When we think of famous prostitutes, we usually think of women. Royal mistresses like Madame de Pompadour or Nell Gwynn, the hetaerae of the ancient world like Aspasia or Phryne, the women of the century demimonde like Marie DuPlessis (immortalized in Verdi’s La traviata) or La Belle Otero, or more recent women like Xaviera Hollander (The Happy Hooker) or Brooke Magnanti, writing under the pen name Belle de Jour.

But male prostitutes have made history, too. They’ve inspired poets and artists, led rebellions, brought down powerful political figures, and become infamous serial killers. Two of these men, Lao Ai and Shai Shahar, are famous for their liaisons with women, while the others primarily served other men.

Here are some of the most famous—from ancient times to today.

10 Phaedo Of Elis
Fourth Century BC

Phaedo, a handsome young man from an aristocratic family, was captured in the war between Elis and the allies, Athens and Sparta. He was enslaved in Athens and made to serve as a prostitute.

Phaedo was serving clients at an event where the philosopher Socrates was present and pleaded for his freedom. Socrates’s friends bought Phaedo’s freedom, and he became a philosopher himself.

Plato’s dialogue Phaedo is named for Phaedo, and he was present at Socrates’s death. After Socrates’s death, Phaedo went back to Elis and formed his own school of philosophy.

9 Lao Ai
Died 238 BC

During the regency of Qin Shi Huang, ruler of the Qin state and later the first emperor of China, Lao Ai was recruited to become the queen dowager’s boy toy. He was smuggled into the court as a eunuch, although he was no such thing. In fact, it was the size of his equipment that caught the queen’s eye.

Lao took advantage of his hold over the queen and publicly boasted of his power. Lao and the regent Lu Buwei conspired unsuccessfully against the future emperor with the queen’s tacit approval. After their coup attempt failed, Lao was killed, Lu committed suicide, and the queen was placed under house arrest.

8 Febo di Poggio
1500s

Febo di Poggio was one of Michelangelo’s many male models and lovers. According to Michelangelo’s poetry and contemporary rumor, di Poggio was fickle and mercenary and demanded so many gifts that Michelangelo called him “little blackmailer.”

Michelangelo was so enamored that he wrote two poems to di Poggio, G. 99 and G. 100. In keeping with Renaissance poetic tradition, Michelangelo included several plays on words in these poems, referencing di Poggio’s last name (which means “of the hill”) and his first name (equivalent to “Phoebus,” another name for the god Apollo) in these poems.

However, the relationship ended after a relatively short time and Michelangelo moved on to new loves.

7 John Saul
1857–1904

Although John Saul was born into desperate poverty in a Dublin slum, he became the most famous of London’s male prostitutes and was involved in both major male prostitution scandals of the Victorian period. He might have been the author of the 1881 pornographic novel The Sins of the Cities of the Plain; or, The Recollections of a Mary-Ann, with Short Essays on Sodomy and Tribadism.

In 1884, Irish nationalists alleged that there were homosexual orgies at the castle and named Martin Oranmore Kirwan, the son of a prominent Galway landowner, as one of the participants. Earlier in his career, Kirwan had paid Saul for sexual favors. Saul was brought to London to testify, although he wasn’t actually put on the witness stand.

In 1887, Saul was one of the in-house prostitutes at 19 Cleveland Street, which was involved in a major public scandal in 1890. Saul openly testified during the related trial that he worked there as “a professional Mary-Ann,” the current slang for male prostitutes.

However, he was never prosecuted, possibly because the authorities were afraid that he might name other Cleveland Street clients, including Prince Albert Victor, Queen Victoria’s grandson and heir to the throne at that time.

6 Herbert Huncke
1915–1996

Herbert Huncke, whose last name is pronounced “hunky,” was one of the most prominent Beats of the post–World War II generation and was indeed the one who named the Beat movement. He came from a middle-class family but found street life far more compelling.

Huncke, who briefly worked for Al Capone’s gang, started his prostitution career in Chicago. But Huncke didn’t make it big until he moved to New York City in 1939, where he was known as the “Mayor of 42nd Street.” He was addicted to drugs, especially morphine, from an early age.

