Penoplasty

Plastic penoplasty aims at extending and/or enlarging the penis. It is carried out on men with penis within acceptable size limits and physically and psychologically disturbed.

• Enlargement

Enlargement penoplasty aims at increasing the circumference of the penis, at rest and erect. This procedure is the most common one.

Enlargement penoplasty is performed through a lipostructure or a lipofilling. It consists in increasing the diameter of the penis by injecting fat in this area. The fat cells are removed from the patient himself and cause an increase of the volume of the penis, at rest and erect.

• Extension

Extension penoplasty (or phalloplasty) only gives results on the penis at rest. It is often performed on athletes, it has no effects on sexual life.

The extension is performed through the release of the holding ligament of the penis, linking the cavernous tissues to the pubis bone in order to release the penis. The verge is out and the cavernous tissues released. The extension varies between 2 and 5 cm but only applies to the flaccid penis.

Before the procedure

A preoperative check-up is made following your surgeon’s recommendations. An anaesthesiologist will see you in consultation at the latest 48 hours before the operation. It is highly recommended to stop smoking 15 days before and 2 months after the surgery in order to favour fat graft taking for enlargement and healing for extension. No aspirin-based medication should be taken during the 10 days preceding the operation. A preventive treatment is prescribed to patients subject to genital herpes in order to prevent an outbreak after the procedure. You need to fast (neither eat or drink) 6 hours before the operation. A treatment aiming at suspending temporarily the erections is taken to guarantee proper healing.

• Most of the time, enlargement is carried out under vigil anaesthesia, which is a local anaesthesia completed by tranquillizing drugs, injected in veins, or under general anaesthesia. Hospital stay is short, the patient leaves on the same day in an ambulatory facility.

• Extension almost always requires a general anaesthesia which puts you asleep. Hospital stay is short, the patient leaves on the same day in an ambulatory facility.

The procedure

• The penoplasty: The enlargement

An atraumatic extraction of the the fat tissues is realized through incisions hidden in the stomach area, the thighs or another area with a very thin suction cannula. The extraction areas are chosen depending on the quantity of fat needed and the different possibilities. The quantity of extracted fat depends on the excess and the penis morphology. Fat cells are cleansed, centrifuged (Coleman technique) and injected through small incisions with thin cannulas as micro particles between the skin wrapping the penis and the cavernous tissues through independent paths in order to reach a harmonious result. Lipostructure offers a permanent result but the fat cells transplanted are sensitive to changes in the patient's weight. Weight stability is advised for. The head of the penis is not modified. At the end of the procedure, a light dressing is placed on the penis and the points of fat extraction. The operation lasts between 1h and 1h30.

• The penoplasty: Extension

The release of the holding ligament of the penis is performed according to the personal technical habits of the surgeon, who will adapt his or her acts to you. The incision creates a scar of variable shape, such as a reversed Y on the pubis and down to the scrotum or a Z. Sometimes, depending on the morphology of the scrotum, an additional small incision is required at the base of the penis, on the testicles. A non-compressive sealed dressing is paced at the end of the procedure. The operation lasts between 1h and 1h30.

The extension obtained (2 to 5 cm) depends on the anatomical conditions and is unpredictable before the operation. The penis is extended at rest but the extension during erection is most often minor.

After the procedure

Pains are usually minor and rarely require the usual pain-killers.

Any inopportune erection will require an adjustment of the preventive treatment.

• The penoplasty: The enlargement

The penis is very swollen during the days after the operation and the result is exaggerated due to oedema. Top off may be impossible during the first days, you need to wait without insisting. The progressive deflation of the early days is normal: the oedema disappears but the fat cells remain. Bruising can appear in the areas where fat was extracted during about 10 days. They rarely affect physical activities.

You can have a shower as soon as the day after the surgery. No dressing is necessary.

You will need to wear loose boxer shorts for the fist weeks, because briefs could cause an inappropriate compression.

Usually, you do not need so stop working.

The stitches resorb by themselves after 10 to 15 days, when healing is complete.

You need to wait 2 to 3 weeks before sexual activity, which is however possible after the anti-erection treatment. Wearing a lubricated condom will prevent irritations.

Activities such as motorcycling, cycling or horse riding can be practiced again after 1 or 2 months.

• The penoplasty: Extension

Ecchymosis and oedema commonly appear after the procedure.

Thorough and delicate local care will be performed for about 10 days, until the healing is complete.

Protecting briefs will be worn above the dressing during 15 days to avoid any traction on the scar.

The stitches resorb by themselves after 10 to 15 days, when healing is complete.

You can have showers once healing is complete.

Sexual activity is advised against during 3 weeks.

You will need to stop working during 5 to 10 days, depending on your profession. In case of sedentary occupations, you can go back to work in the days after the operation. Any physical activity is prohibited before the healing is complete.

Activities such as motorcycling, cycling or horse riding can be practiced again after 1 or 2 months.

The result

• The penoplasty: The enlargement

The final aspect will be appreciated within 8 to 10 weeks after surgery. This is the time necessary for the oedema to disappear and the tissues to become supple again. The volume of the penis is final. There may be a variable difference that can reach 30% between the quantity of injected fat and the fat which remains on the penis, but the surgeon takes this variation into account to define the volume of fat injected.

At rest, the circumference can increase between 2 and 3 cm. The erect penis is enlarged too but the result is less visible. A new repartition on the erect penis is also visible.

The scars progressively blur.

The cavernous tissues are not implied, so the erection is not affected after this procedure.

The result is permanent but the patient needs to keep a stable weight or not to lose too much weight, even on long term. The transferred fat is sensitive to weight variations. A weight loss would degrade the result, a weight gain would enhance it.

The benefit of this procedure is to preserve the natural aspect of the penis. The operation is totally invisible, you do not have to reveal the procedure to a future partner if you do not wish so.

• The penoplasty: Extension

The result will be appreciated 15 days after the operation, when the cutaneous scar is present. The increase is between 2 and 5 cm at rest and is inexistent or minor during erection.

After surgery the scars are pinkish and inflammatory. They progressively blur.

Sometimes, patients ask for hair removal because of pubic hair going down the base of the penis.

The strength of the erections is intact, but in some cases it is a bit less vertical (of some degrees). This does not affect sexual intercourse.

Hidden in the pubic hair, the scar will not reveal the operation, which will remain invisible. You do not have to reveal the procedure to a future partner if you do not wish so.

This surgery aims at bringing an improvement and not reaching spectacular volume and length.