Penile Enlargement
Surgical techniques used for penile enlargement (enhancement phalloplasty) are penis lengthening and penis widening (girth enhancement).
There are various ways of enlarging the penis. In my practice, patients either have a lengthening or widening alone, or a lengthening and widening in a single session. I personally see in consultation all of my patients before and after surgery.
The Best Candidates for penile enlargement
In general, the best candidates are:
• The penis is short and/or small or relatively that interfere severely to confidence of patient
• In good physical health
• Psychologically stable
• Informed about limitations
• Free of known allergies to the implant material
• Realistic in their expectations for the outcome
The above is only a partial list of the criteria that your surgeon will consider in determining whether or not this procedure is appropriate for you. Be sure to ask your surgeon if he / she considers you an ideal candidate
Preparing For Your Surgery
Your surgeon will give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins, and medications.
If you smoke, plan to quit at least one to two weeks before your surgery and not to resume for at least two weeks after your surgery.
Do not eat or drink anything after midnight except a sip of water for medications. Please do not eat any spicy foods the day before surgery, or imbibe more than one social drink of spirits or beer.
Where Your Surgery Will Be Performed
Your penile enlargement may be performed in a hospital, an outpatient surgery center, or a surgeon's office-based facility. It's usually done on an outpatient basis, for cost containment and convenience. If you're admitted to the hospital as an inpatient, you can expect to stay one or two days.
Type of Anesthesia
penile enlargement are performed under general, spinal or epidural anesthesia, which means you'll sleep through the operation. In selected patients--particularly when a smaller incision is being made--the surgeon may use local anesthesia, combined with a sedative to make you drowsy. You'll be awake but relaxed, and will feel minimal discomfort.
The Surgery
PENILE LENGTHENING
Approximately one-third to one-half of the penis is inside the
body, and is internally attached to the undersurface of the
pubic bone.
Penis lengthening involves the release of the fundiform ligament and the suspensory ligament that attaches the 2 erectile bodies to the pubic bone. The suspensory ligament makes the penis arch under the pubic
bone. Release of this ligament allows the penis to protrude
on a straighter path, further outward to give more functional
length. I use a 1" to 1½" lower abdominal incision in the
pubic hair area for concealment or a incision in the
penile-pubic crease for concealment. This is a relatively minor procedure. There will be no scar on the penis and there is no possibility of pubic hair on the penis. I highly recommend use of specially designed penile weights to maximize penile lengthening and combat possible scar formation.
Penile length gain in the flaccid state.
Average expected length gain is 1 inch. Well motivated patients may gain up to 2 inches. After penile widening, the penis does not shrink to its original small flaccid length, but stays slightly longer. Penile length gain in the erect state.
Usually there is a slightly smaller penile length gain in the erect state than in the flaccid state.
Some penile length may be obtained by significant weight loss (greater than 35 lbs.) if a large infrapubic fat pad is present or by a penile stretching device.
PENILE WIDENING
This procedure can use both Autograft Dermal Fat Graft and Allograft Dermal Matrix Graft. I have noticed a permanent increase in penile girth (circumference) in the flaccid state with Allograft Dermal Matrix Graft technique. While a 40 to 50% gain in girth (flaccid state) may be achieved, most men get an increase of about 30%. An approximate 10 to 15% gain in girth is obtained in the erect state.
The advantages of Allograft Dermal Matrix Grafts over autograft dermal fat grafts are: it eliminates the need for incisions and scars at the donor sites (because there are none) and it significantly reduces the length of surgery.
With the Allograft Dermal Matrix Graft technique ,I are adding multiple layers of Allograft Dermal Matrix Graft under the penile skin on top of the erectile chambers to give thickness by "stacking" or "folding" the grafts. I do not use strips of Allograft Dermal Matrix Graft, but create a conjoined graft. There are no contour defects and appearance and feel are normal. A penile stretching device is suggested after the widening procedure to combat Allograft Dermal Matrix Graft contraction that might occur. This technique is effective with a high satisfaction rate.
After Your Surgery
Your penis may feel tight and sore as the anesthesia wears off, but you can control any discomfort with the pain medication prescribed by your surgeon.
You are not allowed to shower for at least 2-3 days and must keep the incision(s) dry to prevent infection and to aid in healing. Usually, you can get the incision(s) wet about 10-14 days. Do not rub the suture area(s), but rather pat dry.
Usually there are no sutures that need to be removed. If your sutures are removed ,you do not use a hot tub or whirlpool bath until one week.
The penile dressing will be removed by your physician in 10 to 14 days if you had the penile widening procedure.
Use boxer shorts and sweat pants as long as you have discomfort or penile swelling. When dressing, do not bend or fold your penis. You may wish to place your penis up on the abdomen for the 1st 4 days after which we want you to allow the penis to hang down in boxer shorts for 4 to 6 weeks.
You may expect some swelling and discoloration of the penile shaft, scrotum, lower abdomen for approximately 1 to 2 weeks. You may elevate the scrotum and penis on a towel placed between your legs to minimize swelling.
While complications (i.e. infection, bleeding, any part of an) is unlikely, I wish you to watch for signs of infection, i.e., redness, swelling, green drainage. If any of these occur, please let me know within 24 hours. If bleeding occurs, apply direct pressure with a gauze for 15 minutes. Call me if bleeding occurs after this. If incision opens, please let me know within 24 hours, and if you are using a stretching device stop using it immediately.
An doctor visit is required 24 to 72 hours after surgery to observe the incision(s) and surgical sites and to change the dressing, if necessary. A second doctor visit is recommended one week later. Out of town patients must be seen at least one time prior to leaving town.
Routine follow-up visits at 1 and 3 months after surgery are recommended.
PENILE STRETCHING DEVICE :If you have had the widening procedure (pericavernosal) alone or in combination with the lengthening procedure, you will start using a penile stretching device under my supervision between 6 and 8 weeks. If your procedure is staged, meaning it is performed in two parts, with the first procedure being the penile lengthening, you may start using the weights about 4 weeks after the surgery. Initially, you will have the weights on for 5 to 10 minutes and then off for 15 to 20 minutes. This may be repeated in sets of 4 to 5, before work in the morning and in the evening. Alternative exercise programs will be discussed with you.
These weights are extremely safe when used properly. However, potential risks include: contact dermatitis, bruising; vascular, erectile tissue and nerve injury, possibly causing or contributing to erectile dysfunction or loss of the penis. See detailed instructions from the manufacturer included with the stretching device.
After a period of time, you may gradually increase the amount of weight and length of time, determined by your comfort level and the guideline I will give you. You should never use the weights if they cause discomfort, or change in penile sensation (feeling), color or temperature of the penis. If you have any concerns you should stop using the weights and inform me before starting again. For optimal results, you may wish to use the weights for about 6 months.
Getting Back to Normal
Light activities may be resumed in about 3 to 7 days and strenuous activities in 4 to 6 weeks.
Athletic and other strenuous activities such as running or extensive walking must be avoided for at least 5 weeks. No aerobics or contact sports are allowed for at least 6 weeks. You may engage in upper body exercise after 3-4 days.
You should sleep on your back as much as possible for 1 to 2 weeks
You should not have penetrating sex (i.e., sexual intercourse) or sustain any genital trauma or significant pressure for 6 weeks.