William S. Burroughs wrote his first novel, Junkie, about Huncke and Jack Kerouac later used Huncke as the primary inspiration for the character Elmer Hassel in his famous book On the Road. In addition, Alfred Kinsey used Huncke to recruit subjects for his sexual research.

5 Jean Genet
1910–1986

Jean Genet was one of the best-known dramatists and thinkers behind French Modernism, inspiring Jean-Paul Sartre and Jacques Derrida, among others. The son of a prostitute, Genet wrote about his experiences servicing sailors in his autobiographical novel, Our Lady of the Flowers.

This book’s frank depiction of life among prostitutes and the criminal classes became an instant scandal and is now considered a classic piece in the literature of gay liberation. Genet followed the book with the plays The Balcony, The Blacks, The Maids, and The Screens. He also wrote the novels Querelle of Brest, Funeral Rites, and The Thief’s Journal, and a short film, A Love Song.

Genet became a political activist as well as a playwright and even inspired a David Bowie song, “The Jean Genie.”

4 Denham Fouts
1914–1948

Denham Fouts led a colorful life. He counted the wealthy, artists, and royalty among his clients as well as many of the period’s most famous authors and Bright Young Things among his friends.

In the 1920s, after Fouts robbed a Greek millionaire client and was sentenced to jail, the Welsh poet Evan Morgan (the 2nd Viscount Tredegar) bailed him out and supported him. Fouts left Tredegar for Prince Paul of Greece, but Paul ended the relationship when he became king.

Fouts then took up with Peter Watson, an industrialist and publisher of the literary magazine Horizon. Christopher Isherwood said Fouts was “the most expensive male prostitute in the world.” He fell in love with a picture of Truman Capote and sent Capote a blank check and his address in Paris. Fouts died young of heart failure in Paris.

3 Shai Shahar
Retired 1999

Shai Shahar, a former soldier in both the United States and Israel, was the first man to go on display in the famous windows in Amsterdam’s red-light district. He claimed that his clientele, there and elsewhere, included royalty, politicians, and movie stars.

Shahar also claimed to have had sex with 500 different women and 40 couples. After retiring from prostitution, he became a singer and promoter for burlesque productions as well as an advocate for legal prostitution and sex worker rights.

2 Mike Jones
20th century

Mike Jones, who prefers to be called an escort rather than a prostitute, became famous for outing his client, Reverend Ted Haggard. Haggard was one of the best-known evangelical leaders in the United States and was a regular adviser to President George W. Bush.

Haggard, a married man, was an active proponent for the Defense of Marriage Act, which banned same-sex marriage. This advocacy made Jones decide to out Haggard, despite knowing that it would almost certainly cost him his career. “This [hypocrisy] is so strong for me, and it hurt me so deeply, that I simply reached the point where I had to say something.”

1 Jeff Gannon
Born 1957

Jeff Gannon (born James Dale Guckert) lived two lives, one as a member of the White House Press Corps during George W. Bush’s administration and the other as a professional escort named “Bulldog” who advertised on websites such as militaryescorts.com. He did not, however, have a military background.

Gannon was able to bypass the standard clearance procedures for White House press passes, which later raised suspicions that he had received special treatment. During a press conference on January 26, 2005, he asked President George W. Bush, “How are you going to work with people [Senate Democrats] who seem to have divorced themselves from reality?”

This overtly partisan question brought him to national attention. Reporters began digging into his background and revealed that he had been a male escort. In 2007, Gannon published a book, The Great Media War, about his experience and the media in general.

+ Andrew Cunanan
1969–1997

Andrew Cunanan was a very successful prostitute on the West Coast of the United States who made a good living off multiple clients. One, Norman Blachford, flew Cunanan around the world and gave him a car, housing, and an allowance.

Cunanan was a habitual liar, exaggerating his background and frequently pretending to be independently wealthy. For some unknown reason, he embarked on a violent murder spree in 1997.

His first victim was Jeff Trail, a former lover, followed by David Madson, an architect. Cunanan then murdered Lee Miglin, a famous and wealthy real estate developer, which put Cunanan on the FBI’s Ten Most Wanted List. He then killed cemetery caretaker William Reese, the first victim who had no apparent preexisting link to Cunanan.

