Penis Enlargement in Darmstadt – Evidence-Based and Scientifically Sound, by Prof. Littara
Penis enlargement performed by an internationally renowned specialist in penis enlargement, using surgical methods that have been established for 27 years.
The issue of penis length is a concern for many men and can significantly impact their quality of life. Prof. Littara evaluates each case individually and plans the surgery according to the patient’s needs
Evidence-based penis lengthening is an established procedure in genital surgery that can permanently and effectively increase the visible length of the penis. At UGRS in Darmstadt, this procedure is performed by Prof. Alessandro Littara, who is named as a reference physician for penile lengthening in the current guidelines of the European Association of Urology (EAU) and has been personally performing this surgery for 27 years.
He places great emphasis on achieving a natural-looking, aesthetic result as well as on the well-being and safety of his patients.
An honest, trusting consultation is the foundation for a good outcome.
Treatment Overview: Penile Surgery by Prof. Littara
Is it possible to lengthen your penis?
Yes, penis enlargement is possible in both states. Evidence-based surgical procedures in genital surgery can permanently increase penis length. In the hands of a physician who specializes in and is trained in this field, penile lengthening is an established procedure performed in specialized clinics with natural-looking and aesthetically pleasing results. For many men, it can be an opportunity to have their desire for greater length professionally fulfilled.
Penis Lengthening with Prof. Littara in Darmstadt
Prof. Alessandro Littara is a board-certified surgeon, andrologist, and sexual health specialist. He has several decades of experience in the field of penile enlargement. As a specialized surgeon and medical training director at the International Academy of Penoplasty, he has professionally and successfully performed several thousand procedures to date. He is highly specialized in male genital surgery and possesses extensive expertise and experience in this highly specialized field.
This enabled him to compile and publish one of the world’s largest case studies on surgical penile enlargement, in which the long-term results of 355 patients were evaluated.
From left: DRS Hagen, Prof. Littara, Melone, Belli
The procedures he performs are outpatient and low-risk, usually conducted under professional local anesthesia and with the patient in a state of twilight sleep—general anesthesia is generally not necessary, but can be provided without difficulty.
Both twilight sedation and general anesthesia, if required, are always administered by an experienced anesthesiologist who is present throughout the entire procedure. The anesthesia is administered in such a way that the patient recovers very quickly after the surgery and can leave the clinic feeling relaxed and virtually pain-free.
Using the proven technique developed by Prof. Littara—which he has modified based on his extensive expertise and experience for the benefit of the patient—the visible length of the penis can be increased by an average of 3.5 to 6 centimeters. Due to Prof. Littara’s high level of expertise, results of over 8 cm may occur in individual cases when he performs the surgery.
We deliberately avoid using foreign materials such as silicone, in accordance with the recommendations of the European Association of Urology (EAU) in its current guidelines. Instead, we use suturing techniques developed specifically for this procedure and the patient’s own tissue. If necessary, additional procedures (e.g., autologous fat grafting or the innovative use of stem cells) can be employed to aesthetically adjust the penis thickness and shape it to match the newly gained penis length. Sensitive structures such as the base of the penis, through which nerves, blood vessels, and the urethra pass, are avoided and spared during this surgery.
What are the benefits of penis enlargement?
Penis enlargement —whether through lengthening or thickening —can be very important to men. The reasons for undergoing such a procedure vary. An honest, professional consultation with Prof. Littara, based on evidence-based options, is an absolute prerequisite for successful treatment.
This is the only way to achieve a patient-centered, lasting improvement.
Patients undergo penis lengthening surgery performed by Prof. Littara for various reasons:
- Increased sexual satisfaction: Changes in the length and girth of the penis can often have a positive impact on the sexual experience and improve and enhance a man’s well-being. This can lead to increased self-confidence and a more positive body image and body image.
- Correction of Irregularities: Penis lengthening surgery may also be useful as a complementary procedure to correct deformities or asymmetries.
Prof. Littara opposes penis enlargement for aesthetic reasons, as performed by some plastic surgeons who lack the necessary training in this surgical technique and the function of the penis.
