Penile Girth Enhancement
It’s important to fully understand the limitations and enhancement capacity of penis size and the surgical correction possibilities. The penis is composed of three large cylinders: two corpora cavernosa dorsally, which contain the erectile tissue, and the corpus spongiosum, which constitutes the urethra. The main components of the penis are surrounded by areolar tissue and peripherally encased with skin. Each layer of the penis plays an important role in the function and dynamics of the penis during sexual activity and voiding. The two internal chambers (corpora cavernosa) that allow a penis to expand in length and girth with erections are fixed in size. No amount of stretching, injecting, vitamins, surgery, or hormones can make them any bigger.
Skin plays an important role in protecting the penile tissues from trauma during intercourse and as a barrier from bacterial infection. The skin is firmly attached to the glans and only loosely attached to the shaft, allowing for mobility during intercourse. Deep under the skin lies the superficial and deep fascia, which supply additional structural support. At the base of the penis, the dartos fascia combines with smooth muscle fibres and creates a well-defined penoscrotal angle between the scrotal wall and the skin. The deep fascia adheres to the tunica albuginea.
Now, another sought after enhancement with the penis is with the girth. Many methods have been employed to achieve this; the most common is injecting a material or solution between the skin and the corpora cavernosa. Different types of injectable materials have been used for penile augmentation, including liquid silicone, polyacrylamide, hyaluronic acid, and mineral-oil. However, there is a significant risk of unsatisfactory results or untoward outcomes, such as foreign body reaction, where the immune system rejects the material, swelling, penile distortion, granulomas, and need for removal.
Increased demand for penile girth enhancement in recent decades has meant there have been continuous developments in the field. New methods have been discovered and studied to deliver safer and more satisfactory outcomes for patients.
The most common, and preferred, way of increasing the diameter of the organ is by injecting the patient’s own treated adipose tissue, which is an analogous material, meaning from the same organism, into the skin surrounding the organ. This has progressed from the injection of synthetic or heterologous materials, meaning from a donor or different organism. The use of the patient’s own tissue is safest, especially in the case of reabsorption and significantly decreased possibility of any complications or undesired side effects compared to its predecessors. Compared to normal volume fillers of heterologous or synthetic origin, the use of autologous fat presents a series of advantages, which range from the impossibility of rejection and incompatibility to the absence of the risk of transmitting infections and diseases and the complete integration with the receiving anatomical area.
The latest development in this area is the application of platelet rich plasma (PRP) therapy and fat purification, which is employed to allow higher retention of tissue for better and lasting results. Fat purification allows the breakdown to smaller or purer forms of harvested bigger fat tissues, which usually causes granulations and deformity or asymmetry to the organ before application to the target area. PRP is supposed to stimulate regrowth of new tissues and lead to a bigger penis. The increase of the circumference can be up to 30 percent and, in most of the cases, no revision or further procedures are required. The use of PRP in penoplasty enlargement increases the possibility of engraftment and survival of the transplanted fat and the quality of the fat itself, thanks to the presence of a high quantity of platelets, which improve the conditions and the biochemical environment at the transplant site. PRP is very rich in bioactive proteins and growth factors, which accelerate and improve the production of new blood vessels (neoangiogenesis) and accelerate the healing process. The use of PRP improves cellular processes at many levels, ranging from the propagation of cells to the formation of collagen to the production of cellular matrix. All this occurs at a more rapid than normal rate. This is its most important property with regard to volumetric surgical applications since the transplanted fat requires a lot of nourishment to survive and not be absorbed by the organism. Stimulated by PRP, the formation of new blood vessels ensures the transplanted fat gets the nourishment it needs.
The procedure consists of three main phases:
1). Fat is collected from the abdominal area and/or the inner thighs of the patient through micro incision using a specific cannula.
2). Platelet rich plasma (PRP) therapy and fat purification: the fat obtained is then processed via PRP and the Puregraft System, making the sample denser and more concentrated.
3). Uniform implantation: through two or three small incision at the base of the penis, the fat is uniformly injected through the epidermidis and then massaged to ensure a proper distribution along the organ.
A whole blood sample will be obtained first from the patient and will be treated in centrifugation for 15 mins, separating the red blood cells and resulting in platelet rich plasma, which will then be used on the fat sample obtained from the patient.
For both length and girth enhancement, the procedure starts with the application of topical anaesthesia to the area just above where the penis meets the pubic area and along the shaft of the penis. Injections of lidocaine are then introduced to the pubic area to create a field block to reduce sensitivity of the penis.
Preferably, these procedures are performed under general anaesthesia and/or sedation. This is the safest and most comfortable way for the patient to undergo the procedure, especially in the collection of the patient’s own adipose tissue. However, depending on the surgeon’s clinical judgement, girth enhancement can sometimes be done with simpler local anaesthesia, which means light sedation and easier and faster recovery. This varies from patient to patient and the options will be fully explained to you.
The procedure generally takes 1 to 2 hours. It is generally performed as day surgery with no need for an overnight stay.
Depending on the nature of your job, further consultation and clinical advice will be provided by the surgical team on when it’s safe for you to return to work. Patients who undergo this surgery can normally resume work in 3 to 7 days.
You should make a full recovery and completely heal in 2 months. Complying with the surgeon or team’s post-operative care and advice can enhance and shorten recovery time.
Patients are advised to only resume physical activity, such as exercise or going to the gym, after 3 to 4 weeks of rest. Return to the gym or fitness regimen must be carefully planned in your consultations. Considering the sensitivity of the area, it is suggested you gradually increase the intensity of exercises or physical exertion.
You can safely resume sexual activity after one month.