Ever wish you could remove fat from your belly or love handles and simultaneously make your penis longer and girthier? A 30-year-old man in Sweden tried to do exactly that this week, by electing for penile enhancement surgery, but he had a heart attack during the procedure and died.

The case report describes “autologous fat transfer” as the process of removing fat cells via liposuction from a patient’s body and relocating them in an area the patient wishes to engorge — like the lips, butt, breasts, or penis. This Swedish patient was the first to die during what the case journal insists is a relatively safe procedure.

The surgeons in Stockholm blamed the fact that their patient elected to have two different kinds of penile enhancement surgery back to back. As Dan Vergano reports at Buzzfeed, “It appears that the key risk in the Swedish surgery was that the man had also had the penis elongation procedure just before the fat injections intended to increase girth. Some of the fat meant to increase the girth of his penis leaked into his veins cut during the first procedure, traveled to his lungs, and killed him.”

So, is penile surgery safe enough? There’s something to be said about any kind of elective, cosmetic surgery that carries the risk of death — this man felt such immense pressure socially to reshape his penis that he was willing to pay money, and put himself at risk, to see it happen. There is no information available on the case regarding his penis size, or the size he intended to be, but many studies prove that people of both genders prefer penises to be larger than they naturally are, on average. Interestingly, women who sleep with men prefer the penises of one-time sexual partners to be larger than the penises of men they commit to for longer periods of time.

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How much do you trust your penis?

A recent study by a redditor found that women are actually more satisfied, on average, with their partner’s penis size than men are with themselves.

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Redditor SaintUpid analyzes his own data.

Again, it’s unclear whether the man who died during surgery in Sweden was fixing a medical issue — perhaps trying to enhance a micro-penis, which can be devastating to a man’s mental health (again, largely because of social pressure), or if he was trying to attain a length and girth that most women don’t even tell researchers they want. Either way, it’s difficult to say whether the risks in penile enhancement surgery outweigh any benefits. On one hand, if an adult wants to modify their body to increase their self-esteem and feel at home in their skin, shouldn’t that be their right? On the other, anyone whose body image is so negatively affected by their perceived understanding of what potential sexual partners want is at risk of hurting themselves just to try and please an imaginary audience. But if that’s the case, then who can intervene?

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Dr. Tobias Kohler told Buzzfeed on the subject of penile enhancement, “It’s a completely useless procedure that never works and disfigures men, and could kill you.” He also added a harrowing detail, saying, “If you end up with something that nobody recognizes as a penis […] that is what we call sub-optimal.” Kohler, a urologist, subscribes to the same official belief as the American Urological Association, which says on its website that the surgery is neither safe nor useful.

If you have a penis, and you’re wondering where its girth and length fall among average measurements, you can measure yourself and double check here. However, no matter where you fall among the averages, keep in mind that prospective sexual partners, no matter their gender preference, have a wide range of ideas regarding ideal penis size. Chasing an imagined ideal, through all the risks of invasive surgery and despite most data arguing for a different penis size, probably isn’t healthy.

If, for whatever reason, you feel your penis isn’t big enough to please another person, consider that most women are unable to reach orgasm through penetrative sex alone. If sexual pleasure is an economic question, your ability to dole out orgasms as currency is more effectively increased by learning how to perform oral sex, or please a woman through clitoral contact, than changing your penis size. If you’re hoping to please a man and you feel your penis isn’t big enough to stimulate his prostate through anal sex, there’s always toys.

See also: What happens when you fracture your penis

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