WHAT IS PENILE AUGMENTATION?
Penis enlargement surgery is the generic name given to the set of techniques used to increase the visible part of the penis in length, girth or both. It is also called penoplasty. Concerns about the size of the penis are far from recent and there are a number of stereotypes that associate penis size with virility, dominance and power. Currently, the media, the film industry and pornography, spread the idea that a big penis as a symbol of masculinity, making men more “attentive” to the size of their penis. But what is the normal size of the penis and for which cases is penis enlargement surgery indicated?
INDICATIONS FOR PENIAL AUGMENTATION SURGERY
Many men are dissatisfied with their penis size, which is why penis enlargement interventions are very much in demand. While some men are dissatisfied with the length, some are with the girth and others are with both. Surgical techniques enable the augmentation in length, girth or both. It is important to note that not all men who resort to penile augmentation surgery have a penis smaller than what is considered normal. Expectations regarding the size of the penis are very personal and the important thing is for the man to be satisfied and feel comfortable with it and with his intimacy. Good candidates for penile augmentation surgery usually have the following characteristics:
- Length and/or girth of the penis is lower less than what is considered normal;
- Dissatisfaction with the length and/or girth of the penis;
- Emotionally stable;
- Surgery does not correct hormonal or congenital conditions, such as micropenis;
- If other associated problems exist (erectile dysfunction, reproductive, urinary or other disorders), these should be assessed and receive proper treatment prior to the penoplasty.
TNORMAL PENIS SIZE
Although the size of the penis evolves throughout life and within different communities, the flaccid adult penis measures between 7.6 cm and 13.0 cm in length and between 8.5 cm and 10.5 cm in girth. The length of an erect penis is between 12.7 cm and 17.7 cm in length and between 11.3 cm and 13.0 cm in girth.
WHAT RESULTS CAN I EXPECT
WITH THE PENIAL AUGMENTATION SURGERY?
The release of the suspensory ligament of the penis enables an average length increase of between 1 and 4 cm. The average gain in girth after one fat grafting session is 25 to 35%. These measurements should be made 3 months after the surgery, when the results have settled. Several sessions of fat grafting can be performed according to the desired results and the degree of absorption of each patient.
PENIAL AUGMENTATION SURGERY
The first step of your penis enlargement medical appointment is an assessment of your expectations, health status and lifestyle. The surgical plan will be outlined after the medical diagnosis.
2. Detailed explanation
During your penis enlargement medical appointment, a personalized surgical plan will be presented and you will understand all the risks, pre- and post-operative care, and the results you can expect.
After the doctor’s appointment, you will be presented with an exact price for your penile augmentation surgery. The value of the surgery will depend on whether you want to increase length, girth, or both.
TECHNIQUES FOR INCREASING THE LENGTH AND GIRTH OF THE PENIS
There are non-surgical ways to enlarge the penis, such as medication, diet or stretching machines with vacuum or weights. However, the results obtained by these methods are temporary and barely visible. Surgery is the only way to permanently increase the length and girth of the penis. The choice of technique or combination of appropriate techniques is made after medical evaluation and discussion with the patient, taking into account his objectives, expectations and initial characteristics of the penis. From the various possible interventions, the following stand out:
Suspensory ligament transection: the increase in the length of the penis is achieved by releasing a small ligament that connects the base of the penis to the pubic symphysis. The patient will get only a small scar above the base of the penis. With this procedure it is possible to increase the length of the penis from 1 to 4 cm. When indicated, suspensory ligament surgery can be combined with pubic liposuction to give the penis a longer appearance.
Infrapubic Liposuction: these interventions are used when the base of the penis is partially covered by fat, and the problem is worsened by the volume of abdominal fat. The elimination of fat from this area gives the penis a longer appearance, as it increases its exposed part.
Fat grafting: to increase the girth, the most widely used technique is transferring the patient’s own fat, grafting it under the skin of the penis. This can translate into an increase in girth of 25% to 35%.
Phalloplasty: phalloplasty is the surgery to increase the length and girth of the penis. It consists in combining some of the surgical techniques mentioned above to achieve the best possible result.
