I’m going to continue to see increases as more of the implant descends.
Take us through all your penis measurements before and after the surgery.
Pre-surgery, I was 3 inches flaccid with a 4-inch girth (5.125″ length x 4.5″ girth erect), and my current measurements from my 14-month post-op is a flaccid length of 5 inches and 5.5-inch girth, and 6 inches erect with a girth of 6.5 inches. Today, I already consider the surgery a success with both flaccid and erect length and girth gains. As I continue to see elongation, I hope to see an additional 0.5-1.25 inches of erect length as the implant descends more. The ultimate length will depend on my anatomy.
Did you notice a difference in your self-confidence?
I mentioned that my primary motivation was function. I do have a better ability to deliver sexual stimulation, and that has increased my confidence that a sexual encounter will be pleasurable for all parties. I also am confident wearing any sort of clothing (and I am shameless vs. some patients who are concerned with not revealing their body contour) or dropping clothes in a locker room.
What’s masturbation like now?
Much the same. As with intercourse, lube is required due to the greater friction because of the larger surface area. I try to limit the amount of masturbation I do and prefer intercourse, as I feel like I get a better quality stretch of the penile tissues with intercourse, which over time helps elongation of the penis with Penuma.
What are the rules around sex after surgery?
There’s no sex until you’re cleared at around week eight, which is important because patients who don’t follow those rules or guidelines can have complications. Sex at week 12 is better than sex at week eight, because you’re continuing to heal. Also, post-surgery, you have some sensation loss, which slowly comes back as your nerves heal. So, you slowly start having better and better sex.
How’s your sex life now?
Now, I’m able to … deliver more consistent pleasure and orgasms to women. And you can see with their bodily responses and moans and so forth that they can definitely feel the difference. [Editor’s note: The vast majority of vulva-owners need clitoral stimulation to orgasm and can’t climax from penetration alone. If you’re not sure what your partner likes in bed, ask them!]
Does sex feel different for you at all?
I had to relearn some sexual techniques since the angle of the erection is lower for me with Penuma. Also, my techniques for stimulating myself during intercourse have slightly changed. There’s more surface area and volume in general, and so I found that occasionally putting more of my body weight into the penis during a stroke is good stimulation. Also, I got used to regularly using a water-based lube which I never required pre-surgery.
What did your wife think of your new penis?
My wife went with me to the surgery and was there for my recovery in the hotel. In the immediate period after surgery, there was not much said. I had the JP drain for a few days and stayed wrapped. My wife didn’t comment about [the] size or results yet.
Once [it] healed, she noted that the flaccid size was larger. When I was cleared for sex at week eight and began seeing elongation (length increases) and capsule formation (more girth increases), she’d comment every 2-4 weeks that she could feel more of the penis. During sex, [I’ve noticed] more bodily movements and moans from my wife, and more consistent orgasms for her. She is more vocal and says more dirty language.
She asked me if I got Penuma with the idea of having sex with other girls. I said “yes,” talked to her about other girls during sex, and now she lets me do that knowingly. Now I regularly get comments from her and other partners that the penis is “gigantic,” or that she was sore the next day when we’ve had lengthy vaginal sex. Or she’ll say (and look like) her jaw is tired when giving oral sex.
You say the Penuma procedure has changed since you got it. Can you talk about that?
When I had my surgery, I had the incision made in the super pubic area, which is the area of the abdomen above the penis where there’s some fat. But now, the best practice is making the incision on the side of the scrotum, which heals without a scar. Plus, there are fewer complications involved with having an infection of incision line and things like that. So, it’s actually an improved procedure.
Any advice for penis-owners interested in Penuma?
There are some recovery issues that you need to be prepared for. Recovery takes some time, and the body has to go through a healing process and adapt to the implants. As long as you understand those things, you’ll be in good shape.
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