SIZE IS ALL IN THE MIND
 A SHAPE like a German helmet is good, say his friends. Such is the 'locker room' talk among a group of men who visit Batam regularly for paid sex.
Private chat about private parts. Fuelled by penis envy.
And, yes, it is ridiculous - and dangerous.
But it is what makes some Singapore men foolish enough to opt for surgery, some even seeking out Thai doctor Dr Kaweewat Hengsawas in Bangkok.
Dr Woffles Wu, a consultant plastic surgeon at Camden Medical Centre, said he recently had a group of patients who came in asking for circumcision followed by a request is to sew it up 'roughly'.
'They tell me to make their penises look ugly, so that it looks fierce and misshapened and can give women more 'shiok',' said Dr Wu.
But the irony is that a plastic surgeon cannot deliberately make any part of the body 'ugly'.
'It offends my aesthetic sense. So what I do is to remove the foreskin but also leave behind more of the mucosa, the inner foreskin, which is particularly sensitive and contributes to sexual pleasure,' he said.
He added that the head of the penis can be enlarged by injecting a filler material along the rim of the head to give it a 'German helmet or Darth Vader' appearance.
'I will only use resorbable fillers and never silicone. Along the shaft of the penis, it is no point injecting anything as it gravitates under the skin and will move around like a bag of blobs during the vigorous movements of the sex act,' he said.
He realised that the group of middle-aged men all knew each other when he interviewed them at length about their desire for an 'ugly' penis.
'They came to see me one after the other, all asking for the same thing. I realised that among this group, a penis with a ferocious jambu-shaped head was the 'in' and desirable thing,' he said.
He's also had many other patients who have asked for bigger, longer, broader penises. He gets about two such requests a month.
Four other doctors we spoke also said they had received similar requests.
Most such requests are turned down because of the potentially disastrous outcome of infections and impotency.
Dr Wu said he has repaired damage done to the penis due to botched procedures and infection done elsewhere.
One example was a patient who had many small silicone balls inserted into the shaft of his penis.
'It was so badly infected when he came to see me that he was at risk of losing the function of his penis,' said Dr Wu.
He had to remove the balls, clean out the infected areas and put the man on medication.
Professor Peter Lim, a consultant urologist at Gleneagles Medical Centre, also sees many men asking for bigger penises.
He estimates that about two in 1,000 men actually have a smaller than normal penis. The rest simply think they have a small penis.
Penis envy is not just prevalent here but everywhere else, he said.
Many of these men who see Prof Lim have suffered psychological blows when they were ragged by their peers while serving national service.
Said Prof Lim: 'Imagine, if they had been exposed to ragging by their peers who jeer at the size of their organs publicly, the psychological impact is great.'
If it is a functioning penis capable of erection and ejaculation, Prof Lim will not offer any services to enlarge it.
'I usually ask them about their relationship with their wives? Do they have children? If they are having normal sexual relations and they have children, then I'll counsel them and tell them that their penises are normal.
'That usually does the trick,' he said.
He makes it a point to differentiate between men who think they are too small and men who have erectile dysfunction (ED).
Those with ED actually have a medical problem which can be treated with drugs and surgery such as penile implants.
But for those who think they are too small and do not have any medical issues, it is probably all imagination.
And if these men think that penis enlargement operation is the easy way out, they should think again, said Prof Lim.
Both he and Dr Wu say that silicone injections will have disastrous results.
The silicone will remain in the body for life and it has a tendency to shift. The man will end up with a lumpy-looking organ.
Removing all the silicone after it has shifted in the body is near impossible.
Said Dr Wu: 'It's a nightmare. Any responsible surgeon will tell such patients that it's impossible to remove.
In the June issue of Urology, a medical journal, Dr Rany Shamloul, speaking at an Egyptian andrology clinic in Cairo, said he studied 92 men who complained of having small penises.
NONE WERE SMALL
None in fact had a small penis. Most were reassured to hear that, wrote Dr Shamloul in the journal. He works at the University of Saskatchewan in Canada.
'Men complaining of short penises can be treated using the basic principles of sex education with objective methods of penile size evaluation,' he wrote.
'This combination can correct any previous sexual misconceptions, relieve unnecessary anxiety concerning penile size, and decrease the desire to undertake still-to-be-verified lengthening procedures.'
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Can cause more damage than good
THINK again when you see a pop-up in your computer which says: 'Give Yourself a Major Confidence Boost: Penis Lengthening and Enlargement' with the phone number of a urologist ready to operate.
Surgical enlargement will not boost your self-esteem; it is more likely to ruin your penis for good.
Most doctors would not operate on perfectly functioning penises especially when their owners only want their organs to be up-sized.
The reason: All surgery carry a risk and it does not make sense to operate on someone who has a functioning penis.
Two surgical approaches are available but it will be a challenge to find doctors who will do them for you here.
One is penis lengthening. It is based on the fact that the penis extends into the lower abdomen.
The internal penis is anchored there by the penile suspensatory ligament. Cut this ligament, and much of the internal penis emerges from the lower abdomen, adding about 2.2cm to what is seen externally.
But this procedure has a significant drawback. The suspensatory ligament is a key component in erections.
When sexually aroused, a surgically-lengthened penis becomes firm but hangs down. It must then be directed by hand.
The other surgical option is girth enhancement.
This is a two-step procedure involving fat removal from the buttocks or tummy, and then re-injecting the fat under the penile skin.
Dr Woffles Wu, consultant plastic surgeon at Camden Medical Centre, has done a couple of these.
He said the biggest problem is that the skin and anything under it will slide up and down as the shaft of the penis moves in and out during sex.
This makes it very unstable and wobbly.
'It also makes the penis look like a misshapened sausage when it is not erect.
'I have stopped offering this procedure,' he said.
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How do you measure up?
RESEARCHERS at the National University of Singapore took 10 years to measure and collect data to determine the average size of the Asian penis.
Most men fall well within the normal range - which is on average, 12cm long and 11cm around - more than adequate to have satisfactory sex.
Information on the study was released in 2000 at the Eighth Symposium on Male and Female Sexual Dysfunction, organised by the NUS Department of Obstetrics and Gynaecology and the Society for the Study of Andrology and Sexology, Singapore.
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