TYPE OF ANESTHESIA
Penile augmentation surgery is usually performed with sedation and local anesthesia, but the decision is always made by the anesthesiologist, according to the combination of procedures and the patient’s clinical history. Sedation is administered intravenously so that the patient falls asleep and is unaware of anything during the entire surgery. Then, with the patient asleep, local anesthetics are administered so that he does not feel any discomfort during the surgery. The anesthesiologist will be present during the whole procedure to ensure patient’s comfort and safety.
TYPE OF INCISION - SCAR
In the case of a suspensory ligament transection, for length increase, a small incision is made in the pubic region, which, after healing, is practically imperceptible, hidden in the pubic hair.
In the case of fat grafting, for girth increase, no “cuts” are made. Only a small mark remains where the cannula is inserted to eliminate fat in the abdomen, flanks or other area of the body. Fat is applied to the penis through injections.
The first step is to make the markings in the intervention area and in the area where the fat will be harvested.
Sedation is administered intravenously by the anesthesiologist and then the local anesthetic is injected into the area to be treated.
The fat is centrifuged and prepared to be applied to the penis.
The liposuction cannula is inserted in the harvest area, to aspirate the fat.
The fat is centrifuged and prepared to be applied to the penis.
A small incision is made above the penis and the small ligament that connects the base of the penis to the pubic symphysis is released to achieve an increase in length.
The previously purified fat is injected into the penis to increase its girth.
The incisions are closed with small stitches that are usually removed after 7 days.
The patient is awakened by the anesthesiologist and is then transported to the recovery room where he remains under observation for a few hours before being discharged.
PREPARATION FOR PENILE AUGMENTATION SURGERY
- All patients are evaluated in a medical appointment before surgery. During the medical appointment, a clinical examination is performed and it is ensured that there are no anatomical changes or other genital pathologies.
- Appropriate preoperative exams are requested, which usually include chest X-rays, electrocardiograms and blood tests. Additional exams or assessments may be required.
- Do not take anti-inflammatory drugs or aspirin 10 days prior to the surgery, to reduce hemorrhagic risk. It may be necessary to make changes to your usual medication.
- It may be necessary to make changes to your usual medication.
- Do not take weight loss medication the month before surgery.
- Do not smoke the month before surgery, and after surgery, while healing is taking place. Smoking increases the risk of complications, impairs the healing process and affects fat graft survival.
- Carefully read all the documentation provided as questions may arise.
- If you get sick or feel ill in any way in the days prior to the surgery, you must immediately inform the medical team.
- Do you have questions about the surgery preparation or postoperative care? Do not wait for the day of surgery and ask all your questions beforehand.
- On the day before surgery, you should have light meals only, in order to avoid indigestion. On surgery day, you must be fasting since midnight - do not eat or drink any liquids including water.
- Shower with the prescribed antiseptic shower gel the day before and the day of surgery.
- The pubic hair must be completely removed with an electric trimmer.
- Bring comfortable/loose clothing to wear after being discharged.
- You can neither drive nor go home unaccompanied. You must be permanently accompanied for the first 48 hours. If you have no one to take you home and help you there for the first few days, you must inform us before the day of the surgery.
- All social and professional activities must be programmed in order to guarantee complete tranquility in the days following the surgery.
- You should not lie down all the time, nor stay in the same position for too long – you should walk around at home to promote circulation.
- Take the prescribed medication accurately.
- Be extra careful with your personal hygiene.
- Avoid intense physical activity (namely sports) for 4 weeks.
- Avoid sexual activity for 6 weeks.
- Most patients can return to work /study 1 to 2 days after surgery. However, it is advisable to take the first week following the procedure to rest and recover in a peaceful way.
- Do not smoke.
- Have a balanced and healthy diet and maintain good hydration drinking plenty of liquids.
BENEFITS OF PENIAL INCREASE
Penile augmentation surgery does not treat functional problems, but it does offer several benefits. The advantages include:
- Penis girth increase of 25% to 35%;
- Penis length increase of 1cm to 4 cm;
- Improved sexual confidence;
- Improved self-esteem;
- Improved relationship with one’s own body;
Dr. Alice Varanda Pereira / Plastic Surgery
Member of The Portuguese Medical Association, Nr. 47051
Graduated by the Faculty of Medicine of the University of Lisbon, she completed her master’s degree in human sexuality and is currently developing her PhD at this same institution.