Unfortunately, Prof. Littara is increasingly having to perform corrective surgeries on patients who have undergone procedures at other practices or clinics by plastic surgeons, with poor results or no results at all.
If you are interested in penis enlargement, Prof. Littara, our other doctors specializing in penis enlargement, or an experienced member of our administrative staff will be happy to provide you with a thorough consultation.
During this consultation, you will receive all the important information about the various treatment options, surgical techniques, and the expected results.
Penis Enlargement Through Specialized Surgery
(This graphic is protected by copyright and belongs to Jörg Hagen, chief physician at UGRS. Any use of this graphic outside of UGRS or Prof. Littara’s presentations is unauthorized.)
For men who wish to lengthen their penis, various medical methods of penile augmentation are available. One of the most commonly used techniques is surgical penile lengthening. There are two different types of surgery, which differ in their effect on penile length. The evidence-based ligamentolysis with subsequent stabilization performed by Prof. Littara often yields very good results. In this procedure, the ligaments that anchor the penis to the body are released. This causes a portion of the inner part of the penis to be displaced outward, resulting in a visible and measurable lengthening of the penis. The increase in length is visible both when the penis is flaccid and when it is erect.
In addition to ligamentolysis, it is possible to increase penis size through autologous fat transplantation (penis thickening) or autologous fat injections. This procedure uses the body’s own fat tissue. Another technique involves injections of hyaluronic acid; however, this does not result in permanent enlargement.
Before deciding to undergo surgery, it is essential to have a detailed consultation with a specialist experienced in male genital surgery. This specialist can provide patients with professional, scientifically sound advice on the various methods and, together with the patient, select the method best suited to the individual case.
Although surgical penis lengthening is increasingly offered by plastic surgeons, it is not included in the training curriculum for plastic surgery specialists in Germany.
Since the penis serves not only an aesthetic purpose but also several functions, this surgery should only be performed by experienced physicians who are trained in this procedure, and it should always be planned on a case-by-case basis.
Prof. Alessandro Littara follows the recommendations of the European Association of Urology (EAU) to ensure patient safety and achieve the best possible outcome.
Prof. Littaras's Highly Specialized Technique for Penis Lengthening
When it comes to penile lengthening, it is crucial that the procedure be performed effectively and, at the same time, safely and in full compliance with medical standards. Prof. Littara has developed his own scientifically sound methodology for this purpose. It is based on proven principles of male genital surgery and is complemented by his skill and experience.
The goal is to achieve the harmonious lengthening discussed with the patient without compromising natural structures and functional elements.
The male penis consists of a visible external part and a part located inside the body. Both the international press and informational websites have often repeated the description given by the head of the UGRS, Dr. Jörg Hagen, that this ratio is approximately 50:50.
Ligamentolysis is performed through a small incision made by Prof. Littara in the shape of an arc to mimic a skin fold. This incision is located in the pubic hair area. The posterior ligaments remain intact. The nerves and blood vessels supplying the penis run through this posterior region. The view of Prof. Littara, an expert in male genital surgery, that these ligaments must remain intact to avoid any risk to the patient has gained international consensus.
When performed professionally—as Prof. Littara does with his extensive experience—the result is an increase in length in both the flaccid and erect states.
The technique used by Prof. Littara—which he has also published on in scientific journals—takes advantage of an anatomical feature of the internal portion of the penis: This naturally curved section is straightened, and the resulting geometric overhang creates the lengthening. This shifts the ratio of the external to the internal portion of the penis, lengthening the externally visible portion to its objective advantage. As a result, the penis length can increase by an average of 3.6 to 6 centimeters. Results exceeding 8 cm may occur in individual cases—depending on the patient’s specific circumstances.
No foreign materials, such as silicone or implants, are used. Prof. Littara thus follows the guidelines of the European Association of Urology (EAU), with which he fully agrees. Instead, the patient’s own tissue is brought in from the side and secured using specially developed suturing techniques. Prof. Littara preserves the important base of the penis—where nerves, blood vessels, and the urethra enter the penis—and leaves it unchanged. Since no incisions are made into the penis itself, the risks that would otherwise result are eliminated.
