Brief Answer:
Your size is fine,except surgery no proven approach is there

Detailed Answer:
Hi XXXX,

Thanks for writing to us.From your question I understood that you are asking to increase size of penis permanently.

Many of young men like you feel some apprehension about sex life before marriage.I get many questions about increasing size of penis also on this forum.

I want to clarify general things about size of penis.

Normal size of penis in flaccid state is 2 to 4 inches while in erect position 4 to 6 inches. It varies according to body structure and race. Size of penis does not matter much for satisfying partner.
Anterior 3 inches of female vaginal wall is sensitive to sexual stimuli.Only 3.5 inches of erect penis is sufficient to satisfy female.Hope you are clear about concern of size of penis now.

You did not mention whether your size 4.5 inches is during flaccid or erect state. Anyway it is sufficient.

In my opinion you are absolutely fine and nothing to worry about this issue.

In market lots of oil are advertised saying that they can increase size of penis. But no medical scientific evidence of the same.

Urologist should be consulted when there is need to increase size of penis permanently. Only surgery is the proven approach for the same. No medicine or instruments can do the same with proven scientific results though lots of approaches has been claimed for the same.

For your information I want to mention measures to increase size of penis during sex.
If someone have difficulty in getting erection treatment is there to increase size of penis during sex.

Treatment of erectile dysfunction(ED):
5- PDE inhibitor group of medicines like sildenafil or tadalafil are used. One of them should be used 2 hours prior to sex. They causes headache,stuffy nose nausea and gastric discomfort like common side effects. Proper physical check up of cardiac system should be done by a doctor before starting the same.These are prescription medicines and one needs to consult doctor/psychiatrist/sexologist for the prescription.

Another medicine cum vitamin supplement containing pyridoxal-5-phosphate, mecobalamin and l-methylfolate (trade name tetrafol plus in India)is very helpful in my patients. It has shown improvement in 50-60% patients of mine with ED.One should take it after meal twice a day. If some improvement is there in 20 days one should continue for at least 2 months. You may get this medicine over the counter as it is vitamin product.

Ayurvedic medicines tentax forte can also be used for ED.They are without any side effects.

There are some natural lifestyle measures which help to improve blood flow to penis and overall sexual performance.

- The most important factor is healthy heart. Blood is pumped in to body by heart.So regular exercise and avoidance of fatty fast food are important measures to prevent heart disease. Regular walking, swimming or running overall improves blood flow to whole body circulation including penis and keep the mind fresh.

- Good healthy food is also an important aspect. Bananas, Garlic, dry fruits(they contains vitamins), eggs, cow milk, cow butter are good food which may help in erectile dysfunction.

- Avoid smoking and alcohol. Low amount of alcohol can help in increasing blood flow but more amount can cause opposite effects. So better to avoid the same.

Hope I have answered your query, I will be happy to help further.

Regards,
Dr.Chintan Solanki.

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Brief Answer:
opinion of urologist/plastic surgeon is needed

Detailed Answer:
Hi,

Thanks for follow up.

The techniques to increase length include the cutting of a structure called the suspensory ligament of the penis, often followed by the use of penile weights and other stretching devices. When the ligament is cut in, this alters penile support and causes a low hanging penis, and scarring forms.

In general there are many complications of this surgery and specially when it is not done by a specialized experienced surgeon.This surgery is done by urologist or plastic surgeon or by both.

You can get best information about its pros and cons from consulting urologist.After physical examination and local ultrasound doctor can guide you about how much length can be increased.

I would not recommend to go for this surgery only for sexual aspect.

All the best and take care.

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