Phalloplasty is a surgical procedure to increase the length and/or girth of the penis.

 

Who requires this procedure?

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Penile plastic and reconstructive surgery has undergone considerable development in recent years, having to provide an answer to the growing demand from patients to increase the size of their organ. Lengthening and/or enlargement phalloplasty is a valuable aid both in those patients who are dissatisfied with their size and in patients suffering from Penile Dysmorphia (Stripper Syndrome or Small Penis Syndrome). In addition, with these surgical techniques it is also possible to treat conditions such as Induratio Penis Plastica (La Peyronie's Disease), Hypospadias, Failed Hypospadias, Penile Carcinoma, Incarcerated Penis (Trapped/Buried Penis), Micropenis.

 

Is there a single standard procedure to increase penis size?

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No. In principle, the choice of surgical method is related to the different physical characteristics of each patient. In fact, there is no standard surgery for all patients. What is important to emphasize is the tailoring of the surgery to the patient (Tailored Therapy).

For example, in a patient with a small penis and in the presence of considerable suprapubic fat, lengthening surgery by a combined procedure of penile suspensory ligament incision, dermolipectomy or suprapubic liposuction, and penile skin redistribution will be indicated. 

Conversely, in a patient with erectile dysfunction, penile fibrosis or Induratio Penis Plastica (La Peyronie's Disease), conditions that alter the function, shape and size of the penis, in order to increase penile length and girth, prosthetic implant surgery with reconstruction of the tunica albuginea will be indicated.

With this type of surgery, a real lengthening and enlargement of the corpora cavernosa of the penis (1 to 5 cm) will be achieved by incision of the anatomical structure covering them (Tunica Albuginea) thus ensuring the increase in size of the organ. At the same time, implantation of penile prosthesis is performed through the same incision. 

 

Instead, many patients present with a 'webbed penis' or 'bat wings,' an anatomical, congenital or acquired condition characterized by an abnormal insertion of the skin of the scrotum at a higher point along the penile shaft. This abnormality may be present from birth (congenital) or acquired such as after overly aggressive circumcision surgery for phimosis.This results in physical and psychological discomfort and requires surgical correction by a 'Scrotoplasty'. 

Same 'scrotal lift' technique can also be used in cases where the skin of the scrotum becomes less elastic and stretching causes excessive drooping downward.

 

 

Is it possible to increase the circumference of the penis?

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It is possible by means of lipopenosculpture

What does it consist of?

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Coleman's lipopenosculpture is essentially based in autologous transplantation (fat cells) from excess adipose at the abdominal - pubic level and then re-injected at the level of the foreskin. Increases of about 25 to 30% are described with this technique. The results are satisfactory: the penis appears longer and increased in thickness especially in a flaccid state.Are there any patients for whom it is inadvisable to undergo the procedure?

Yes, chronic smokers have a tendency, due to altered microcirculation, to absorb the injected fat more quickly.

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Is it a technique that solves the problem permanently?

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No, after about 12 months the fat reabsorbs.

Is there a more durable enlargement technique?

 

Yes; phalloplasty with freeze-dried porcine dermis matrix. A freeze-dried, lab-grown collagen dermis graft is used, which is very similar to penile cavernous tissue. The flap is grafted at the level of the penile dermis without incising the corpora cavernosa and is sutured with stitches that will resorb independently

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How many days of hospitalization do these procedures require?

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Lengthening and enlargement phalloplasty procedures are performed on a day-surgery basis or at most with only one night of hospitalization

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What are the benefits of these procedures?

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The benefits from a sexual point of view can be both psychological and physical. The former come from the patient's increased self-esteem, while the latter are due to the increased size that results in greater sexual pleasure for both partners.

The increase in penis size varies from patient to patient. Usually elongation appears greater with the penis at rest or in patients who have had a suprapubic panniculus adiposus removed. It usually ranges from 2 to 4 cm at rest. As for the increase in girth, it can range from 2 to 5 cm depending on the technique used. Separate discussion regarding tunica albuginea grafting and penile prosthesis implantation surgeries due to which elongation at erection can range from 3 to 5 cm

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What are the most common adverse effects?

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Like all surgical procedures, this technique exposes to potential undesired effects such as preputial or penile edema, hematoma of the corpora cavernosa. One must keep in mind, however, that they are all reversible and short-lived.

 

What happens in the postoperative period?

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The patient is discharged the same day or after 24 hours; the rules to follow in the postoperative period are simple. Rest for a few days, avoid cigarette smoking, a varied and balanced diet. In addition, the patient should come to our clinic for all check-ups and dressings to prevent any complications. We recommend abstaining from sports activity for 2 weeks, and 3 weeks for sexual activity.

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Are there also non-surgical alternatives for penis enlargement?

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Non-surgical techniques for penile enlargement can be achieved through the use of medical-surgical devices such as the vacuum device and the penile extender. The results depend strictly on the duration of the treatment; in fact for there to be a satisfactory result for the patient there must be constant application for months or even years.

In the field of noninvasive solutions, a very effective technique for penile enlargement is the injection of hyaluronic acid.

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What is hyaluronic acid?

Hyaluronic acid is a biocompatible filler (filler) that has been used in aesthetic medicine for years.  This naturally occurring carbohydrate polymer found in epithelial, neural, connective (cartilage), eye (vitreous) tissues can also be used to proceed with non-surgical penile enlargement.

Hyaluronic acid injection for volume augmentation is performed on an outpatient basis and should be done precisely between the Dartos and Buck's fascia, above the neurovascular bundle.

Hyaluronic Acid Injections if performed by an experienced andrological surgeon are absolutely safe.

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What are the most common side effects?

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Pain and redness at the injection site.

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How long do the benefits of hyaluronic acid last?

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High-density hyaluronic acid is used for penis enlargement that is completely resorbable in 12 months. The increase in girth can range from 2 to 5 cm.
If the patient is satisfied with his penis enlargement, he can repeat the treatment without any contraindications

Before undergoing genital surgery, it is advisable to correct certain behaviors such as reducing caloric intake, reducing blood sugar, and reducing or eliminating cigarette smoking. Just smoking represents one of the major problems for this type of surgery, going to interfere with the peripheral vasculature, impair tissue healing and increase postoperative complications.

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