Penis implants now only come in L, XL, and XXL. Â According to Dr James Elist, “Nobody wants a small. So we don’t have a small, we don’t have a medium. We start from large.” Â He has performed around 1,300 operations with a starting price of $13,000 each. Options for men were limited until Elist invented the Penuma in 2004.
Pneuma is a sheathe of silicone inserted directly into the penis which can enhance both length and girth.
According to a 1996 Journal of Urology study, the average erect penis is about five inches long and four and a half inches in circumference.