Lengthening phalloplasty consists of a partial section of a membrane (the suspensory ligament) connecting the penis to the pubis, combined with skin plasty.
About 2.7 cm in length is gained.
The result is only visible when the penis is flaccid. The surgical procedure does not alter the length of the corpora cavernosa which cause the erection.
Two techniques are possible :
- Either lipofilling : Fat is removed to be reinjected into the penis. The gain is 2.6 cm in circumference.
- Or penoplasty through a hyaluronic acid injection : The volumising product is injected directly beneath the skin. There is a thickening of the circumference of the penis of two to three centimetres.
The result is visible when the penis is both flaccid and erect.
Testicle lift surgery
The scrotum is the bag of skin containing the testicles. It is naturally elastic and can be overly distended in some men, causing aesthetic and functional difficulties related to drooping testicles.
A scrotal lift must then be performed in order to reduce the excess skin and lift the testicles.
This procedure mainly concerns men who are at least fifty years old.
Phalloplasty makes penis enlargement possible. Most patients wishing to thicken or lengthen their penis have a normal sized penis. However, the embarrassment caused is so great that it can develop into a complex, or even into a real inhibition.
When the size of the penis is not satisfactory, the man may consider phalloplasty. The perception of size is often very different from one man to another. In its flaccid state (at rest), the average penis measures ten centimetres in length and nine centimetres in circumference. When it is erect, it measures an average of fifteen centimetres in length and twelve centimetres in circumference.
The desired increase must be realistic. Taking account of the patient’s motivation and expectations is very important so that the final result is not frustrating.
How the procedure works
The penis surgery operation is carried out under local or general anaesthetic without hospitalisation and lasts between thirty to forty five minutes.
Lengthening alone is very rare, because it is obvious that there is nothing to lose by combining it with thickening. In this case, in fact, there is an increase in the circumference of the penis when it is both flaccid and erect. In addition, the weight of the added fat stretches the penis and simultaneously helps to encourage the expansion of the skin tissue.
Patients often prefer thickening alone as it is lighter than the overall procedure, but both operations can be easily combined.
It is carried out using lipofilling. The fat is extracted from the pubis, the inner or outer thigh area, the abdomen or sometimes the buttocks. These areas are rich in adipocytes, have minimal sensitivity to weight changes and allow for better support of the fat graft over time.
The surgeon removes, without any prior infiltration, an amount of fat which varies between 40 and 70 cm3, using a cannula with a foam tip connected to a syringe. The fat is then transferred directly without being decanted or centrifuged.
The entry point for the fat injection is at the level of the groove that separates the glans from the shaft of the penis (the coronal sulcus). The surgeon then performs a balanced sowing of small amounts of fat, with an average of 0.5 cm3, up to the base of the penis, at its pubic angle.
The thickening of the penis can also be carried out using penoplasty by injecting hyaluronic acid instead of fat. The procedure is more gentle than lipofilling, but the results are temporary and the injections must be repeated every 18 month or so.
It involves making a partial section of a membrane, the suspensory ligament connecting the penis to the pubis, so that it hangs a little more, combined with skin plasty. It does not cause any inconvenient changes to the erection angle of the penis. The incision is made in the pubis.
After the procedure
The follow-up is mild and not very painful.
After a thickening of the penis
- No sutures.
- Slight swelling, a few bruises and no pain.
- No sexual activity for 2 weeks.
- Return to work 24 hours after the operation.
After a lengthening of the penis
- The sutures are removed ten to fifteen days after the procedure. There is no dressing to be made, the patient just needs to wash the area with soap and water.
- Pain therapy for a few days. Oedema and temporary deformation of the penis for a few days.
- No sexual activity for 1 month.
- Return to work 1 week after the operation.
One year after the phalloplasty procedure, the gain is approximately 2.7 cm in length and 2.6 cm in circumference. The penis retains its natural appearance and sensitivity and the patient feels no discomfort during sexual intercourse.
Penis thickening: Visible results when flaccid and erect
If the increase in length remains stable over time, additional sessions of fat injections are often necessary to achieve the desired volume of thickening. Indeed, the increase in penile circumference is 1.8 cm after one session and 2.6 cm after 3 sessions. It is important for the patient to be aware of these changes so they can anticipate the end result and not be disappointed after the first injection. The thickening of the penis is gradual. It is apparent when the penis is both flaccid and erect.
Penis lengthening: The result is only visible when the penis is flaccid.
The surgical procedure does not alter the length of the corpora cavernosa which cause the erection.