Growing Pains

Glen Rains's operation didn't work out quite as he had hoped.
"My penis is all globbed up on one side and dented on the other," he explains slowly. "It's out of contour. Before, it was reasonably concentric. Now there's a divot on one side."

Not surprisingly, his wife, Kathy, is disappointed. She also is hurt. "I'm just not as trusting as I used to be," she says. "I wish we could go back in time."

Dr. H.L. Safford III is more upbeat. But then, he has performed almost 500 surgeries for the benefit of men who crave longer, wider--more macho--members. (About 10,000 such operations have been performed across the country.) "I constantly have made improvements," Dr. Safford says enthusiastically from his fifth-floor office in midtown Denver. "I'm having fewer and fewer complications and better results."

A fourth-generation physician, the grandson of one of the country's pioneering urologists and a board-certified urologist himself for a quarter-century, Safford underwent a professional transformation three years ago. He abandoned an apparently successful and locally esteemed practice dedicated to standard penis and prostate problems to begin a new career as the only practitioner of surgical penile enhancement--officially called phalloplasty--between Chicago and Las Vegas.

Cynics might carp that Safford did it for the money, pointing out that 500 operations multiplied by $7,000--what he charges for the inflationary surgery--comes out to a tidy $3.5 million over less than three years, a salary dreamland for most urologists. Patrick Haley, a local urologist and colleague of Safford's, suspects Safford did it to escape meddling insurance companies. But Safford will tell you that none of this is so.

He says that his new practice has been personally rewarding and that, when the medical changes of a grander penis are combined with the patient's psychological advances, penile-enhancement work has been more satisfying than the procedures he labored over as a traditional urologist.

"Before, when I did regular urology, removing cancers and so on, people walked out of my office and they were relieved," he says. "Now people walk out of my door and they're proud."

But what sort of man walks in Dr. Safford's door? What leads a man, even a man's man--Glen Rains is an auto mechanic--to voluntarily place his most private privates at the mercy of cold surgical tools? And why would one of Denver's most highly regarded urologists veer off the road of professional respectability to pursue a procedure that for years women have been assuring men is unnecessary?

HL. Safford III is a pale man with a long face, rimless glasses, gray-blue eyes with heavy lids, and close-cropped graying hair that makes him look exactly like one of those ageless Army veterans, which he is. He is tall and gangly, and his green surgical scrubs don't quite reach his ankles.

One wall of his small office is covered with diplomas, certifications and photos of mentors and idols, including an old picture of Dr. Michael DeBakey, the famous heart surgeon. Another wall holds his model train collection. A Xeroxed "Far Side" cartoon shows several cowboys sitting manfully around a campfire. One of them has his legs crossed, talk-show-guest style. "Frank...don't do that," one of the other cowboys tells him.

Although he is operating on what many physicians would consider the fringe of established medicine, Safford prefers to position himself differently. He suggests he is the latest in a line of misunderstood medical pioneers who endured vigorous public opposition before history and science vindicated them.

His grandfather, family doctor T. Leon Howard, practiced urology in Alabama at the turn of the century before helping found the American Board of Urology. Safford himself graduated from Baylor College of Medicine in 1968. He served in the Army for several years ("They used to call me the White Tornado because I was always in the front office arguing about quality of medical care," he remembers); upon his honorable discharge, he practiced mainstream urology for the next two decades. Among other prestigious appointments, he held the title of chief of urology for St. Joseph's Hospital in Denver. He performed his first penile-enhancement surgery just over three years ago, and he has done about 425 more since then.

During that time, Safford also has become a historian. He's in the process of writing a book about big penises through the ages. "People have been thinking about this for thousands and thousands of years," he says, citing, for example, the practice among some primitive tribes of tying rocks to boys' privates. "By the time they're young adults," he reports, "their penis is two feet long."

In America, surgical penile enhancement grew out of work first done in the beginning of the century on infant boys born with what doctors considered congenitally small penises (in adult sizes, that translates to less than three inches erect). Initially, it involved simply cutting the ligament above the penis, which permitted the penis to fall away from the pubic bone and thus lengthen. In the early 1980s that technique was combined with new procedures being used to reshape parts of a person's body by moving fat from one part, usually the legs or buttocks, to another, such as the lips or breasts.