Surgical Penis Enlargement Mini Forum ~ Penis surgery

BG, I think the thread is back on course. Stmheath seems to be suggesting simply that fat lost via pubic liposuction can be gained back easily. I don’t know if that’s true, but I’m curious what Crash’s experience has been.

Wow, while we sleep…
Xefon,
The choice of the surgeon to put off lipo for you is most likely to avoid a higher risk of complications due to being over weight. This could be a number of things such as poor circulation, and decreased healing capacity. Cosmetic surgery can only take you so far, there only allowed by law to lipo a given amount per session. If you lost more weight on your own, which you seem to be on the right track, lipo will be more effective and safer also.

Prodigal son,
A combined price for length, girth, glands, is about $8500-$13,000 on average amongst the phallo surgeons I’m aware of.

Forum,
Without having its own forum it is very hard to control tangents that do not pertain to the subject at hand. Please refrain from subjects that do not belong with my intentions.
Thank you,
Crash

THE SURGEONS:

Competent / Recommended list / Better track record

Penis Surgery: Vasectomy, Penis Enhancement Miami Fl | The Reed Centre Reed

The domain name drwhitehead.com is for sale Whitehead (hiatus)

Alexander A. Krakovsky, formerly Rheinschild

Gary J. Alter M.D. | Leading Los Angeles Plastic Surgeon Gary Alter (length only)

http://www.beve … lssurgical.com/ Rosenthal

Non-recommended list / Danger! (Free Fat Transfers, outdated length procedures.)

http://www.lengthandgirth.com/ Burman

Aesthetic Plastic Surgery International | Phalloplasty | Alexandria | Virginia | USA Giunta

Barron

http://www.cosm … surgeryint.com/

Gustein

Unknown/ Not enough information:
http://www.plen itas.com/landin … s=za&moneda=dol Plenitas (Argentina)

http://www.aest … eticavenue.com/ Lee Hang-Fu

For girth the procedures have been pretty similiar. Some sort of graft or analogous tranfer was performed. This technique surgically splits the tunica. The tunica has been discussed to exaustion as being a limiting factor to girth gains. My concerns with this procedure would be loss of sensation, a ban of scar tissue easily felt under the skin, weak erections. What are some of your opinions to the effectiveness of such a procedure and possible downfalls?

This is the only surgeon I am aware preforming this surgery.
http://www.aest … eticavenue.com/ Lee Hang-Fu

I remember reading an article in a magazine about 10 years ago about a doc that performed enlargement surgery without implanting any substance, so I think this could be the same surgery as Lee Hang-Fu. I think his name was Dr Roo. Also the surgey was carried while the patient was under general anesthetic but with an injection induced erection.

Harold Reed is a leader in the field of genital reasignment surgery, operating on the most complex cases of genital surgery, as you could imagine. He is also a very respected phalloplastic surgeon, and I trust his skill. This is an informative article on penile girth enhancements. He does not perform Free fat Transfer, but only explains the procedure.

FROM THE OFFICES OF HAROLD REED MD

Advisories Relating to Penile Girth Enhancement,
AlloDerm, Testicular Enhancement, and Foreskin
Restoration

These advisories provide additional information. They
are not exhaustive in detail nor intended to serve as
a substitute for office consultation.

The average penile girth of the flaccid penis is 8.5
cm or 3 3/8 inches around. Men may wish to have girth
enhanced by:

A. The subcutaneous injection of harvested fat or
B. implantation of dermal fat grafts or
C. AlloDerm

A. Liposuctioned fat is removed by cannula from the
suprapubic area, or if need be the lower abdomen or
buttocks. Up to 60 cc (2 ounces) of fat is distributed
subcutaneously to provide ultimately a 1” gain in
circumference. After the liposuctioned fat is
injected, it is then molded cylindrically by the
surgeon’s hands.

The sites of fat aspiration being rather small heal
inconspicuously as does the injection site. The
advantage of this approach is that the procedure can
be done in somewhat under an hour and is comparatively
economical. The disadvantages are possible loss of fat
and the formation of lumps under the skin. The
likelihood that significant loss or lumps could occur
is about 50%. Followup care for 2 years is included,
should there be contour deviations greater than 1/8”.