Then Cunanan fled to Miami, where he shot and killed fashion designer Gianni Versace and later shot himself. To date, no investigation has uncovered a motive for the killings.

Ann is a researcher, writer, and currently, a job hunter. Learn more about her on LinkedIn or see more of her writing on Medium.

Between the 16th and 18th centuries, tens of thousands of people were executed for witchcraft in Europe. Then as now, witches were typically thought of as female, and most of the victims in the witch trials were women.

However, men were occasionally accused and executed for witchcraft as well. Sometimes, they were linked with a female witch. Other times, they were accused independently. In a few areas of Europe, such as Estonia and Normandy, men actually made up the majority of the accused.

10 John Fian

In late 1589, the Scottish king James VI traveled to Scandinavia to marry Princess Anne of Denmark. While sailing home, James and his new queen were stalled by terrible storms. Instead of bad luck, the Danish authorities blamed the weather on witchcraft, duly arresting and executing six supposed witches. Back in Scotland, some of James’s subjects were accused of a conspiracy to magically sink the king’s ship.

John Fian, a schoolteacher, was allegedly one of the plot’s ringmasters. According to the many wild legends surrounding him, Fian could fly and unlock doors by blowing on their locks. In one bizarre story, Fian asked a local boy to steal pubic hair from his sister. The hair was an ingredient for a love charm. But Fian was tricked and given cow hair, making a cow fall in love with him instead.^[1]

After being taken into custody for treason and witchcraft, Fian was tortured and interrogated. He confessed that the charges were true, escaped from jail, and then ended up being tortured again. This time, Fian recanted his confession and refused to budge, even after having his nails pulled out and his legs crushed. Despite Fian’s resilience, his interrogators and King James VI weren’t convinced. Fian was strangled and burned at the stake in Edinburgh in January 1591.

9 Thomas Weir

Thomas Weir was probably the last person anybody would suspect of being a witch. He was an elderly veteran of the English Civil War, a stern, religious man who was greatly respected in Edinburgh. In 1670, however, Weir suddenly suffered a kind of breakdown. He’d been harboring a lifetime of guilt and wasn’t nearly as saintly as everybody believed.

From the time his sister, Jane, was 16 until she was 50, Weir had repeatedly slept with her. He’d also had sex with his stepdaughter, his maid, and some mares and cows.^[2] After the secret was leaked, Weir and his sister were arrested for incest. Jane not only confirmed her brother’s claims but told the authorities that she and her brother were witches.

Weir freely admitted to being a witch. He claimed that he’d slept with the Devil and that his walking stick was actually a wand. In the end, Jane was repentant about what she’d done. On the other hand, Weir refused to apologize. Both brother and sister were sentenced to death, although curiously, only Jane was convicted of witchcraft.

8 John Walsh

Not everybody who used magic in Early Modern Europe was considered evil. In England and Wales, for example, the “white witch” used its magic for good. Since the label “witch” was a negative one, these benevolent magicians went by other names, like cunning-man, wise woman, or conjuror. Though they might have been popular with the ordinary people, these folk healers and seers weren’t always safe from the law.

In August 1566, an English white witch named John Walsh was arrested and questioned in Essex about his powers. Walsh claimed that he was in contact with fairies and that he could tell when a person was bewitched. He also had a familiar, a supernatural creature said to help witches with their magic.

Walsh’s familiar would come to him in the shape of a dog, bird, or cloven-footed man. It could identify thieves and tell Walsh where the guilty had hidden what they’d stolen. Walsh swore that he never hurt anybody with his magic, but what ultimately happened to him is unknown. Witches were hanged rather than burned in England. Convictions were rare, so there is a chance that Walsh was acquitted and let go.^[3]

7 Thomas Looten

In September 1659, a merchant named Thomas Looten was plagued with gossip that he’d killed a neighbor boy. Looten had given the boy a plum. When the boy died a few days later, some neighbors believed the plum was bewitched. To clear his name, Looten asked the town bailiff to arrest him and give him a trial.

