PENILE WIDENING

While surgeons who do penile cosmetic surgery are consistent in their view of how to lengthen the penis, they are divided on methods to increase the thickening or girth. To increase the circumference of the penis, something must be added to it.

Transferring the patient’s own fat obtained through liposuction was the earliest form of tissue transfer and is still popular today. When first done in the 80s, the results were inconsistent and the revision rate was high.

Since then, surgeons have gained great experience in using the patient’s own fat for cosmetic application as a filler. New techniques were developed to harvest the fat which resulted in better and longer lasting results where placed. Still, criticism of fat as a graft has persisted because of uneven results and unpredictability.

PRP TO THE RESCUE

Great strides have recently been made when it was discovered that adding the patient’s own blood components rich in growth factors called PRP (Platelet - Rich Plasma) results in almost complete take of the fat where placed. The processing of thes e factors - previously common only in the hospital setting - are now available in the outpatient office setting resulting in the use of fat with its adherent advantages - no risk of foreign body reaction or rejection, usually abundant supply. Scarring is minimal, usually one fourth of an inch, because the only incisions needed are for a small cannula.

ALLODERM® WIDENING

The second common girth-enhancing technique is the addition of grafts to the penile shaft. The graft can be the patient’s own tissue from another part of his body or the use of Alloderm®, which is treated graft material from another human.

In each instance, the graft material is sutured to the appropriate place on the penile shaft resulting in a 35% increase in circumference. When fat injections are used, the second fat injection 3 months after the first can result in up to 50% increase in girth.

The maximum degree of enlargement is not possible for everyone, due to anatomical differences between individuals. The patient must have a realistic expectation when undergoing this surgery.