Thoughts to keep in mind:

1. Following aspirated fat
grafting, the penis will be swollen for a while. When
the swelling subsides,
some patients think they have lost fat. Our goal is to
provide a 1 inch increase in circumference over the
baseline.

2. Although autologous fat grafting to other
parts of the body has been reported for decades and is
practiced widely, penile transfer has only been done
for about 8 years.

3. No sex for 5 to 6 weeks so
that the fat can become fixated to the surrounding
tissues.

4. Injecting the foreskin (of uncircumcised
men) will produce a starched non-retractable foreskin
with a Victorian collar look.

For this reason, circumcision as an independent
procedure is recommended first, so the fat can be
placed all the way distally on the shaft.

5. In that
the glans (head of the penis) is not increased by this
process, too much fat will produce the “wiener in the
bun” look.

6. Too much fat will also cause the optical
illusion of a shorter penis, because any object that
becomes wider without increase in length will seem
shorter.

7. Casual
palpatation of the penis following girth enhancement
will not disclose any appreciable change in texture,
and erections will remain firm to tense.

8. Occasionally the contour line may be altered by
reabsorption or aggregation of fat. This has happened
less frequently as patients are now advised to wear
loose fitting clothing and not to “fold” their penises
during the first few weeks after surgery. If this
appearance is not acceptable, a lump can be easily
trimmed or a defect brought up to grade with a little
local anesthetic after 3 months.

9. This is not a recommended procedure for
patients with retractile penises (that is patients
with reasonably adequate erect length, but who have
very short flaccid length). Fat is inserted with the
penis on the stretch, so the very act of retraction
disperses and redistributes the fat in a most
unappreciated manner.

since the first procedure performed over 8 years ago,
close to 10,000 patients (not all mine) have had
autologous fat transfer to the penis with varying
results. Experience has confirmed the dictum” less is
more.” The end result is more natural. Transferred fat
that has earned its right of domicile (say 6 weeks
post surgery) and is viable, remains durable and does
not melt away with sexual intercourse.

B. Dermal fat strips are harvested from the upper
posterior thigh
(one strip from either side) and the incision is
closed mainly in the infragluteal crease line below
the buttocks or one long strip from the lower
abdominal area. These infra gluteal strips are
typically 1 inch high and 5 to 7 inches long. The
distal ends of the graft are sutured under the rim of
the head which flares the head somewhat. The skin on
the top side of the penis is undermined and the strips
passed into the pubic area. The incisions are then
closed carefully. The advantage of this approach is
minimal to no absorption and typically no lumps.
Because this procedure is more involved, the operating
time runs 2 to 3 hours. Installing an
overly thick strip will compress circulation. Our
office strongly advises that should you elect penile
lengthening and strips, that these procedures be
staged. Allow for a 4 to 6 month waiting
period after lengthening to get the added length
penile traction provides. Grafts survive better when
the incisions are more
limited and the host tissue is in close apposition to
(hugs) the graft. Dermal grafts notoriously do
contract initially for 2 to 3 months and then elongate
with erectile activity and gentle massage.
Before & after photographs are available for viewing
on the internet (PENISDOCTOR.COM) and upon your
initial consultation.

C. AlloDerm is a donated dermal tiss_e product of
LifeCell Corporation. During the manufacturing process
cells are removed leaving in essence a connective
tissue matrix. When implanted under the skin your body
cells grow into the matrix providing added
girth. AlloDerm is FDA approved and has been in use
since 1992. Typically AlloDerm has been used to
enhance lips of models, build up facial deformities,
replace skin loss and cover raw surfaces.

AlloDerm grafts can be folded, rolled or stacked to
provide the amount of tissue needed. There has never
been a documented case of HIV transmission or allergic
reaction from the transplant of any freeze-dried,
processed tissue graft. More than 25,000 patients
have received AlloDerm grafts. The advantage of
AlloDerm is the avoidance of harvesting incisions.
With time the eventual reabsorption of the matrix
leaves behind only the patient’s newly generated soft
tissue. Experience with Alloderm in the penis is
limited and is in clinical trial at this time.
Surgical fee: $6,000.