The final result depends on factors such as the initial angle of inclination, the length of the symphysis, the ligamentous structures, and, in particular, the structure of these ligamentous structures. Just as patients differ, for example, in the structure of the connective tissue in their intervertebral discs, the same is true for the ligamentous suspension of the penis.
Part of the professionalism behind Prof. Littara’s evidence-based surgical approach is his strictly individualized planning of each procedure, taking into account his patients’ anatomy and wishes.
What is important to consider before undergoing penile lengthening surgery?
Penis lengthening requires careful preparation to ensure that patients can give informed consent. This includes a comprehensive, honest, and objective consultation, clarifying realistic expectations, and explaining possible complications.
It is also important to take certain factors into account early on in order to be optimally prepared for this surgery. After all, the safety and well-being of patients are particularly important to Prof. Littara:
- Anticoagulant medications —such as aspirin—should be avoided before surgery, as they increase the risk of bleeding.
- You should stop smoking nicotine-containing products a few days before the procedure so as not to interfere with healing.
- You should also avoid alcohol, since it is toxic to cells.
- If the patient has diabetes, it should be optimally controlled to promote wound healing
- Certain weight-loss medications that delay gastric emptying increase the risk of aspiration during surgery and should therefore be discontinued well in advance.
- Medications used to increase thyroid function could affect the outcome of the thickening procedure, which is why I recommend optimizing the dosage prior to surgery.
You will receive all other specific information during your personal consultation.
What should you keep in mind after a penis enlargement procedure?
Even after the surgery, Prof. Littara remains available to his patients at all times. Patients also receive written explanations and instructions regarding post-operative care, as following these instructions is a key factor in the success of the surgery.
After a penile lengthening procedure, mild swelling may occur, which is a normal reaction of the body to the procedure. In some cases, applying cold compresses can significantly shorten this phase.
After about two to three weeks, most daily activities can be resumed without any problems. Sexual intercourse and sports can be resumed after about five weeks.
Prof. Littara takes the existing skin of the penis and scrotum into account when planning and performing the surgery. There is enough skin to cover the lengthened portion without tension, so no skin grafts are necessary.
The use of special materials and modified suturing techniques minimizes the retraction forces caused by scar formation that could affect the final result. The surgery leaves only a small incision in the pubic hair area, which Prof. Littara—thanks to his extensive experience—is able to make curved and thus virtually invisible.
For patients prone to scar retraction due to excessive scarring, the use of a professional extension device to stretch the tissue during the healing phase may be recommended as a supplementary measure to stabilize the long-term result. Follow-up care is always tailored individually to each patient.
Thanks to Prof. Littara’s professional, scientifically sound approach, a follow-up visit after the healing phase was not strictly necessary, but it can, of course, take place at any time at the patient’s request.
What are the risks associated with penis enlargement?
Penis enlargement is a surgical procedure—and like any surgery, it carries certain risks. These include, for example, infections, swelling, or excessive scarring. While such risks can never be completely ruled out, they can be significantly reduced through extensive experience, precise surgical technique, and careful postoperative care. Prof. Littara explains to patients in detail and in an easy-to-understand manner how to best care for themselves after such a procedure.
At UGRS, Prof. Littara, as a specialist, personally performs all procedures. Together with a team of physicians and trained medical staff, he ensures the highest standards in genital surgery. With several hundred penile lengthening and thickening procedures performed each year, Prof. Littara has extensive experience in this highly specialized field.
Why Prof. Littara's experience is crucial to your treatment
Penis lengthening is a complex procedure that requires a high degree of experience and expertise from a doctor who specializes in male genital surgery. Patients not only want an aesthetically pleasing result, but also wish to preserve function and sensation, as well as ensure the greatest possible safety during the procedure. That is why it is important to consult a specialist who has been performing this surgery regularly for years with proven, scientifically documented success.
