Penile implant technology has improved remarkably since the first inflatable devices of the early 1970s. The improvements were primarily to make the devices more reliable and less likely to mechanically fail. Various other modifications have been made to try to optimize the sizing of the prosthesis to prevent shortening and to provide the optimum length and girth to the penis. Unfortunately one can not make the penis longer or wider with a prosthesis as the tunica albuginea limits the length and girth that the penis can expand. When an implanted prosthesis is too large, it will simply buckle, create serpentine deformities of the penis or kinks and knuckles within the prosthetic cylinders. The key to placing a penile prosthetic is proper sizing. There are therapies that have been offered to potentially lengthen the penis using such things as vacuum devices or weights; these have not been demonstrated to result in any true lengthening of the penis without potential compromise in girth, and may indeed cause internal damage. Certainly the quest for making a larger penis remains, and the individual who discovers the key to this will certainly be able to write their own ticket to success.