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Over time the popularity of penis enlargement products and penis extenders has grown tremendously. There are over 20 different types and brands of extenders and it is often difficult to differentiate between them. Each may have their particular advantages and disadvantages. A crucial indication of the efficiency and safety of a penis extender is doctor approval or recommendation.
If a product has not undergone clinical studies or trial, it is often difficult to assume the quality, efficiency and safety of the product. For instance, non-approved extenders may not use non-allergenic metals, resulting in infections or allergic reactions to the low quality metals. If a product does not indicate that it is doctor recommended, it is important that you contact your doctor in order to ensure that the product is safe for use.
It is also important to note the type of doctor whom approved the product. Often penis enlargement products are approved by doctors who may not necessarily be associated with the field of penile enlargement. Doctors who are in this field are usually referred to as andrologists, urologists and phalloplasticians.

As a consumer you should note whether a doctor practices andrology, urology or phalloplasty prior to purchasing. While majority of penis extenders have received doctor approval, many devices have yet to undergo clinical study. The X4 Extender is amongst one of the only devices to have doctor approval as well as undergone clinical studies. It is also certified as a medical device and therefore abides by strict quality and medical standards.