Penis enlargement procedures (sometimes referred to as "male enhancement procedures" in spam email and television advertisements) are techniques designed to make the human penis larger.

This is frequently the goal of men dissatisfied with their penis size. In general, where there is a perceived need to increase penis size, medical advice should be sought, rather than attempting self-treatment. Most self-treatment methods are believed to be either ineffective, dangerous, or both.

About 0.6% of all men have penises which are more than 2.5 standard deviations from the norm; this is known as a micropenis. This very unusual condition is generally detected in early childhood. Penis-enlargement self-treatments are also not effective on this condition, although childhood and adolescent testosterone treatments may be administered and in adulthood surgical measures have shown some limited success.

Rather than attempt to change the actual size of the penis, one may make it appear bigger, by trimming the pubic hair or by losing weight, which may be of particular use if one is overweight.

Penis Pumps

A penis pump is a cylinder that is fitted over the penis, with a manual or motorized pump to create suction. As the apparatus creates a vacuum around the penis, blood is drawn into the penis causing it to become engorged. The higher the vacuum, the higher the blood-pressure becomes within the penis; excessive pressure causes vascular damage rather than a harder penis.

Pumping must be done very carefully to avoid injury: manufacturers' instructions should be followed. Manual pumps often recommend a gentle pump followed by a pause, then repeated. Over-enthusiastic pumping can burst blood vessels and form blisters. In some cases the testicles can be unexpectedly pulled into the cylinder and cause severe pain and injury. It is also believed that the rim of the cylinder can cut into the skin and over time cause damage to the ligaments surrounding the penis. These dangers are easily avoided by following instructions. Impatiently pumping without reading explanatory material can produce too much suction (anything over 10 mm Hg) and cause permanent injury. Attempts at using vacuum cleaner units for this purpose have resulted in severe injury as the machine produces far too much suction. If the base unit is used without a hose there is also the danger of coming into contact with the rapidly-rotating fan (must feel fantabulous).

Penis pumps are also used for masturbation. In August 2006, Oklahoma district court judge Donald Thompson was sentenced to four years in prison for repeatedly having masturbated with a penis pump while presiding over court cases.

Penis pumps, usually described in this context as vacuum pumps, have use in conventional treatment of impotence. The pump itself is essentially as described above, although often made to higher standards of quality with a much higher price, and arrangements for distribution by suppliers of medical equipment. One or more flexible compression rings are fitted on the open end of the cylinder, then an erection is created by pumping. The rings are pushed by hand onto the base of the erect penis before releasing the vacuum. This enables the erection to be held even in the presence of problems of the vascular or nervous system which would otherwise lead to immediate loss of erection. In the best circumstances erections can be maintained for a considerable time, but manufacturers' literature recommends that rings should be removed after not more than 30 minutes for safety.

Jelqing and Clamping

Jelqing is a method intended to enlarge the penis by increasing the blood pressure in the penis, with the goal of permanently increasing the maximum erect size of the penis. This technique, also called "milking", involves wrapping the thumb and index finger around the penis while semi-erect and repeatedly drawing them away from one's body to force blood into the glans, thus encouraging more vascularity in the corpus cavernosa and associated tissues. Whether jelqing actually works or not is a subject of controversy.

There are many products (tools, instructions, etc.) that one can buy; however, much of what they offer (instructions) is available on forums and free websites. Before beginning an enlargement regimen, one should contact someone experienced with the technique.

Jelqing is typically preceded by a warm-up with a hot compress on the genitals, and concluded the same way.

Clamping is a technique that uses a constricting device, such as a shoe string, cable clamp, or a tight cock ring. The clamp is firmly tied, clamped, or put, respectively, on the base of the erect penis while "edgeing" (extended masturbation) with a firmly erect penis.

Stretching and hanging

Stretching consists of gripping the glans, or just behind the glans, and pulling for a set period of time. Giving a similar effect, hanging consist of attaching a device that grips the glans or just behind the glans and allows a weight to be suspended for specific amount of time.

The idea behind such exercises is to stretch the tunica albuginea and other various tissues of the penis. The general effect is to elongate the penis, although widening can also occur.

Surgical Methods

A related method involves injection of silicone into the penis and scrotum. This technique is commonly used by adult film actors and can cause enormous increases in the girth of the penis (increasing the penis volume by over 900%) but is effectively irreversible and may have side effects including loss of sensation, inability to perform penetrative intercourse, scarring and deformation.

Injections of other substances, including collagen, mineral oil, and even KY Jelly may have similar effects, but also may cause extreme scarring and permanent disfigurement. These may include a bump, permanent or temporary, on the stem of the penis itself, which would actually be the collected collagen or silicone introduced in the erectile tissues. This forms an unsightly lump around the base of the penis where it settles down and may inhibit the flow of the blood itself. Other effects may be the slight decrease of the glans width as compared to the overall stem of the penis.

A further method is to replace the two corpora cavernosa with inflatable penile implants. This is performed primarily as a therapeutic surgery for men suffering from complete impotence; an implanted pump in the groin can be manipulated by hand to fill these cylinders from an implanted reservoir in order to achieve an erection. The replacement cylinders are normally sized to be direct replacements for the corpus cavernosa, but larger ones can be implanted.

As genital beading or pearling, is gaining popularity in Indonesia and southern Asia where small objects are implanted under the skin of the penis, usually close to the glans. Implants such as steel ball bearings, plastic pellets, semi-precious stones, rings and studs are used. The reasoning for this form of augmentation is varied: some do it for supposed magical benefits, others for the pleasure of their partner, although the implant (such as a ring or stud) might be removed before intercourse.

Apparently many women have found it to cause pain, discomfort, bleeding, scarring, and infection more often than pleasure, although it should be recognized that there are over a dozen different kinds of male genital piercing, some of which have been use for centuries in countries like India (the Apadravya is mentioned in the Kama Sutra), and which are often perceived to have different effects on the men themselves and their sexual partners.