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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. I personally see
in consultation all of my patients before and after surgery
and perform all the surgical procedures myself.
Click to see before and after photos of lengthening procedures:
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 Allograft
Dermal Matrix Graft (Alloderm ®) 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.
PENILE
WIDENING (PERICAVERNOSAL)
Click to see before and after photos of widening procedures:
We have noticed a permanent increase in penile girth (circumference)
in the flaccid state with our pericavernosal (P/C) Allograft
Dermal Matrix Graft (Alloderm ®) 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.
Because autograft dermal fat grafts
for penile widening require a donor site(s) and, therefore, incision(s)
and scar(s) --- 6 years ago I stopped using autograft dermal fat
grafts and since then only use Allograft
Dermal Matrix Grafts (Alloderm®) in my patients who wish
penile widening.
The advantages of Allograft
Dermal Matrix Grafts (Alloderm®) 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 (Alloderm ®) technique we are adding
multiple layers of Allograft Dermal Matrix
Graft (Alloderm ®) 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 (Alloderm ®), 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 (Alloderm ®) contraction that might occur.
I have found this technique to be effective
with a high satisfaction rate. These procedures are performed in an
outpatient ambulatory setting, either at a hospital or in a private
surgical facility. State licensed personnel use a combination of
anesthetic techniques that will assure you a painless experience.
SECONDARY
AND TERTIARY PENILE WIDENING (PERICAVERNOSAL)
Click to see before and after photos of widening procedures:
Sometimes a patient who has had penile widening by: liposuction/lipotransfer
(fat injection) or autograft dermal fat graft or Allograft
Dermal Matrix Graft (Alloderm ®) (pericavernosal) wants
additional girth enhancement.
During the last six years I have used my Allograft
Dermal Matrix Graft (Alloderm ®) penile widening technique
to insert Allograft Dermal Matrix Graft
(Alloderm ®) above or below the previously inserted graft(s)
with very satisfactory results in patients who had one or a combination
of the above widening procedures. Click to see before and after photos of glanular enhancement procedures:
Glanular enhancement is a relatively new surgical technique. Very few surgeons around the world are performing it. However, it can be done successfully with the Allograft Dermal Matrix Graft (Alloderm ®). A reasonable expectation is between 15% and 20% increase in the flare of the glans. If performed with penile widening, no additional incision is required. A penile stretching device is not necessary after this procedure. Some men have penile curvature in the flaccid state only. This can be corrected without surgery on the erectile chambers by insertion of Allograft Dermal Matrix Graft (Alloderm ®) when used for penile widening. Click to see before and after photos of flaccid penile straightening: Click to see before and after photos of correction of penile glanular disproportion: If the scrotum extends along the underside of the penis it may make the penis appear short on the underside, like a "turkey neck." This can be corrected by various techniques under local anesthesia, or at the same time as penile lengthening or penile widening or glanular enhancement. Click to see before and after photos of correction of penoscrotal webbing: If the scrotum becomes enlarged due to age or is perceived to be too large it may be reduced under local anesthesia. The foreskin can be modified to a: (1) Standard Circumcision (2) High Circumcision or (3) Low Circumcision. REDUCTION OF INFRAPUBIC AND SUPRAPUBIC FAT PAD If the pubic area has excess fat due to increased pubic or suprapubic fat the penile shaft may be partially or completely hidden. Various procedures can make the penis more visible. These procedures are usually performed at the same time as penile lengthening or penile widening.
LIPOSUCTION AND FAT INJECTION TECHNIQUE Since 1991, surgeons have performed
liposuction and fat injection into the penis. While this can temporarily
widen the penis, in the long run, I find this procedure unpredictable.
It often results in penile irregularity and the augmentation always
decreases with time. During an erection the injected fat will be softer
than engorged tissue that hardens the penis.
Men who are particularly poor candidates for this technique are
those with little body fat (lean men). These men are often: bodybuilders,
weight lifters, models, actors, and dancers. Often these men require
several injections over time to have more fat injected into the
penis.
I do not perform this procedure. Click
on the patients below to view before and after photos of patients
that have experienced penis irregularity and penis deformity after
liposuction and fat injection into the penis. Patient
2, Patient 4, Patient
5, Patient 6, Patient
7 and Patient 8.
DURING YOUR CONSULTATION WITH ME IN MY OFFICE I WILL DISCUSS AND
PUT INTO PERSPECTIVE THE FOLLOWING ISSUES AS THEY RELATE TO MY
SURGICAL TECHNIQUES.
The frequency of complications is not known because there are
no large-scale studies reported in the medical literature. Consequently,
some physicians consider these procedures to be experimental or
investigational.
The following complications from penile lengthening and Allograft
Dermal Matrix Graft (Alloderm ®) widening (pericavernosal)
are theoretically possible:
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 Frequently
Asked Questions about penile enlargement surgery ( phalloplasty
).
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Dr. E. Douglas Whitehead, M.D., a renowned phalloplasty surgeon, provides this penile enlargement web site to explain the various medical procedures available for penile enhancement surgery including penis enlargement, penis lengthening, penis widening, penis straightening (Peyronie's disease), penile girth enlargement and glanular enhancement. The content is not intended to be a substitute for professional medical advice, diagnosis or treatment. For more information about penis enlargement surgery e-mail us for a free informational packet or to schedule a confidential penis enhancement consultation with Dr. Whitehead call 1-800-575-1112. |