Since 1998 · Zagreb & Daruvar
Penis Lengthening and Thickening in Croatia
Lengthening and thickening are not the same procedure and do not change the same dimensions. At Polyclinic Maletić, the decision is preceded by an examination, standardized measurement, and a conversation with Duško Maletić, MD, MSc, specialist in surgery and urology, about the possibilities, limitations, and risks of the procedure.
Penis lengthening and thickening are most often considered out of dissatisfaction with appearance, not because of a functional disorder. These are elective aesthetic procedures whose possibilities have clear limits, so the decision should be preceded by an objective assessment of the findings and a conversation about the expected result, the risks, and the recovery.
Is this for me?
Why men come for penis lengthening and thickening
Dissatisfaction with size is far more common than conversations between people would suggest. In research also cited by the European urological guidelines, around 45 percent of men stated they would like a larger penis. A prospective study published in 2022 in the Aesthetic Surgery Journal sorted the reasons into several groups, from self-confidence and feelings of insecurity to sexual function and medical reasons — with self-confidence cited most often.
Dissatisfaction with size can arise in different situations, from changing in front of others to intimacy. That is why it matters to understand what kind of change a person expects, because lengthening and thickening do not change the same things, and the possibilities of each procedure have clear limits.
How average values are determined
The numbers circulating online mostly come from self-reported measurements. A systematic review published in 2015 in BJU International included only measurements taken by healthcare professionals following a standardized procedure, on a total of up to 15,521 men. The average flaccid length is approximately 9.2 centimeters and the average stretched length approximately 13.2 centimeters, and those two values rest on more than ten thousand measured men. The values for erection — approximately 13.1 centimeters in length and approximately 11.7 centimeters in girth — come from considerably smaller samples and should therefore be taken with more caution.
Many men who are dissatisfied with their size fall, by objective measurement, within the population range. That is why standardized measurement is an important part of the assessment before any decision about surgery.
Micropenis is a rare diagnosis established by measurement
Micropenis is established on the basis of a stretched length more than 2.5 standard deviations below the average for age — always, therefore, in relation to population values. There is no single number the profession agrees on, and the thresholds cited by reference institutions range roughly between 6.8 and 9.3 centimeters of stretched length. It is a rare condition, estimated at less than one percent of men.
A normal anatomical finding does not dismiss dissatisfaction with size, but it changes how the indication, the expectations, and the possible benefit of the procedure are assessed.
The first step
How length is assessed
Length is assessed in a standardized way in the stretched state, from the pubic bone to the tip of the glans. Such a measurement is repeatable and can be compared with population values. Measuring from the pubic bone also reduces the influence of the suprapubic fat pad, which can cover part of the anatomical shaft of the penis.
With a more prominent fat pad, the visible length can be smaller even though the length of the penis itself has not changed. That is why, before considering surgery on the genitalia, we assess whether the tissue above its root also contributes to the appearance.
A realistic assessment
Your decision, with a responsible medical assessment
Penis lengthening and thickening are elective aesthetic procedures. Many men who consider them have normal anatomical findings, so the decision should be preceded by a conversation about what can realistically be achieved, what the limitations are, and whether the expectations are attainable.
Professional guidelines warn that the evidence on aesthetic penile augmentation procedures is limited, and they stress the importance of an objective assessment, realistic expectations, and a conversation about the possible benefits, limitations, and risks before a decision is made.
A procedure can change anatomy, but it cannot guarantee that it will change how a person experiences his own body.
How we work
Penis lengthening by dividing the ligament
Part of the shaft of the penis is not visible; it lies inside the body, attached to the pubic bone by the suspensory ligament. Dividing that ligament changes the angle at which the penis sits, so the part that used to lie inside now lies outside the body. No new tissue is created in the process.
The procedure is performed under general or spinal anesthesia, depending on the findings and the agreement with the anesthesiologist, and takes roughly 30 to 60 minutes. A semicircular incision is made at the root of the penis, after which the suspensory ligament is divided and the resulting space is filled with your own fat tissue. The wound is closed in the shape of a Mercedes sign with resorbable sutures. The scar sits in an area usually covered by hair, so it is generally less noticeable.
