Surgical techniques used for penile enlargement (enhancement phalloplasty) — penile lengthening and penile widening (girth enhancement) — have been in the urologic literature for many years. 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. Glanular enhancement may be performed alone or combined with any procedure.
► 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. Penile 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 new 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.
Penile length gain in the flaccid state.
Average expected length gain is 1 inch. Well motivated patients may gain up to 2 inches. After widening, the penis does not shrink to its original small flaccid length, but stays slightly longer.
Penile length gain in the erect
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. Complications may be associated with these forms of treatment. Also review about penile enlargement surgery ( phalloplasty ).
► PENILE WIDENING BY FAT TRANSFER
Using a person’s own fat to fill many parts of the body (face, breast…) is now a well-established technique which was perfected in the early nineties to a predictable procedure. he necessary fat is obtained by a limited liposculpture through one or several 3-5 mm incisions. It is normally taken from the abdomen or inner thigh. The aspirated fat is processed by centrifuging, filtering or rinsing. Pure liquid fatty tissue ready for injection is the result. The fat is then injected where needed. The fat is evenly distributed into the area by injecting minute amounts in the tissues so that the injected fat is well surrounded by healthy tissue. This ensures that the transplanted fat remains in contact with the surrounding tissues which must supply it with oxygen and nutrients.
► Possible Side Effects
Donor area: bruising, swelling, tenderness, up to 24 hours drainage of anaesthetic liquid.
Treated area: bruising, swelling, tenderness.
The areas that have been treated will be rather swollen immediately after the operation. It is therefore important to use a cold pack and a compress in the first few hours to minimize the swelling. A cold pack is a freezer bag filled with ice cubes and water.
The swelling will increase until about the third day, but will then gradually subside. If any bruises have developed, they might remain visible for a little longer (2 to 3 weeks).
By then most of the swelling will have subsided, but the correction may still look rather exaggerated. Surgeons usually over-correct, which means injecting more fat than is actually needed because 25 to 30% of the transplanted fat cells do not survive. The final result is assessed after three months. The surgeon will then take photographs to be compared with those taken before the procedure. A second session may be scheduled to top up any shortfall in volume.
Asymmetry, irregularities, overcorrection, infection.