Looten was apparently confident that the judges would take his side, saying he didn’t need a lawyer or counterevidence to prove his innocence. As it happened, things turned out the exact opposite. His neighbors testified against him, and a torturer claimed that there was a Devil’s mark on Looten’s body. After being strangled with a garrote, Looten told his interrogators that he attended sabbaths and earned his wealth from money that the Devil gave him.^[4]

A witchcraft confession was exactly what the authorities wanted. A day after his confession, Looten died in jail from his wounds. His corpse was burned and then publicly displayed. To cover the rest of his court costs, Looten’s property was also seized and sold off.

6 Quiwe Baarsen

The Sami, the indigenous people of Scandinavia, had a rich tradition of shamanism. Since ancient times, Norwegians had consulted Sami shamans, who maintained that they could tell the future and travel out of their bodies. The shamans used a special drum for their rituals, which put them in a trance and allowed their souls to roam around.

In 1625, the shaman Quiwe Baarsen was paid by a Norwegian named Niels Jonsen to summon wind for a voyage to the village of Hasvag.^[5] A while later, the wife of a man who left with Jonsen paid the shaman again, asking for good wind that would bring her husband’s ship home. This time, the spell went awry and Baarsen was afraid the wind was too strong.

Coincidentally, Jonsen and his crew drowned during a storm on their way back. Two years later, in May 1627, Baarsen was brought to trial by a court in Hasvag. He admitted to creating wind for Jonsen’s ship and explained how a Sami drum worked. The Christian court took Baarsen’s words as proof of witchcraft, ruling him responsible for the drownings and sending him off to be burned at the stake.

5 Andrew Man

Today, fairies are regarded as harmless, fictional creatures, but some witchcraft interrogators believed that they were demons in disguise. Other interrogators figured that they were delusions caused by Satan. But whatever the cause, people who claimed to be involved with fairies were sometimes tried for witchcraft.

In Scotland, several witch trials mentioned a figure known as the Queen of Elphame, a fairy queen who had an angel husband named Christsonday. Andrew Man, an elderly man who went on trial in 1597, said that he had a sexual relationship with the fairy queen.^[6] Man had first met the Queen 60 years earlier when he was a little boy. She later gave him the power to heal any animal or human.

Man had other magical powers as well, such as being able to steal a cow’s milk and tell the future. Christsonday acted as his familiar, and Man could summon the angel by uttering the word “Benedicite.” Man called Christsonday his lord and king, and he also said that he kissed Christsonday’s bottom. To the authorities, the bizarre story reeked of the Devil, and Man was burned for witchcraft.

4 Johannes Junius

Between 1624 and 1631, nearly 300 people were burned for witchcraft in the German city of Bamberg. The city was gripped with paranoia, and even government officials were suspected of being witches. In June 1628, the mayor Johannes Junius was questioned after he was allegedly seen at some sabbaths.

As with many other witch trials, Junius swore he was innocent until he finally broke down after being tortured. According to his confession, Junius met a demon woman who turned into a goat and threatened to break his neck unless Junius gave himself up to her. The woman disappeared and came back with more demons, and Junius was forced to renounce God and worship Satan.

Junius took the new name of Krix, and the demon woman who converted him became his lover. The demon encouraged Junius to kill his children. But he refused, leading her to beat him on one occasion.^[7]

A few weeks before his death at the stake, Junius sent his daughter a secret letter from prison. He said that his words were “sheer lies” and “made-up things” to keep himself from being tortured. He also mentioned his accusers, who admitted to lying and apologized to Junius before their own executions.

3 William Godfrey

In 1609, the farmer William Godfrey rented out a house to John and Susan Barber in New Romney, England. While living there, the Barbers would hear inexplicable dripping and knocking sounds on the ceiling, making them afraid that the house was haunted. After having a baby, Susan swore that three familiars sent by Godfrey tried to steal her child. The Barbers ended up leaving the house. The Holtons, the next couple to take the house, experienced ghostly phenomena, too.

It wasn’t only Godfrey’s house that weirded out his neighbors. The Barbers had terrible luck after moving to a new house and suspected that Godfrey was the cause. Strangely, the Holtons’ son, who suddenly fell sick in 1614, died an hour after Godfrey paid a visit to the house one day. After years of reputedly bewitching people and animals, Godfrey’s neighbors finally took him to court in April 1617.