How many centimeters are realistically gained
In a published series of patients, the average gain in stretched length was roughly 1.3 centimeters, with a range that went from a loss of one centimeter to a gain of three. Review papers cite a range of 1 to 3 centimeters. We tell the patient in advance that the realistic frame is 1.5 to 2 centimeters.
Expecting a considerably larger gain is not consistent with the results commonly reported in the professional literature. If the expected gain exceeds what the procedure can deliver, the operation cannot achieve the goal that has been set. That is why the conversation about expectations matters as much as the choice of surgical technique.
Why the difference shows in the flaccid state, not during erection
Because it is the position that changes, not the length of the shaft, the change is most visible in the flaccid state. During erection the difference is very small or absent. For some men that is exactly what they wanted, because what troubled them was the appearance in the locker room and in front of others. For others it is not what they were looking for — which is why that difference is discussed at the examination.
Penis thickening with your own fat tissue
Thickening is performed by lipofilling — transferring your own fat tissue. The fat is harvested by liposuction from the abdomen or the waist, then processed and injected with cannulas into the sheaths of the penis. The procedure is done under local anesthesia and leaves no incisions, only the marks of the cannula entry points.
In some patients, circumcision is needed before thickening, depending on the condition of the foreskin. For lengthening it is not required. Whether it is needed in your case is established at the examination, before any date is scheduled.
According to data from the professional literature, the increase in girth depends on the share of transferred tissue that takes, so published series report a range of approximately 1.2 to 3 centimeters, with studies with longer follow-up recording lower values. According to the Polyclinic’s data, the expected increase in radius is approximately 4 to 5 millimeters. The actual result depends on the take and distribution of the fat tissue.
Why it is planned in two stages
Part of the transferred fat tissue is resorbed during the first months. In the Polyclinic’s experience, approximately 25 to 30 percent of the transferred fat tissue is resorbed, while the remaining part takes and establishes its own blood supply. After several months, the result is assessed and a decision is made on whether a second stage is needed to top up the volume. The expected resorption and the possibility of a second procedure are explained to the patient before the first one.
Why we do not use silicone, paraffin, or permanent fillers
This is one of the few points in this field on which the profession has no doubts. The European urological guidelines explicitly, and with the strongest level of recommendation, reject the injection of silicone, paraffin, and petroleum jelly into the penis. The consequence is a chronic inflammatory reaction to a foreign body, which can end in extensive surgical removal of tissue.
Hyaluronic acid fillers differ from permanent foreign materials, but they give a temporary result and also have their own risks and limitations. At Polyclinic Maletić, thickening uses the patient’s own fat tissue.
- Duration
- lengthening roughly 30 to 60 minutes; thickening is shorter
- Anesthesia
- lengthening under general or spinal anesthesia, thickening under local
- Recovery
- rest for a few days; abstinence from sexual activity for 4–8 weeks
- Performed by
- Duško Maletić, MD, MSc, specialist in surgery and urology
Why us
Why choose us for penis lengthening and thickening
Surgeon and urologist in one person
Duško Maletić, MD, MSc, combines specializations in surgery and urology — two perspectives that matter in genital procedures
More than 1,000 procedures on the male genitalia
Duško Maletić, MD, MSc, has been performing these procedures for more than twenty years
A procedure without a medical indication
with normal findings, this is an elective aesthetic procedure, so the decision requires realistic expectations and informed consent
An objective assessment of length
stretched length is compared with reference values to distinguish normal anatomy from a genuine deviation
Your own tissue, no foreign materials
for thickening we use exclusively your own fat tissue — never silicone or paraffin
An anesthesiologist in-house
Ines Maletić, co-founder and anesthesiologist, follows the procedures from preparation to waking
Confidentiality of medical data
the consultation and your records are handled in accordance with the rules of physician–patient confidentiality and personal data protection
Zagreb and Daruvar
the same team is with you from the consultation to the last follow-up
Open about the risks
Risks we talk about before the procedure
For lengthening by dividing the ligament, the literature describes wound infection and impaired healing, hematoma, a hypertrophic scar, an opening of the angle toward the pubic bone with instability of the penis during erection, paradoxical shortening if the ligament reattaches in an unfavorable position, and temporary erectile difficulties. The instability follows from the very nature of the procedure, because a structure that gave the penis support is divided.
