Going into this project I was of course skeptical of whether or not the H2O vacuum pump would be enough to do the trick. FYI Being a Surgical Assistant for a OR team and having experience working on more than enough Genitourological cases to know. Penile erectile surgery should ONLY be a last ditch effort and that should be used only when it is the last possible solution that may fix a condition. So what do the rest of us guys use? I asked a lot of the male professionals I work with about this issue and believe it or not many of them do not have a real answer as for true long lasting penile enlargement. More so stating that there's not much "true" scientific evidence in proving these such devices work. However! One of my colleagues brought up this little device and told me of his personal gains, and let me say having mine for roughly a month. I can now see how and why this device can work. Let me be clear that You WILL NOT gain 4 inches in 4 weeks garbage that some porn sites propagate on there side bar, but overtime in theory as one hyper infills the spongy tissue that makes the penis erect. It should in theory respond to the external stimuli (aka the vacuum environment) and therefore grow to accommodate for the excess blood engorging the penis. FYI the process of Human Cell Division and growth is slow I mean like 10-20 hours a single cellular division slow. So the gains will not come over night. To see gains one must be patient and driven. So far in my journey in a month i now stand 1/4 of an inch roughly longer non-erect and about 1/4-.35 of an inch thicker in girth non-erect. To see constant gains short but frequent sessions must be used, too much time in the tube (longer than 20 min.) and you'll over train and possibly tear and damage tissue and even worse nerves. Slow and steady wins the race. Also too while using the pump make the water as hot as one can stand so that the heat helps expand and relax the penile tissue. As in terms for the actual product it is made of a good PVC like plastic. It's very comparable to the Bathmate Hercules model. The total length of the entire tube and rubber spring from end to end non compressed in a vacuum state is 11 1/2 inches. (if your bigger than 8 inches erect than I recommend buying a bigger model pump btw) overall I see that this product with proper care and handling lasting me several years. If I keep gaining roughly a little less than 1/4 of an inch every month like a am already in the long term... For any male out there reading this this will be the best Investment you will have ever made for yourself. Lastly this also works great too as a prep before sex <- (heard it hear first) device as well. The current GF loves it and it will surely give you brownie points in bed as well because the temporary gains one gets when just finished with the vacuum last for a few hours afterwards as well. So there are short term and more importantly long term benefits with this device. That's it hopefully in this review I cleared up some of the BS that is floating around on the internet in regards to how penile extension works anatomically as well... and again good luck gaining! in a few months I will leave another update with newer data on my gains too.