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Twenty years ago, if a layperson was asked to name the popular aesthetic surgical procedures, most individuals likely would have said “facelift,” “nose job,” “breast augmentation,” or “liposuction.” Many likely were unaware that aesthetic surgeons also were undertaking procedures to improve the appearance of features throughout the body, including the genitals. The popularity of these procedures remained modest for a period of time, and they received relatively little discussion in the academic literature. Within the past decade, however, aesthetic procedures to improve the appearance of the genitals of both men and women have become more commonplace. Application of techniques used with other features is used on the genitals, and the work is now accompanied by thoughtful discussion and research of these procedures and the patients who undergo them, including many articles in the Aesthetic Surgery Journal.1–3 The present study is an example of this growing area of scholarship.4 The investigation used a combination of questionnaires to assess theoretically relevant psychological domains (including self-esteem, sexual relationship satisfaction, and symptoms of body dysmorphic disorder [BDD]) and qualitative interviews of men who had undergone non-surgical procedures to increase penile girth. Twenty-five men completed the questionnaires online, and 6 agreed to participate in detailed semi-structured interviews by telephone. While the use of psychometric measures to obtain quantitative data is typically considered the “gold standard” approach to assessing psychological characteristics, clinical interviews with patients can often yield meaningful qualitative data that can help the investigators, and the field more generally, comprehensively understand the motivations, expectations, and post-treatment experiences of patients. This mixed-methods approach is particularly informative for studies in developing areas of research, such as genital procedures, in which the specific issues and concerns are still being identified. Men reported high rates of satisfaction with the size, appearance, and functioning of their penis following treatment. Retrospectively, they also reported a reduction in symptoms of BDD and improvements in their self-esteem. The qualitative interviews confirmed the high rates of satisfaction seen on the online survey. The interviews also revealed themes of increased self-confidence when their penis could be seen by others, such as in locker rooms and

Commentary on: Nonsurgical Medical Penile Girth Augmentation: A Retrospective Study of Psychological and Psychosexual Outcomes