Phalloplasty

Penis enhancement surgery is a relatively simple, safe operation performed on an out-patient basis under light, general anesthesia. This surgery, which is performed in our state of the art surgical facilities, actually involves two separate procedures. Both are completely natural and do not involve the introduction of implants or other foreign materials.

In the lengthening procedure, the doctor releases the suspensory ligaments that attach the penis to the under surface of the pubic bone. This allows access to the section of the penis hidden behind the skin wall. He is then able to extend the length of the penis in proportion to the length of the internal portion.

The increase in length varies depending on a patients anatomy; however, results generally range from 1 1/2″ to 2 1/2″ when flaccid (not aroused) and 1″ to 1 1/2″ when erect. The limiting factor is the patients’ own anatomy. There is no way to predict what the length gain will be prior to surgery.

Post-operative stretching is essential to the success of the surgery; ensuring that the penis does not retract back into the body.

The enlargement procedure involves a simple transfer of fat cells. The patient’s own fat cells are used for augmentation because they do not run the same risk of rejection from the body.

The result is a penis of the same shape and length, but greater in circumference. Because the penile shaft is narrower than the maximum diameter of the head, the doctor usually fills out the shafts slightly beyond the heads maximum diameter to maintain proper proportions.

Circumference can be increased by 50% or more; depending on the results desired by the patient. In each procedure, increases occur in both the flaccid (not aroused) and erect state although length gain in the flaccid state is generally greater.

The MISL™ Procedure is a minimally invasive surgery, accomplished with the use of LASER ©. In this procedure, no actual length is created; rather, the internal portion of the penis is “advanced” or “externalized”, exposing greater length.

This is accomplished by resecting (cutting) the suspensory ligaments which hold the penis against the under-surfaces of the pubic bone, between the legs. Additionally, another 3-4″ of the penis is located inside the body. This penile root actually arches upward inside the body, and by resecting the suspensory ligaments, this upward arch is extended forward. A simple 1″ curvilinear incision in the pubic area is all that is required to gain access to ligaments.

For overweight men, removal of some of the fat in the pubic area will also add to the perceived length increase of penis. There is a small percentage (2-3%) of men who get no length gain at all in the erect state. More rarely, even a loss of a bit of length due to scar tissue formation and tretraction if the stretching program is not followed is possible.

We have developed and pioneered the use of the LASER© to detach the ligaments. The advantages to this method are a smaller, 1″ incision resulting in less pain, swelling, bruising as well as a quicker healing period.  There is also less scar tissue produced to possibly obstruct the lengthening; producing an overall improved result from the procedure.

The ligaments are then re-stabilized to prevent any change in the angle of erection as well as prevent “scar retraction” which could compromise the results. The use of magnifying loops also helps make this a more precise operation.

1. Begin use as soon after removal of the bandage after surgery as swelling will allow a comfortable fit – usually 10 days to 2-3 weeks. Sometimes more time is needed for uncircumcised patients.
2. Keep minimal tension with the penis pointing upward towards the navel for the first month as instructed. After the first month you can wear it with the penis pointing downward and increase tension as tolerated.
3. Begin with 2-4 hours a day for the first week, gradually working up to 10hrs/day by the end of the first month after beginning to use the “HH”. Sleeping with it will suffice for most of the required time. You may of course use it more if you like.
4. At the end of four weeks you may now start adding the extenders at the rate of one every 5-7 days as is comfortable until you reach the maximum stretch of two inches in length increase. You may use this for as long as you like but A minimum of two months is necessary.

Q: How much of, and for how long, with the fat survive?

A: This varies from person to person, but usually at least 80% or more of the injected fat survives long term, in my experience. The longest patients are over 15 years after surgery and have very satisfactory results. We are now recommending that two transfers be done 3 months apart.

Q: Are there any guarantees?

A: No. Unfortunately, no one can predict the amount of the fat survival in the fat transfer procedure, or the length gain.

Q: Are there any long term ill side effects?

A: Presently, there are no known long term ill side effects related to the fat transfer or length gain.

Q: How much larger can I be?

A: This varies in every patient; however, an increase in diameter (thickness) of 50% is the goal.

Q: Why is width more important than length?

A: During sexual intercourse an excessively long penis can be painful to a woman. However, with an increased girth, the increased sensation along the vaginal walls improves the pleasure of your partner since the sensory nerves are more concentrated in the lower end and sides of the vagina.

Q: How much time do I need off work, and why must I wear a bandage?

A: The procedure is performed on an out-patient basis, and most patients can return to work the following day. The support bandage must be worn to ensure the skin heals smoothly, and to reduce swelling. One week is usually sufficient.

Q: When can I return to sexual activity?

A:  Sexual activity can usually be resumed in 4-6 weeks; however, it takes 3-6 months to achieve maximum erection length. Post operative stretching is essential to gain the full benefits of your procedure.

Q: How much pain is involved?

A: Most patients find the post operative course quite tolerable. Thee is minimal pain in the penis, and most patients complain of discomfort rather than pain. The discomfort resulting from the procedure is easily controlled by prescribed pain medication.

Q: Is there any loss of feeling and how does the penis feel when it is erect?

A:  There has been no reported loss of sensation from the procedure. When erect, the penis remains firm with a thick cape of fatty tissue surrounding it. In about 2% of patients, the fat can form small nodules that are easily taken care of as a minor out-patient procedure under local anesthesia.

Q: Can I see some samples of your work?

A: Certainly. Simply click here to view before and after pictures.

• Testicular Implant
• Scrotal web reduction
• Suprapubic fat removal
• Lifting of excess suprapubic skin
• Circumcision