Phalloplasty

If the size of the penis is not adequate, a man may consider phalloplasty. The perception of dimensions is also very different from one person to another. In the state of flaccidity (at rest), the penis is on average ten centimeters long and nine centimeters in circumference. When erected it measures an average of 15 centimetres in length and 12 centimetres in circumference.

The motivation to increase has to remain realistic. Therefore, taking into account the motivations and desires of the patient is very important so that the final result is not disappointing.

Penile surgery is done under local or general anaesthesia without hospitalization and the duration is between thirty and forty-five minutes.

Lengthening alone is very unusual, because it is clear that the treatment would be more advantageous if it is combined with thickening. In this case, the diameter of the penis increases during rest and erection. In addition, the weight of the added fat extends the penis and at the same time tends to facilitate the expansion of the skin tissue.

Patients often prefer thickening alone, which is less complex than the overall procedure but both procedures can be easily combined.

The thickening penoplasty

It is done by lipofilling. The fat is extracted from the pubis, the inner or outer thighs, the belly, or even the buttocks. These areas are rich in adipocytes that are not very prone to weight fluctuations and allow for better maintenance of fat graft over time.

The surgeon extracts, without prior infiltration, a quantity of fat that varies between 40 and 70 cm3 using a cannula with a foam tip attached to a syringe. The fat is then directly transferred without decantation or centrifugation.

The point of entry for fat injection is at the furrow level, which divides the body from the penis (the balano-preputial furrow). The surgeon then seeds a small amount of 0.5 cm3 of fat on average at the base of the penis, at its pubic angle.

Penis thickening can also be accomplished by a surgical penoplasty with injections of hyaluronic acid instead of fat. The treatment is easier than lipofilling, but the effect is temporary and the injections must be renewed every 18 months.

The lengthening penoplasty

It consists of a partial segment of the membrane, the suspensory ligament that connects the penis to the pubis, so that it hangs a little more, connected with the skin plasty. It does not result in a disturbing change in the angle of erection of the penis. The incision is made at the pubic level.

The effects are moderate and not very painful.

After a thickening of the penis

• No threads.
• Light swelling, few hematomas, no discomfort.
• Sexual pause for two weeks.
• Resume of activity 24 hours after the procedure.

After a lengthening of the penis

• Ten to fifteen days after the operation, the threads are removed. There's no dressing to do, just a simple washing with soap and water.
• Treatment with painkillers for a few days. Oedema and temporary deformation of the penis for a couple of days.
• Sexual break for 1 month.
• Resume of activity 1 week after procedure.

One year after the phalloplasty operation, the increase is approximately 2.7 cm in length and 2.6 cm in circumference. The penis maintains its natural shape, sensitivity and does not feel any pain during intercourse.

Thickening of the penis: Visible results during rest and erection

If the increase in length stays the same over time, additional injections of fat are often needed to achieve the desired thickening volume. Indeed, the rise in penis circumference is 1.8 cm after one session and 2.6 cm after three sessions. It is necessary for the patient to be aware of this evolution in order to predict the final result and not to be disappointed after the first injection. The thickening of the penis is gradual and noticeable during rest and erection.

Lengthening of the penis: Result is visible only at rest.

The surgical method does not change the length of the body responsible for the erection.

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