Recently there has been a flood of Internet chatter on silicone penile implants as an aesthetic procedure to enhance both length and girth (Penile Enhancement Surgery). The procedure is not performed as a surgical option for the treatment of erectile dysfunction. Unfortunately, due to search engine optimization, this has created confusion for those seeking a true penile implant. It must be clear to the inquiring patient that the aforementioned cosmetic implant has nothing to do with the FDA approved ones, two and three piece penile implants. It should also be clear that the traditional penile implant does not make a penis shorter, it makes them function. Impotence makes the penis shorter due to chronic hypoxia and fibrosis of the erectile bodies. Any method of penile length and girth enhancement should be supported by evidence-based research that clearly delineates the risk-benefit profile and I have yet to see any regarding the new silicone sleeve referenced in print and online. Until any patient is presented peer-reviewed and accepted data on safety and efficacy, I would recommend to them caution in making the decision to undergo such a procedure.