Prof. Littara has specialized in this field of male genital surgery for many years and has additional training and extensive experience in andrology and sexual medicine.
While a plastic surgeon—assuming he has even completed specialized training in surgical penile enlargement—can only consider the aesthetic aspect of such a procedure, Prof. Littara is, in most cases, able to draw on his outstanding experience in male genital surgery, andrology, and sexual medicine, to both preserve and maintain the penis’s function as an organ for urination and to optimally address its sexual function—erection.
His extensive knowledge and experience enable him to integrate andrological and sexual medicine considerations, as well as established therapeutic approaches in these areas, into the optimal treatment of the patient. Where appropriate, following consultation and thorough discussion with the patient, complementary techniques from the field of longevity can be incorporated, and supportive methods for dietary changes can be recommended to the patient to ensure the long-term success of the surgery.
With several thousand surgeries performed over 27 years, he and his medical team have an exceptional level of experience in penile lengthening and thickening procedures. His patients benefit from constantly updated surgical techniques, a specially modified suturing method designed to reduce instability, and a procedure that utilizes the highest-quality instruments, which significantly reduces risks such as scar retraction. He does not make an incision into the penis itself, which significantly minimizes the risk of infections or functional complications. Instead of using foreign materials such as silicone or implants, Prof. Littara uses the patient’s own tissue, which he surgically integrates with a high degree of professionalism, extensive experience, and a scientifically sound suturing technique to ensure a successful outcome. Moreover, thanks to his anthropological knowledge, he is able to leave the base of the penis—where the nerves, blood vessels, and urethra enter the penis—intact.
Thanks to his expertise in sexual medicine, he is able to optimally plan the treatment for each patient, incorporating the patient’s individual wishes into the treatment plan. Where necessary, innovative but strictly approved procedures—whose efficacy has been confirmed by evidence-based research—are used as complementary treatments.
In addition to performing initial surgeries, patients seek out Prof. Littara for his extensive experience in correcting previous procedures. Patients who are dissatisfied with the results of their previous surgeries performed by other doctors seek his expertise because of his rare combination of exceptional experience in male genital surgery with expertise in andrology and sexual medicine. Thanks to his specialization and many years of experience in male genital surgery, he is able to contribute to a significant improvement in many cases.
How much does a penis enlargement cost?
The cost of penile lengthening depends on the scope of the treatment and the methods used. UGRS has always offered transparent pricing that includes all services, materials, anesthesia, and ancillary costs.
Billing is conducted in accordance with the law and the guidelines of the GOÄ and the provisions regarding individualized flat-rate fees, as the surgery is performed at a private clinic licensed under Section 30 of the German Trade Regulation Act.
Treatment
Price
Penis enlargement only when flaccid
approx. 5,100 €
Penis lengthening, even when erect
approx. 9,500 €
Penis thickening
approx. 7,500 €
Combined Penis Lengthening + Penis Thickening, Even When Erect
approx. 12,300 €
Payment by bank transfer, credit card, cash, or other flexible payment options. Please contact us!
Please note: The costs of penile lengthening are generally not covered by health insurance and must therefore be paid by the patient.
Combined Penis Lengthening and Thickening
The combination of penile lengthening and thickening makes it possible to improve both the length and girth of the penis in a single procedure. This combination results in a particularly harmonious, aesthetically pleasing outcome. As a result, the patient only has to go through the healing and recovery phase once.
With this combination, Prof. Littara’s extensive expertise and experience enable him to minimize, in particular, the problem of excessive penile shrinkage caused by cold temperatures and the patient’s arousal.
If both procedures are performed at the same time, the base cost of surgery and the associated hospital fees are incurred only once. This combination, which is often used to achieve optimal results, helps patients save nearly EUR 5,000 by having the procedures performed simultaneously.
Alternative Methods for Penis Enlargement
In addition to surgical procedures, there are also various alternative approaches that aim to lengthen the penis. The best known are probably penis pumps (vacuum) and penis extenders, which are intended to promote some tissue growth through mechanical stretching of the tissue. These methods require consistent use over a very long period of time and may lead to moderate lengthening in some cases; however, these results are not scientifically substantiated or reproducible.
