In this article we report the results of a retrospective study of cases of cosmetic elongation, enlargement and combined elongation and enlargement phalloplasty. This was consistent with an IIEF-5 improvement of 6. This study is clinically relevant due to the large cohort of patients included and because it is the first study to use an inverse periosteal-fascial suture not described previously as part of the surgical methodology. Male genital image is correlated, albeit not in a necessarily linear manner 1 , to overall body image, psychosocial variables and sexual health 2 ; in turn, sexual health is correlated to genital image 3. Concern over genital endowment has archaic roots 4 , 5.
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