For thickening with fat tissue, the most commonly described issues are irregularities, nodules, and asymmetry, which arise from uneven resorption, along with the usual risks of any surgical procedure such as infection and changes in sensation.
It is not possible to guarantee a specific number of centimeters, because the final result depends not only on the initial anatomy but also on the surgical procedure, the healing, and the take and distribution of the fat tissue.
Recovery
Recovery, step by step
- The first 2 to 3 days — resting at home is recommended. Pain, sensitivity, and swelling are possible, and painkillers are taken as instructed by the physician.
- Day ten — the first follow-up, at which the wound is examined and the next steps are agreed.
- The first weeks — the sutures resorb on their own, and the wound is cared for and dressed according to the instructions you receive. Nighttime erections can cause pulling and discomfort around the wound, which is discussed with the physician as needed.
- 4 to 8 weeks — sexual abstinence is recommended, with no intercourse or masturbation. The exact duration depends on the procedure and the course of healing and is set at the follow-up examination.
- Several months after thickening — a follow-up and, as a rule, a second stage to top up the result.
- After complete recovery — there is no obstacle to using erection-enhancing aids.
Who we are
Who will be taking care of you
Procedures on the male genitalia at Polyclinic Maletić are performed by Duško Maletić, MD, MSc, a specialist in surgery since 1984 and in urology since 1988, and co-founder of the polyclinic. In genital procedures, the aesthetic question is not separated from function, so both specializations enter the same assessment. The safety of procedures under anesthesia is the responsibility of Ines Maletić, anesthesiologist and co-founder, who follows the patient from preparation to waking.
We founded the Polyclinic in 1998 in Daruvar and run it as a family house. We have four operating rooms with air-recuperation systems and single-bed rooms for recovery.
The consultation and your medical records are confidential and subject to the rules of physician–patient confidentiality and personal data protection. Through the procedure and recovery, the Polyclinic’s team is with you.
Meet the whole team
Price
The price of penis lengthening and thickening
In the price list, the procedures are listed as Penis lengthening by dividing the suspensory ligament and Penis thickening (1 stage) — the professional names that describe exactly what this whole page is about.
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Penis lengthening by dividing the suspensory ligament
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Penis thickening (1 stage)
For lengthening, anesthesia is included in the price. The thickening price refers to one stage.
See the full price listBecause a need to top up the volume may show after several months, the possibility and the price of a second stage should be explained before the first procedure. The examination and consultation do not commit the patient to an operation.
A complete overview of the prices of all procedures is in our price list. You can arrange an examination and consultation through the contact page or by phone, in Zagreb or Daruvar. At the examination we assess the findings, the possibilities of the procedure, the expected result, the limitations, and the risks.
Related procedures in the same area: circumcision and testicular prosthesis implantation. You can browse all the procedures of this pillar on the aesthetic surgery page.
Patient reviews
What our patients say
Reviews taken from our Google Business profiles, Zagreb and Daruvar, translated from Croatian.
★★★★★
“The best team of physicians, extremely professional and kind. I have been loyal to Polyclinic Maletić for more than 10 years and I am always satisfied with the results. Thank you.”
★★★★★
“I came to Dr. Maletić with a big problem and a lot of stress. I was met with such warm empathy and kindness, and patience in answering all of my questions. Thank you, Dr. Maletić, for your advice and sincere support. I know I can always turn to her for advice, and that means a lot to me. The staff of the Zagreb polyclinic are also very accommodating and kind. My thanks to them as well.”
★★★★★
“I can only recommend Dr. Maletić’s practice, both in Daruvar and in Zagreb — and I have had several procedures — because I felt very comfortable there and in expert hands!”