For more information on AlloDerm you may contact our
office or write to LifeCell Corporation at 3606
Research Forest Drive, The Woodlands, Texas 77381 or
call 1-800-367-5737.

Testicular Enhancement: Traditionally when a testicle
has atrophied or surgical removal has been
necessitated, a soft silicone prosthesis can be
inserted as a replacement which is of full size and
feels very much like the real thing. While I certainly
do not
recommend removal of small but functioning testes,
their size can be enhanced with a crescentic silicone
mold that covers the front and sides of the actual
testicle like a cap. At this time we have done close
to 30 cases, (42 testicular prostheses implanted) and
there have been absolutely no complications except for
one patient who truly needed a larger size. All
patients are pleased. However risks generic to all
incisions include wound infection, separation of the
incisionalline, pain, numbness, and bleeding into the
wound site. The effects on fertility are not known
although the spermatic duct is not transected in
surgery.

Patients contemplating fatherhood at any time in the
future are discouraged from having the procedure
performed, until more is learned regarding the effects
on fertility. Our office will pay for any patient to
have a seminal analysis when scheduling surgery with
the understanding that 6 months later another seminal
analysis will be performed “gratis” for comparison.
Surgical fee: $3850.

Foreskin Restoration performed surgically is a 2
stage procedure.
(There are non surgical methods reported on the
internet related to prolonged skin stretching). In the
first stage a tissue expander is placed under the
proximal penile shaft skin. New penile skin is created
by periodically filling the expander with sterile
solution.

After a 2 month period, 5 ounces of fluid are
contained within. In the second stage the expander is
removed, the mid and distal shaft skin is transferred
over the head to create a neo-foreskin. The deficit of
skin in the midshaft is replaced by a flap of the
expanded skin from the base. As this procedure
requires close
doctor-patient rapport and follow up visits when
concerns present, due consideration must be given
beforehand. Risks include tissue necrosis, wound
infection, separation of incisional lines,
paraphimosis, and failure to completely cover the
glans. Surgical fee: $6000.

This is an article written by Douglas Whitehead MD, regarding the lengthening procedure and how it has evolved.

Every cosmetic surgeon, be he a urologist or a plastic
surgeon, is interested in the final cosmetic
appearance of his surgical procedure. Similarly, the
patient is interested in a cosmetically pleasing
incision. As a result, cosmetic surgeons try to make
incisions in natural skin lines so that the incisions
are concealed as much as possible.

Additionally, an incision
can be concealed by naturally located hair, such as
the pubic hair, and as a result, the incision will be
less noticeable. Cosmetic surgeons also use sutures
and surgical techniques that will tend to give a
pleasing cosmetic result. A selection of suture
materials exists as well as types of suture placement.
Your surgeon will make the best selection using his
skill and past experience to produce a pleasing
result.

Over the years numerous types of incisions for penile
lengthening have been used. These are made in the
infrapubic region (lower abdominal area), just above
where the penis meets the body. These incisions have been
called by names representing their appearance, such as
the M-plasty, Zplasty, ZZ-plasty, V-Y-plasty,
transverse incision, longitudinal incision and
curvilinear incision. The M-plasty, Z-plasty,
ZZ-plasty, V-Y-plasty incisions actually create skin
flaps intended to cover the base of the penis at the
junction of the abdomen and penis where the erectile
chambers have been advanced outwards.

While any incision can “open” (dehisce) and skin
breakdown can occur even when such efforts as taking
of Vitamin C or cessation of smoking are employed,
these problems are much more likely after Z-plasty,
M-plasty, and small V-Y-plasty incisions. There are
also other problems associated with these infrapubic
skin flaps, such as scrotalization (where the scrotal
skin appears at the base of the penis). This may be
seen with large V-Yplasty incisions. Additionally,
dorsal humps may form with the V-Y-plasty incision due
to thick skin and hair being placed at the base of the
penis, particularly if the incision extends to the
penile shaft. Longitudinal infrapubic incisions should
not be used because, during healing, normal
contracture of the incision will tend to shorten the
penis and may impair blood flow and sensation on the
other side of the incision. All incisions have the
potential for developing a thick scar (hypertrophy),
incisional pain and infection; and a cutaneous (skin)
scar contracture, and subcutaneous (under the skin)
deep adhesion might result in shortening of the penis.