She joined the University faculty academic staff in 2008 as a lecturer of the Institute of Anatomy. It is in this unit that she produces most of her research projects, mainly in the area of surgical anatomy, whilst also supervising master’s thesis for undergraduate students.
IS PENILE AUGMENTATION SURGERYSAFE?
Concerns about penis size is far from recent. There are many historical reports that refer to various penile enlargement techniques, using everything from weights to snake venom. The use of surgical methods is also not new. Thanks to advances in science, techniques to increase the size of the penis are currently safe and allow long-lasting and very satisfactory results.
HOW MUCH DOES A PENILE AUGMENTATION SURGERY COST IN LISBON?
Regarding the price of a penile augmentation procedure, every case is different as it will depend on whether the patient is seeking an increase in length, girth, or both, as it will also depend on the combination of procedures required. The exact price of the surgery is disclosed during the medical appointment, after diagnosis.
WHAT SCARS DOES PENIAL INCREASE SURGERY LEAVE? DO THEY DISAPPEAR OVER TIME?
The scars from penile augmentation surgery are permanent, but they are small enough to be well disguised. In the case of a girth increase, only a small mark remains, in the place where the cannula is inserted to collect the fat. In the case of length increase, there is a very small scar above the base of the penis. Over time, they become thinner and lighter. The final appearance of the scar is variable and depends on the genetic characteristics of each patient and post-operative care. The scars’ final appearance is expected 12 to 18 months after the procedure.
APART FROM PENILE AUGMENTATION, ARE THERE OTHER GENITAL AESTHETIC PROCEDURES?
Male genital surgery is increasingly common. Although most patients come to us for questions related to the dimensions of the penis, there are other procedures that can also be performed, such as lifting the scrotum, filling the glans with hyaluronic acid or penis whitening.
DOES PENILE AUGMENTATION SURGERY TREAT ERECTION PROBLEMS AND OTHER DYSFUNCTIONS?
Penile augmentation surgery, as the name implies, aims to increase the penis’ length, girth or both, for purely aesthetic reasons. Surgery does not pertain to correct hormonal or congenital alterations such as micropenis. It also does not treat problems related to your urinary system or ejaculation. However, penis enlargement can improve sexual function in men with low self-image, decreased sexual confidence, or anxiety about their partner’s response to his body.
CAN PENIS SENSITIVITY BE AFFECTED?
There may be transient changes in the sensitivity of the penis associated with swelling/edema, which are common to every surgery. Permanent sensitivity changes are an extremely rare complication.
WHEN CAN I RESUME SEXUAL ACTIVITY?
Sexual activity should be avoided for approximately 6 weeks.
WHEN CAN I PRACTISE SPORTS AGAIN?
You should not perform physical activity or any physical effort for 30 days, and then make a gradual comeback. You must be extremely careful at this stage, as this not only warrants a quicker recovery, as it also contributes to obtaining better results.
HOW PAINFUL IS THE RECOVERY?
The postoperative period is usually very well tolerated by patients, with minimal discomfort, but following medical recommendations is crucial to reduce the risk of complications and have a peaceful recovery.
HOW MANY CENTIMETERS CAN I INCREASE IN LENGTH AND GIRTH?
The surgery to release the suspensory ligament allows an average increase in penis length of 1cm to 4 cm. In terms of girth, the fat graft procedure allows an increase of 25% to 35%.
IS THE RESULT IMMEDIATELY VISIBLE AFTER THE SURGERY?
The result of the penile augmentation is visible immediately after surgery, but the measurements must be made 3 months later, when the results have stabilized.
WHAT ARE THE RISKS AND COMPLICATIONS OF THE SURGERY?
As in any other surgical procedure, penile augmentation surgery is not free of risks and complications such as hematoma, seroma, infection, scarring alterations, instability in the penis positioning which is usually not too disturbing, irregularities in the contour, and higher fat absorption rate.