★★★★★
“I come from the United Kingdom and I had an extremely positive experience here. From the moment I arrived I felt welcome and cared for, the team is incredible, and the doctor is outstanding! They offer a large number of treatments, and mine went perfectly and without any problems. If I need another treatment in the future, I would definitely choose them again. I absolutely recommend them!”
★★★★★
“My experience at Polyclinic Maletić in Daruvar was extremely positive. From the very beginning I was delighted by the professionalism and kindness of the entire staff. The physicians took the time to inform me about all the procedures in detail, which gave me a sense of safety and trust. The whole team was exceptionally professional and attentive, and the result exceeded all my expectations. I would certainly recommend Polyclinic Maletić to anyone looking for quality, personalized healthcare.”
★★★★★
“Greetings from Makarska! I have no words that would not, of course, be in superlatives for all of you. From the welcome itself, and my fear before the operation, all the nurses guided me so nicely through everything I had to go through before the procedure — and I must point out, with a huge smile on their faces. Since I had not slept for a few days beforehand from excitement and some inner restlessness, it is incredible how much humor all the nurses, and the doctor herself, used to draw my thoughts elsewhere just so I would not stay focused on the operation. A big thank you to everyone, and I was especially touched by the nurse who kept my spirits up during the procedure and with her humor nearly moved me to tears. I send my regards to the whole team and the doctor of Polyclinic Maletić in Daruvar. All the best to everyone!”
★★★★★
“Polyclinic Maletić deserves all the praise! The team is exceptionally professional, expert, and kind. The whole procedure was explained to me in detail, and the result is excellent. The atmosphere at the polyclinic is pleasant, and the approach to patients warm and approachable. I recommend them to anyone looking for a top-level service.”
★★★★★
“An exceptionally professional, pleasant, and expert team who know and love their work. It is a good feeling to be in the hands of some of the greatest experts in their field, who provide the kind of service I would wish for and recommend to anyone.”
Questions and answers
Frequently asked questions
How many centimeters can penis lengthening add?
In the professional literature, the average gain after dividing the ligament is approximately 1.3 centimeters, with considerable differences between patients, while review papers cite a range of 1 to 3 centimeters. No specific number of centimeters can be guaranteed in advance, because the result depends on anatomy and healing.
Does it also increase length during erection?
The procedure does not create new tissue; it changes the position of part of the penis relative to the pubic bone. The change is therefore most pronounced in the flaccid state, while during erection it is very small or absent. The procedure is not suitable if the main expectation is greater length during erection.
How do I know whether my findings are normal?
By measurement, not by estimate. Length is measured in the stretched state, from the pubic bone to the tip of the glans, because this excludes the influence of the fat pad above the root of the penis. According to the largest review of measurements taken by physicians, the average stretched length is approximately 13.2 centimeters. Micropenis is rare and is defined as a length more than 2.5 standard deviations below the average for age.
Does a visible scar remain?
For lengthening, the incision is made at the root of the penis, in an area usually covered by hair. A scar remains, as after any surgical incision, but because of its position it is generally less noticeable. With fat-tissue thickening, small marks remain at the cannula entry points.
How long is sexual abstinence after the procedure?
Sexual intercourse and masturbation are avoided for 4 to 8 weeks, depending on the procedure and the course of healing. That period is not a formality, because how the wound heals — and what result remains — depends on it directly. After complete recovery, there is no obstacle to using erection-enhancing aids.
Why is thickening sometimes performed in two stages?
Part of the transferred fat tissue is resorbed by the body, which is an expected part of the process, not a complication. What remains permanently is the portion of tissue that establishes its own blood supply. After several months, the result is assessed and, if needed, a second stage is planned to top up the volume.
Does the procedure affect fertility, sensation, or erection?
The goal of the procedure is not to change function, and as a rule it does not. Still, as with any operation in this area, the literature describes possible sensory disturbances, erection instability due to the loss of the support the ligament provided, and temporary erectile difficulties. We discuss all of this before the procedure, not after it.