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Their path to Schoemen's door begins in the sports pages of the Post or Chronicle, where advertisements for Surgicare for Men frequently appear, tucked among the box scores and other ads for gun stores and topless bars. Callers to the number in the ad usually get a recorded message assuring them confidentiality and directing them to leave a message because "all medical staff are currently with patients." That's curious, since the entire office "staff" consists of Schoemen, the 20-ish, quick-talking marketing man for Surgicare for Men. He returns the calls and makes appointments for a "free consultation."
Prospective patients are greeted by a busy brunette who also fields a barrage of calls for the businesses that share the fifth-floor suite with Surgicare for Men, including Optimal Energy Inc. and Injury Management Organization Inc. "It's hard to remember what to say," the secretary admits, since each blinking button is linked to a different greeting for a different business.
Schoemen ushers potential customers back to an office sparsely adorned with three framed certificates on a wall, a bookshelf, three chairs and a desk. Screenings take anywhere from 15 to 30 minutes "depending on how many questions they have," he explains.
Schoemen describes the penile enlargement procedure and its cost -- $3,900 for widening or lengthening; $5,900 for both latitudinal and longitudinal enhancement -- and displays "before and after" photos of (apparently) satisfied customers. Easy credit terms are discussed; those who'd like to secure a loan for the cosmetic surgery (not covered by medical insurance plans) are referred to a finance company. The procedure, candidates for enlargement are told, is performed at the Northwest Freeway "surgery center" of Dr. B.R. Ringer, a local osteopath (who did not return calls for this story).
Surgicare's ad in the Post -- with the come-on that "Dreams Do Come True" -- promises an average increase of one to two inches in length, a 30 percent to 50 percent increase in width and, somewhat cryptically, "self-improvement." Surgicare for Men also advertises in Penthouse and the bodybuilding publications Muscular Development and Iron Man.
The other penile lengthening and enlargement enterprise that advertises in the local sports pages markets the services of a Dr. H.R. Safford III, who offers "over 20 years of surgical experience on males" (the cosmetic use of penile surgery, however, began only about three years ago). Safford, who lives in Denver, is described in the "for men only" ad as "the only M.D. board-certified urologist performing this surgery in Texas."
That distinguishes him from Dr. Ringer, who doesn't have an "M.D." after his name but is a doctor of osteopathy, a discipline that requires slightly different training but is recognized as a standard system of medical and surgical care. The ad does beg at least one question: if Safford is the only board certified urologist performing this surgery in Texas, is there a reason why other traditionally accredited surgeons aren't doing it?
Yes sir, there is.
Mainstream urologists say the procedure can be risky and note that there have been no studies published on its effects.
And it isn't necessary, they say.
Dr. Perry Nadig, a clinical professor of urologic surgery at the University of Texas Health Science Center at San Antonio, has blunt advice for anyone thinking of having penile enlargement surgery: don't.
"First of all, why would someone want to have it done?" he says. "If you have a self-image problem, you don't go to a cosmetic surgeon, you go to a psychiatrist."
But Ed Tilden, the marketing boss for Surgicare for Men in Newport Beach, California, says that if women can have cosmetic surgery, why can't men? "Twenty years ago when women came in and said they wanted face-lifts and breast enlargements, no one told them to go see a psychiatrist. What's wrong with a man trying to improve himself?"
Nadig is distressed by the widespread marketing of the surgery, especially the advertising "for an experimental procedure, and that's what this is. I feel very uncomfortable because the patients need to have full disclosure. They need to know it's an unproven procedure of unproven safety and efficacy." Nadig is virtually quoting the American Urological Association's two-sentence policy statement on penile enlargement, which notes that no scientific study has been done to support the ads' claims. Conversely, none has been published to debunk them, which is no surprise to Nadig. "It's hard if you're trying to prove a negative. If you don't think something is going to help a patient, you don't want to do it to them."
Surgicare's Tilden doesn't dispute the lack of studies, but he says that's because the surgery is relatively new. Previously, the procedure was done only to correct rare cases of microphallus -- an abnormally small penis -- or after penile damage due to trauma.
So how's it done?
The lengthening of the penis is achieved by cutting the suspensory ligament at the root of the penis, thus advancing the appendage from underneath the pubic bone, usually for about one to two inches. That decreases the stability of the penis and sometimes results in loss of elevation on an erection. It also requires the use of hair-bearing skin at the base of the penis.