William Clarke, a man who thought Godfrey had bewitched his ducks, was the first to testify. The trial lasted months. During the wait, Clarke and Godfrey got into a brawl after Godfrey joked about bewitching Clarke’s mare. Other neighbors were brought in as witnesses, but the court ultimately acquitted Godfrey in February 1618. The only person charged with anything turned out to be Clarke, who was fined for assaulting Godfrey.^[8]

2 Chonrad Stoeckhlin

Chonrad Stoeckhlin was a healer and horse wrangler who lived in the German town of Oberstdorf. In 1579, Stoeckhlin met a guardian angel who took him on a nocturnal journey to a “strange and distant place.” Stoeckhlin and his angel would go on these trips several times a year, accompanied by other travelers known as night phantoms. The night phantoms helped turn Stoeckhlin into a powerful healer, and he also learned how to identify witches.

Based on information from his night phantoms, Stoeckhlin accused a woman named Anna Enzensbergerin of being a witch in 1586. Enzensbergerin was arrested, but Stoeckhlin was also taken into custody. His stories about the night phantoms roused the authorities’ suspicion, and soon Stoeckhlin was being investigated as a witch, too.

During his trial, Stoeckhlin’s night phantoms were interpreted as witches. His guardian angel was seen as a demon, and the “strange and distant place” was theorized to be a sabbath. Furthermore, Enzensbergerin and another woman accused by Stoeckhlin confirmed that his mother was a witch.

After the usual bout of torture, Stoeckhlin confessed that everything was true. Ironically, the man who cried “witch” was sentenced to burn at the stake in January 1587.^[9]

1 Louis Gaufridi

In 1609, the French priest Father Romillon became convinced that two nuns, Madeleine and Louise, were possessed by demons. The women would go into horrible convulsions and cried and screamed when Romillon attempted to exorcise them.

Madeleine told Romillon that a priest named Louis Gaufridi had raped her when she was nine years old and that the same man had used spells to fill her body with demons. Months passed without the nuns getting any better, and they made more accusations against Gaufridi when another priest exorcised them.

In February 1611, Gaufridi was arrested and interrogated. He admitted that he was a witch, explaining that he had found a magical book in his uncle’s possessions years earlier.^[10] As he read the book, Gaufridi inadvertently summoned a demon. The demon made a deal with Gaufridi. In exchange for his body and soul, the demon would advance Gaufridi’s career and make any woman he wanted fall in love with him.

Madeleine was questioned as well, and both she and Gaufridi said they attended sabbaths together. In April the same year, Gaufridi was strangled and burned at the stake. Unsurprisingly, Madeleine was eventually accused of witchcraft herself. She was sentenced to life imprisonment but was let out early after serving 10 years.

Tristan Shaw runs a blog called Bizarre and Grotesque, where he writes about crime, folklore, and unsolved mysteries.

Most plastic or cosmetic surgery is apparent to the naked eye: Her breasts look bigger (or smaller or higher). His nose looks straighter. But some plastic surgery results are visible only to the recipient (and perhaps their significant other).

Requests for plastic surgery on genitalia are on the rise, motivated by desires for an improved self-image or increased sexual satisfaction. And while most plastic surgery procedures are performed on women (about 80 percent, in fact), it turns out that more men than women request work on their private parts.

This list reveals some of the procedures that are currently on the menu. Would you consider going under the knife down there?

10 Monsplasty

The mons pubis, or mons, is the triangular fatty pad covering the pubic bone, running from the top of the pubic hair down to the genitals. Both men and women have it, but it’s more obvious in women. The surgery is more popular with women, but men can also receive the benefits.

Fat accumulation and loose skin—from weight gain/loss, aging, C-section, hormones, even genetics—can lead to an enlarged mons. Monsplasty removes excess skin and fatty tissue to give the mons a firmer, flatter appearance.

While many cosmetic procedures involve liposuction to remove fat, monsplasty is surgery that uses a scalpel to remove the offending skin and fat. The procedure often accompanies a tummy tuck because a bulging mons pubis is often more noticeable after removing fatty tissue and tightening the skin on your abdomen.

