Deep Dive

Below the Belt: The Men’s Guide to Cosmetic Urology

For some men, it starts as curiosity. For others, shame. A quiet “Is this normal?” they’ve never said out loud. 

We don’t talk much about penis appearance, but that doesn’t mean men aren’t thinking about it.

This article is for men navigating questions about sexual health, confidence, and appearance.

Whether you’re recovering from treatment, entering a new life chapter, or just curious—you’re not alone.

What Cosmetic Urology Includes

Cosmetic urology spans more than most people realize. These are medical procedures. 

When done thoughtfully by skilled professionals, they can offer meaningful change—physically and emotionally. 

Common options include:

• Cosmetic circumcision and revision: For men who want improved appearance or experience discomfort due to excess or uneven foreskin—often refined with surgical precision
  

• Penoscrotal web release: A minor outpatient procedure to remove excess skin connecting the shaft and scrotum—can improve visual length and comfort
  

• Scrotal lift: Can reduce sagging and refine contour, especially when paired with web release
  

• Pre-pubic fat pad liposuction: Reduces the fatty area above the base of the penis, helping reveal more of what’s already there
  

• Hyaluronic acid-based fillers: Temporary and reversible. These can add modest girth. Most men will need to repeat treatment over time, but they can also be safely dissolved if desired
  

• PRP (platelet-rich plasma) injections: Uses your own blood, spun to concentrate platelets and injected to potentially improve sensitivity. While marketed for ED, data is still evolving. Some urologists pair this with vacuum therapy to maintain length or tissue health
  

• Scrotal Botox: Sometimes used to reduce sweating or create a smoother, lower-hanging look by relaxing the underlying muscles
  

• Laser or lesion removal: For benign but bothersome changes like pearly penile papules or pigment spots
  

• Shockwave therapy: Can be effective in men with mild ED. We cover this more deeply here → Straight Talk on Shockwave Therapy for ED

Healing varies. Some treatments involve little downtime. Others, like liposuction or surgery, take a few weeks. 

No result is permanent or guaranteed. Maintenance, follow-up, or minor asymmetry is normal.

What to Avoid

Not all procedures are created equal. Some are oversold or risky:

• Suspensory ligament release: May create the illusion of added length when flaccid, but often compromises angle and stability during erection
  

• Non-dissolvable fillers: Can clump, harden, migrate, or cause infection
  

• Penuma and similar implants: Silicone sleeves placed under the skin; marketed heavily but carry risks of sensation loss, infection, and poor cosmetic outcome
  

Every procedure comes with risks. That’s not fear-mongering—it’s responsible decision-making.

I often remind men: focus on the typical outcome, not the too-good-to-be-true best-case scenario.

Who Should You See

The safest and most successful results come from:

• Urologists who specialize in prosthetic or reconstructive men’s health
  

• Plastic surgeons with specific experience in penile and scrotal work
  

Ask the hard questions:

• How often do you perform this exact procedure?
  

• What are the most common side effects or complications?
  

• What are the limitations? What will this not do?
  

• What happens if I’m unhappy with the result?

Avoid one-size-fits-all clinics, traveling sales pitches, or flashy medispa ads promising big results with no downtime. 

Your body deserves better than that.

Why Men Seek It

Let’s be honest—it’s sometimes about size. Or at least, the feeling of enough. 

For some, it’s an old insecurity. 

For others, it’s about moving into a new phase of life—after weight loss, divorce, cancer recovery, or a milestone birthday.

These choices can be deeply personal, rooted in self-esteem, intimacy, or identity. 

They don’t always fix the story we tell ourselves—but when done thoughtfully, they can help rewrite part of it.

It’s not always about chasing more. Sometimes it’s about feeling whole again.

See our related piece on cosmetic surgery for men →

Other Options to Consider

• Weight loss and exercise: One of the most impactful—and often underrated—ways to improve visible length, blood flow, and overall sexual confidence
  
  I often tell patients: “Lose 20 pounds and you might see an inch of visible shaft you didn’t know was there.”
  
  Think of a house buried in snow or hidden behind an untrimmed hedge. When the snow melts—or the hedge is trimmed—you see what was there all along.
  
  It’s not new growth. It’s just finally visible.
  

• Pelvic floor therapy: Can improve erectile quality and muscle control
  

• Lifestyle change: Better sleep, alcohol moderation, stress management—all move the needle in self-perception and performance
  

• Sex therapy or coaching: Especially when body image and confidence are the deeper issue
  

• Penile implants or injections: For men whose concerns are functional, not cosmetic—learn more here

What It Costs (and What It’s Worth)

Most cosmetic urologic procedures are not covered by insurance. 

Costs range from a few hundred dollars for injections to several thousand for surgical procedures.

There’s no harm in reflection. Asking questions, reading, even seeing a specialist for an opinion—that part is free. 

But before you pay for anything, make sure you know what you’re actually buying.

How to Think About It

• Be honest with yourself: is this for you or for someone else’s approval?
  

• Understand limitations: no procedure can change your identity—but it may help you align with it
  

• Choose care over impulse: just because something is available doesn’t mean it’s right for you
  

• Know your motivation, do your homework, and always prioritize safety over hype

Final Word

Cosmetic urology isn’t a punchline. It’s not vanity. It’s not desperation. It’s about choice.

Done responsibly, it can support men in reclaiming confidence, comfort, and control.

But it works best when approached with clear goals, realistic expectations, and the right expert at your side.

You’re allowed to ask questions. You’re allowed to care about how you look.

You deserve honest answers. You deserve real expertise.

And you deserve care that respects your body—and your story.