Special exercises such as jelqing or other massage techniques are also frequently cited as ways to increase length. However, there are no scientific studies or evidence regarding their effectiveness.
Since vacuum pumps, penis extenders (stretching belts), and excessive manual techniques all place strain on the penis, improper use can lead to nerve and tissue damage.
Prof. Littara offers only scientifically proven methods. For this reason, he does not offer procedures marketed as “Penis Shot” or “P-Shot,” which some doctors misleadingly promote to patients as innovative therapies. In particular, the European Association of Urology (EAU) warns against the use of PRP plasma on the penis in its guidelines, which were most recently published in March 2026. The EAU recommends that such techniques be used exclusively in scientifically controlled studies, as there is no scientifically sound research to confirm whether such techniques are effective when applied to the penis, nor are the side effects of their use on the penis known.
Since PRP involves the use of platelet-rich plasma, there is a theoretical risk of vascular occlusion due to platelet aggregation, which could impair erectile function.
Furthermore, some doctors who offer this technique lack the professional and technical expertise to assess whether patients actually have erectile dysfunction that should be treated with the PRP method. Without first establishing a diagnosis, however, it is particularly inadvisable to use a procedure whose effects are unclear.
Other Procedures in Male Genital Surgery
Penis lengthening is just one of several options in male genital surgery. Often, men seeking treatment also wish to change the girth or shape of their penis to achieve a more aesthetically pleasing symmetry. The doctors at UGRS therefore offer treatments tailored to each patient’s individual needs and wishes:
- Combined Penis Enlargement: A combination of penis lengthening and thickening.
- Penis Thickening with Autologous Fat: Autologous Fat Grafting for a Lasting Increase in Girth.
Since penis thickening with hyaluronic acid has not yet been sufficiently studied scientifically, and since serious side effects and extremely poor results—particularly at the head of the penis—have been described in the scientific literature, Prof. Littara does not use this method. As an exceptional specialist in male genital surgery, he is committed to offering patients only positive and scientifically sound methods.
Contact Prof. Littara
The decision to undergo penile lengthening or another form of male genital enlargement is based on various reasons, as described.
An experienced physician, board-certified specialist, and expert like Prof. Littara takes the time to answer patients’ questions and work with them to find the right solution. His more than 27 years of specialization in male genital surgery make him particularly well-suited for this, and he is always supported by Dr. Jörg Hagen, the director of UGRS, who has been performing surgical penile enlargement for 30 years. In addition, Prof. Littara personally selects anesthesiologists for this procedure. At UGRS, patient care and safety are ensured by at least two experienced physicians working together under the dual-supervision principle.
Please feel free to schedule an appointment for a personal consultation. We’ll take the time to address your individual needs.
At UGRS, you’ll also receive support from staff with many years of experience in non-medical areas as you plan your therapy.
The article has been checked, verified and approved by the Co-author Jörg Hagen. Author: Prof. Alessandro Littara.
About the author
Alessandro Littara is an international luminary in the field of urological reconstructions. He specializes in surgical penis enlargement.
Thanks to his pioneering work in the field of phalloplasty, which began in 1990, he is considered one of the forefathers in the field of male genital plastic surgery. He teaches his modified technique for surgical penis enlargement at the International Academy of Penoplasty.
His quest for the most effective solution with maximum safety led him to develop a method that does not require any foreign materials.
The current guidelines of the European Association of Urology (EAU) from March 2026 confirm his tireless fight against the use of silicone implants or similar foreign materials in surgical penis enlargement, most of which are not approved in Europe anyway, in a table(https://uroweb.org/guidelines/sexual-and-reproductive-health on page 100) that warns against the use of foreign materials.
Activities
His medical positions are in addition to his work at the UGRS Center Darmstadt:
- Former head physician of the Department of Medical and Surgical Andrology and Sexology at the Mercurio-Quisisana Private Clinic in Montecatini Terme, where he performed his first thousand penis enlargement operations.