While the procedure delivers aesthetic improvements, it has other benefits as well, making intercourse, urination, and even hygiene easier.^[1]

9 Labiaplasty

A labiaplasty is a vaginal rejuvenation (or “designer vagina”) procedure. Vaginal rejuvenation often involves lasers, ultrasound, or other energy devices to tighten the vaginal area. But a labiaplasty is surgery that reduces the size/shape of a woman’s genitalia.

The labia can become enlarged due to childbirth, aging, sexual activity, or genetics. The condition, when revealed by form-fitting clothing, is sometimes referred to as “camel toe” or “crotch cleavage.” An enlarged labia can cause difficulties with exercise, sex, and hygiene and may lead to urinary tract infections. It can also interfere with wearing clothes like yoga pants and swimsuits.

There are different ways to reduce the size of the labia (e.g., trim procedure, wedge procedure). The overall goal is to remove the excess part of the labia minora (the inner tissues of the female genitalia), so it lines up with the labia majora (outer part).^[2]

8 Clitoral Hood Reduction

The skin fold that covers and protects the clitoris is called the clitoral hood. The clitoris contains thousands of sensory nerve endings and is extremely sensitive. The clitoral hood protects the clitoris from friction and clothing that could irritate it. It also makes a lubricant (sebum) that helps the hood glide over the sensitive clitoris. When a woman is sexually aroused, the clitoris becomes engorged. This swelling pulls back the clitoral hood (much like the foreskin of a penis) and aids in a woman’s ability to achieve orgasm.

Some women may want to reduce their clitoral hood to eliminate discomfort. Women who’ve had the above-described labiaplasty may find their clitoral hood looks top-heavy. Other women may simply want to increase sexual clitoral sensation by exposing more of their clitoris. Each of these things can be addressed with a vaginal rejuvenation procedure called a clitoral hood reduction.

The clitoral hood reduction (aka clitoral hoodectomy, clitoral hoodoplasty, clitorial unhooding) reduces the excess tissue in the folds of the clitoris. The outpatient procedure involves trimming the skin and suturing with disposable stitches. The surgery should result in better-looking and more comfortable genitals.^[3]

7 Hymenoplasty

The hymen is the thin membrane that partially covers the vagina. In many cultures, an intact hymen is thought to be a sign of virginity, but penetrative sex isn’t the only cause of a torn hymen. The membrane can be torn by exercise, horseback or bicycle riding, tampon insertion, masturbation, or a pap smear.

Women who want to restore their hymen can opt for a hymenoplasty, also known as hymenorrhaphy or temporary hymen reconstruction. The desire to do so isn’t always cosmetic. It might stem from the cultural or religious belief that a woman must prove her virginity on her wedding night. For women who have been sexually abused or traumatized, the procedure may provide psychological and emotional relief.

With this surgery, a thin layer of tissue is taken from the vaginal wall and placed in the location of the torn hymen. The restored hymen will tighten the vaginal opening and—like the original hymen—may or may not bleed upon penetration.

This procedure, which is illegal in some European countries, provides no greater medical or physical benefit.^[4]

6 Labia Majora Augmentation with Fat Grafting

A woman who wants to plump up her labia might opt for dermal fillers like those used to make lips larger. But there’s also a longer-lasting surgical alternative: labia majora augmentation with autologous fat transfer.

This outpatient surgery liposuctions fat from the patient’s abdomen, hips, or flanks and transfers it to the labia majora. The intent is to improve the fullness and firmness of the labia majora and eliminate sagging skin for a more youthful-looking appearance.^[6]

5 G-Spot Amplification

G-Spot amplification is another surgical procedure that aims to improve a woman’s self-esteem, sensation, and libido. It also involves using autologous fat transfer. This method seeks to magnify the G-Spot up to four times and is also known as G-Shot or G-Spot augmentation.

