WHETHER it’s because of an accident of birth or the result of tragedy, it’s good to know there’s someone out there who can create you a new 4-5 if you need it.

According to The Sun, British surgeon David Ralph is one such expert. He told them the long and complex steps he takes in making a new 4-5.

Step one is to grow a flap of skin which will be rolled and transformed into the new 4-5.

"The forearm is the gold standard as it is nicer skin with more sensation," David said.

Once the skin flap is shaped like a 4-5, the next step is attaching it to the person. This involves surgery which can last as long as 10 hours.

"We use a microscope to join up the blood vessels and nerves so you have some erogenous sensation and we also join up the waterworks at this stage," David says.

Three or four months later it’s time for the shaping surgery.

"This is a more cosmetic operation on the head of the penis to make it look less like a tube of skin," he said.

Next, it’s time to implant the special cylinder that is used to make the 4-5 erect.

Besides the cylinder in the 4-5, the device also involves a pump and a small bag of fluid placed inside the stomach.

"When you squeeze the pump you transfer fluid from the reservoir into the cylinders inside the penis which mimics an erection," said David.

"Then when they’ve finished having sex there is a little button that you press and the fluid goes back."

Most men are also able to ejaculate, as long as there is enough sensation in the new 4-5.

The process is not the same as the one followed for penis enlargements, said the doctor.

It is also different to the penis transplant operation that has been successfully carried out in several countries – including Mzansi. This involves attaching a donor’s 4-5 to the person needing it.