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Men believe that their actual penis size is significantly smaller than the ideal size (i.e., what they think their penis should be or what they expect it to be after penis enlargement surgery). Table 2 shows patients who present for medical treatment due to small penis size. Growing dissatisfaction among males regarding their penis size is driving the popularity of penile augmentation procedures that may lengthen or widen the male reproductive organ. Division of the suspensory ligament, with or without bulking agent, fat pad excision or V-Y plasty is the most widely accepted surgical technique for penile elongation (45). This attachment prevents the penis from moving further outward and creates an arched angle to the penile base (44). Penile augmentation with fat grafts also increase the weight of the penis, which can itself increase the length by 2–3 cm (35). Results may vary depending on age, health, and lifestyle factors. 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