A German doctor named Dr. Gräfenberg was the first to describe the concept of the G-Spot, an area on the front inner wall of the vagina. The procedure includes an injection of hyaluronic acid or collagen filler to this erogenous area. It is believed that this procedure increases the sensitivity, the duration of female orgasms, and their frequency.^[6]

Don’t worry, guys. We haven’t forgotten about you. The rest of this list is dedicated solely to you…

4 Penis Lengthening Surgery

A man’s perception of his genitals is directly related to his self-esteem and sexual identity. That may be why men are all-in on this cosmetic trend.

There is rarely a medical need for penis enlargement surgery. The Urology Care Foundation says it’s only necessary in cases of micropenis—an abnormally small penis caused by hormonal or genetic issues. The average penis size for an adult is 13.24 centimeters (5.21 inches) when stretched. A stretched penile length of less than 9.3 centimeters (3.66 inches) is considered a micropenis. However, the majority of men seeking this type of surgery have a penis of “normal” size.

Penis elongation surgery is a bit of a misnomer. In this procedure, the suspensory ligament that attaches the penis to the pelvic bone is cut. The enables the flaccid penis to hang lower and look slightly larger even though its size has not been altered. Sometimes a skin graft is necessary to complete the surgery. Complications are a concern. Wound separation, scarring, pubic depression, or hairlessness may occur. The penis may develop an unnatural hump at the base, while a change in the angle of erection may also result.

The penile length gained may increase by a centimeter (less than ½ an inch) or so, but it’s possible that no lengthening results. Using weights or stretching devices postoperatively—and for a period of months to years—may allow additional length gain. Removing the fat from the area around the penis can also make it look bigger than it is.^[7]

3 Penile Girth Augmentation

Increasing penile girth is another sought-after cosmetic procedure. Achieving good results (i.e., symmetrically increased girth) is difficult. Girth surgery can lead to severe complications and deformities.

The patient’s own fat is injected into the penis. If the injections are irregular or too much fat is injected, unsightly nodules may occur. Asymmetry and loss of penile rigidity due to excess fat are other complications.

Alternatively, skin grafts can be used to increase girth by up to 4 centimeters (1.5 inches). The grafts are secured around the circumference of the penis with sutures. Severe complications (scar formation, penile shortening, penile curvature) may result if the grafts do not survive completely.

Some practitioners inject synthetic materials, such as liquid silicone or hyaluronic acid, to enhance girth. Injections may provide a good short-term appearance, but long-term results are unlikely.^[8]

2 Testicular Implants

There are many medical conditions that can contribute to the size and symmetry of testicles: infections, tumors, medication, or genetics. Some men are simply born with one testicle, uneven testicles, or testicles that fail to descend. And some men are sensitive about these “abnormalities.”

A testicular prosthesis is an artificial testicle implanted in the scrotum to provide the appearance of the real thing. Like saline-filled breast implants, testicular implants can be made to the size and consistency desired by the patient.

This minor outpatient surgery can be completed in about 30 minutes. Pain meds and antibiotics are typically prescribed, and the surgical stitches eventually dissolve on their own. Gentle manipulation of the area will help the implant settle in a natural position. Regular exercise and activity can resume around two weeks after the procedure.^[9]

1 Scrotoplasty

A man’s scrotum can become stretched and loose due to genetics, aging, trauma, or injury. Many men, both young and old, struggle with scrotums that are sagging, large, or low-hanging. In extreme cases, a stretched scrotum can cause painful chafing, interfere with sexual intercourse, or even reach the water when the toilet is being used. Men with stretched scrotums complain of discomfort, hygiene concerns, sexual problems, and overall embarrassment and low self-esteem. Nonsurgical treatment involves wearing supportive underwear or a jockstrap, which may slow but not stop the sagging.
.
Scrotoplasty (aka scrotum reduction, scrotal lift) removes excess skin from the scrotum to improve appearance and comfort. The result is a tighter, smaller, rejuvenated scrotum. It’s a fairly simple procedure that can boost a man’s self-confidence and pleasure during sex.

The outpatient surgery does not interfere with the testicles or fertility. The majority of men undergoing this procedure are over age 40. Consider rest, scrotal elevation, and ice compresses for several days after the operation to help with healing. Avoiding constipation, straining, and heavy lifting are encouraged. Most patients return to regular activities and sexual intercourse within three weeks.^[10]