Eight years ago, Beverly Hills urologist James Elist invented the Penuma, a new form of cosmetic surgery to enhance men's penises. For $16,000, Dr. Elist makes an incision just above a patient's penis and inserts the Penuma, a sheath of silicone, into the shaft, adding anywhere from one to two inches in length and up to two and a half inches in girth. Elist has performed the surgery on some 5,000 patients since he pioneered the procedure in 2015 and has a long waiting list of clients. Cosmetic surgeons from around the world have visited to learn his technique.