Furthermore, Gregory highlightings two other recent developments: the proliferation of pornography and the rise of TV shows where brutal physical objectification has become, for the first time, an equal-opportunities phenomenon.

” Young humen generally become preoccupied with the size of their genitals when they compare with others ,” she says.” Historically, this was limited to changing rooms or the odd top-shelf magazine. But now there is this almost routine exposure to porn via smartphones. And that is creating a generation of men whose expectations of what they should look like are entirely unattainable .”

Added to that, she says, is the popularity of reveals such as Love Island where objectification comes as standard. In the summer of 2017, one male contestant was described as having” a penis like a baseball bat “; it was, unequivocally, a compliment. None of this objectification is new, of course: it’s just new for men.” But that doesn’t mitigated the impact ,” Gregory says.” For the individual who is going through the trauma of dreading his penis is too small, this is still devastating .”

All this might be leading to more than simple image anxiety; some have pointed to a new mental-health issue they words penile dysmorphic disorder.” It is a minority of men- and we don’t know how many- but it certainly exists and it’s as damaging as any other body dysmorphia ,” says Professor David Veale, of King’s College London, an authority on health anxieties.” These men might seek out surgery, and for a few months they will be happy with the results. But then the same anxieties reappear. So, they seek out further surgery. It becomes a circle. But you cannot keep making your penis bigger. This requires therapy .”

Largely, he says, these cases remain undisclosed.” Those who suffer don’t inevitably realise themselves, and rarely acknowledge it. It is an invisible illness .”

So how can we be sure it really exists?” Because the number of men seeking surgery, or the growth of this strange industry selling pills and other so-called enlargement redress, these numbers do not map up with the numbers of men who actually have a significantly smaller penis than average ,” Veale says.” So, these men are worrying about- and trying answers for- a problem they do not have .”

Veale’s theory chimes with the experience of a retired marketings director I satisfy in a drab Sheffield consultancy room. A lifelong bachelor, Eric Bell, 68, is charming and well-dressed, if, with a beard tinted blue, a touch eccentric. He is also in preparations for his third penis expansion- an operation that, judging from the sizeable member already between his legs, is unnecessary.” I’d just like it a bit fatter here ,” he explains, circling thumb and middle thumb around the top of his shaft.” I’m single, but it induces me happy knowing I have something eye-opening down there .” We expend five minutes discussing the merits of this before he asks his own question:” Can I put it away now ?”

Bell says he had his first enlargement in 2015, a year after agony the trauma of his brother drowning in York’s River Foss.” I suffered severe depression ,” he says.

Are the two things linked? “Possibly,” he says.” I don’t know. I don’t think about it .”

Bell is a patient at Moorgate Aesthetics, which has head offices in Doncaster. When I ask managing director David Mills if this may be one client who doesn’t need any more girth, he waves away the concern. Bell, he says, knows his own mind, and has passed a psychological evaluation. The operation goes ahead.

This evaluation is something all clinics I speak to insist on. It involves a patient meeting with a surgeon or psychologist to have their general mental wellbeing assessed. If there is any hint of underlying concerns, problems or mental health issues, the operation does not go ahead. But, given that such a repudiation would entail clinics losing PS5, 000 a pop, one does wonder how rigorous these assessments are. Is the entire industry merely profiting off insecurity bordering on dysmorphia?

Dr Roberto Viel supposes not.” I tell my patients we can give you a bigger penis, but we cannot build you happy ,” he says.” You must be happy first, in your heart and head. If not, this operation “re not for” you. All it would mean is you are still unhappy – you just have a slightly bigger penis .”

Professor Ralph at UCL believes that some clinics are feeding patients’ unrealistic expectations.” Initially, they don’t see doctors, they watch marketings people. It’s a hard sell:’ We can get you an extra inch or two .’ I’ve been practising in the NHS for 30 years: if it was that easy to increase the length of a normal penis, I’d be in the Mediterranean on my cruise liner now .”

Ralph thinks that” penile stretchers”, marketed under the name Andropenis, can be just as effective; but few humen are prepared to stimulate the commitment of wearing a traction device for six hours a day for six months. He also points out that, for men with an unhealthy BMI, weight loss can be enough to induce the penis appear bigger.

In a last brief conversation with Alistair, he asks if I would ever consider running under the knife. I tell him I’ve seen such a bewildering array of shapes and sizings over the past few weeks, I don’t even know what normal is any more. If it does the job nature intended, I say, that should be enough. For many humen wanting an expansion, it’s probably not so much about what’s in their pants as what, somewhere along the way, has got into their minds- and that can’t be fixed by a fat injection and a severed ligament.

Alistair thinks about this and appears to agree:” Once it’s in your head, it’s difficult to let it go- even after you’ve had surgery .”

* Alistair’s name has been changed.