- Training manager at the International Academy for Penoplasty https://www.penoplastycourse.com/
- Medical Director of the Milan Center for Sexual Medicine
- Head surgeon of the surgical penis enlargement section at the UGRS Center Darmstadt
Internationally recognized expert on penis enlargement
He is interviewed by numerous daily newspapers, lifestyle magazines, radio stations and TV stations both in Europe and especially in the USA as an expert on the subject of surgical penis enlargement.
He is considered an international expert in surgical penis enlargement by the following media, among others:
USA Today, New York Post, Daily Mail, Le Parisien, Yahoo Sports, Marca, SVT, Aftonbladet, Expressen, de Telegraaf, RMC Sport/BFM TV, Nettavisen, Yle, Sapo/Portugal, la Repubblica, Corriere della Sera, La Stampa, Panorama and RAI News.
In cooperation with the Italian Ministry of Health, he has promoted digitalization in the field of urology and was one of the pioneers in providing information on medical topics via digital media.
Special recognition of his medical work
In the current guidelines of the European Association of Urology (EAU) https://uroweb.org/guidelines/sexual-and-reproductive-health, he is the only doctor named on the subject of surgical penis enlargement.
Until recently, he performed high-end operations by special invitation at the Harley Health Village in the famous Harley Street (internationally renowned for excellent plastic surgery) in London. During his time working here he performed over a thousand penis enlargements on British patients alone.
He is an accredited expert on Wikitia, the science-based offshoot of Wikipedia.
Special scientific merits
He has close scientific ties to the University Hospital in Pisa and is the author of the world’s largest scientific study to date on the subject of surgical penis enlargement, which is listed in the National Library of Medicine USA (PubMed).
His memberships in addition to the UGRS membership
- Italian Society of Andrology (S.I.A.)
- Italian Society of Sexology and Sex Education (S.I.S.E.S)
- Italian Society of Male Genital Surgery (S.I.C.G.E.M.)
- European Society of Sexual Medicine (E.S.S.M.)
- International Society for Sexual and Impotence Research (I.S.S.I.R.)
- Member of the American Academy of Cosmetic Surgery (A.A.C.S.)
- Trainer of the European Association of Genital Plastic and Cosmetic Surgery and Rejuvenation
About the medical co-author Jörg Hagen
Special merits:
The doctor Jörg Hagen has been working on the subject of surgical penis enlargement for over 30 years and has made a decisive contribution to the establishment of this operation in Germany.
With reference to the UGRS (then known as the GC of Urology), the British newspaper GUARDIAN described Germany as the world champion in penis enlargement in 2014.
He is the current organizational head of UGRS Darmstadt.
Interview with co-author Jörg Hagen (often referred to as “Dr. Penis”) on the RTL+ podcast
The medical information provided on this website is for general information purposes only and does not replace a personal consultation with our doctors. As a tertiary medical center, we are also available for second opinions.
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List of sources:
2 American Board of Urology (2024). Residency Requirements and Training Standards.
Link: ABU Residency Requirements
6 Falagario UG, Piramide F, Pang KH, Durukan E, Tzelves L, Ricapito A, Baekelandt L, Checcucci E, Carrion DM, Bettocchi C, Esperto F. (2024) Techniques for Penile Augmentation Surgery: A Systematic Review of Surgical Outcomes, Complications, and Quality of Life. Medicina (Kaunas). 2024 May 2;60(5):758.
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DIN Media (Official Sale): https://www.dinmedia.de/de/norm/din-en-iso-4074/263522064
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DIN Media (draft): https://www.dinmedia.de/de/norm-entwurf/din-en-iso-4074/382482368
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31 Lever, J., Frederick, D. A., & Peplau, L. A. (2006) Does Size Matter? Men’s and Women’s Views on Penis Size Across the Lifespan. Psychology of Men & Masculinity, 7(3), 129-143
Full-text PDF (UCLA)
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