“He’s been a sexual maniac,” the wife told me. “He has erections all day long every day now. We haven’t had this much sex since when we first got together.” And that was 20 years ago. Getting the Penuma, the plumber said, “basically saved our marriage. I wish I had done it sooner.”
But until Elist
—an affable Iranian-born father of three with a mischievous, slightly goofy laugh—got FDA clearance for his implant in 2004, the only procedures available for growing a man’s manhood were temporary, or potentially damaging, or disgusting, or all three. To this day, some surgeons cut the suspensory ligament in the groin so the penis will hang lower, potentially giving the appearance of greater length (but sometimes making stand-at-attention erections tricky). Other doctors inject collagen gel, or your own fat, or insert cadaver cells into the penis, leading to temporary gains (but sometimes to misshapen, lumpy results).
In Tijuana, there’s a doctor who will inject a Brazilian product called Metacrill, which is not approved for use in the U.S. (one doctor I talked to compared it to liquid plexiglass), and there’s a surgeon in Cairo who’s developed a procedure to rotate a flap of groin fat into the penis to make it larger. Still, even as breast implants have become a $300-million-a-year business in the U.S., men have largely been left to make the best of what God gave them. In a world that has always devoted greater resources to diseases affecting more men than women, elective cosmetic surgery has long been an industry focused on females.
That’s begun to change. Especially over the past five years, procedures such as calf and cheekbone implants have increased as men shake off the stigma and embrace the prime drivers of such surgeries in women: vanity and self-affirmation. Without exception, the Penuma patients I interviewed said that their lives had improved since getting the implant. And it wasn’t just about sex. To have continued to settle for the status quo, they said, would have been to deny their potential in every area of life.
By this point you may be wondering: How have I not heard about this? The answer: Elist is currently the only doctor authorized by the FDA to insert the Penuma, and he has all the patients he can handle without doing any marketing other than a basic website. A 66-year-old surgeon with 13 patents to his name, Elist has inserted about 1,300 of his implants in men from all over America and from other countries around the world. The procedure has a 95 percent success rate, according to a five-year clinical study Elist commissioned and presented at an industry conference. That study is part of an ambitious expansion effort spearheaded by his son, a Harvard man who took a leave from his job at a top consulting firm to help his dad make Penuma huge. Elist is petitioning the FDA for clearance that would enable him to begin selling the devices to other doctors and teaching them how to perform the procedure. But until that happens, he’s the only game in town.
Elist’s urological career began in 1976, when he came to the U.S. as a medical resident from Tehran. Back in the ’80s, he was the lead author on the first scientific paper that linked cigarette smoking to impotence. Today, in addition to his Penuma surgeries, he is one of L.A.’s go-to guys for prepping adult ritual circumcisions. (Men who want a bris must be conscious to receive the mohel’s blessings, and Elist has a reputation for his skill at administering local anesthetic.) He is also an infertility expert. In his office on Wilshire Boulevard, he has a bulletin board labeled mission accomplished that is covered with photos of babies born with his help. Still, it was the nagging sense that he’d failed to accomplish another mission that led Elist to invent the Penuma.
Since 1980, the doctor had been inserting inflatable penis prostheses (5,000 of them to date) into impotent men, including Hustler publisher Larry Flynt. The devices, which were invented by a Texas surgeon in the early ’70s, re-invigorated these men’s sex lives, and they were grateful—at least at first. But as time went by, many of Elist’s patients came back with a not-small complaint: It seemed their penises were shrinking. It turned out they were right. Because the prosthetic is inserted into the spongy tissue in the core of the penis, as the body encapsulates the foreign object, the tissue constricts. (The opposite happens with the Penuma, because it is inserted under the skin and moves freely, preventing encapsulation. Men report that they actually gain length over time with the Penuma, thanks to the pull of gravity.)
The bottom line: Elist felt that as he solved one problem, he had unintentionally created another. And he wanted to fix that. He knew that silicone was the obvious material to use, because it had been proven safe (and was FDA-cleared) for breast implants and because it does not affix to tissue (thus allowing removal, if necessary, with minimal complications). Design-wise, he did not want to encircle the penis completely, because it needed to be able to expand; he envisioned an implant that would envelop about 80 percent of the organ, leaving a gap along the length of the underside.
The more he got into the logistics, the more Elist realized that the potential market for such an implant was far larger than the number of men who’d experienced shrinkage from inflatable prostheses. Elist’s “dream,” he told me, was to enhance the quality of life of men and their partners—like one gay couple he told me about, both of whom got the procedure done in the hopes of bettering their relationship. For the doctor, this wasn’t just about maximizing patients’ manhood, he said earnestly. This was about making the world a genuinely more joyful place. His original name for the implant? The Hap-penis.