Sometimes revision surgery or injection treatment for
a hypertrophic scar or cutaneous or deep contracture
is necessary. Scar revision surgery is possible and in
many cases will produce a satisfactory result without
compromise of the penile lengthening that has already
been performed. For those patients who wish scar or
deep contracture correction without surgery, various
softening treatments are available using
steroids or other medications combined with a pain
medication given by injection into the lesion for
several months combined with physiotherapy using a
gentle pulling motion of the head of the penis and/or
penile weights during the period that the injections
are given. My favorite regimen for softening such
lesions uses Verapamil and Lidocaine weekly for three
months, starting approximately six to eight weeks
after the surgery, or as soon as such a problem is
noted. Some physicians use a powder of Vitamin E (400 IU,
three or four times a day) to prevent these problems;
and some physicians inject medication into the
surgical site in the hope of preventing deep
contractures.

Recently, skin flaps have fallen into disfavor and
many urologists and plastic surgeons no longer use
them because of the problems described above, and
because often the infrapubic skin is not advanceable
to the penis, but just advances the flap to a slightly lower
part of the abdomen unless extensive incisions are
made on the base and sides of the penis, which then
results in significant hair being advanced onto the
shaft.

Another reason why skin flaps have fallen into
disfavor is the belief that
the skin is not the limiting factor for penile length,
but rather the limiting factors are: subcutaneous and
deep adhesions, failure to use penile
weights, failure to close the “dead” space at surgery,
and lack of frequent erections. As a result, most
urologists and plastic surgeons now prefer a
transverse incision or a curvilinear incision.

My preferred incisions for penile lengthening

Transverse or curvilinear infrapubic incision
Most surgeons now prefer a transverse or curvilinear
infrapubic incision. With a meticulous three-layer
skin closure early use of penile weights can be
employed if there is no skin tethering of the
peno-pubic skin angle. If tethering is present, penile
tension with early use of weights would tend to open
up the incision.

Scrotal incision

I have recently adopted a technique that does not use
a penile or abdominal incision for penile lengthening.
By using a midline scrotal raphe incision (the natural
line on the front of the scrotum) or a superior
lateral incision (on the upper side of the scrotum) it
is possible to divide the suspensory ligament and the
fundiform ligaments. While this is a technically more
difficult operation for the surgeon, it eliminates
almost all of the potential complications indicated
above, and after a few months this incision is
completely unnoticeable. Furthermore, it allows use of
penile weights three to five days after surgery. Use
of penile weights as early as this is desirable and
would tend to prevent shortening of the penis due to
deep adhesions (contractures) or incision contracture
and will maintain the length gain obtained at surgery.

This is the thing about the Lipo, You are born with a set number of fat cells that number NEVER increases they just expand or contract If you remove the fat cells they cant come back, Although the ones you have left can expand, But for someone like me Removing that little bit of fat would help with self conciseness.

Crash, did they do the lipo from the opening that they did the lig cut from or did they put more holes in you?

Well, I was sleeping at the time. I didn’t wake up with any little holes until I got back home. I assume that they used the incision at the base of my penis. There is a pretty good photo where you can see the lipo effect, here’s the link.

Pumped.. 30 min.

Crashhex invited me to share my experience as well — I underwent girth enlargment procedures in July 2002 and November 2004. I gained approximately 1” in girth both times, bringing me to just under 7.5” around today — which is quite a jaw-breaker, though not impossibly so.

In both cases, the procedure was quick and relatively painless; the healing time was much longer the first time than the second, even though I tried to follow the doctor’s instructions to the letter both times.

For me the pros are obvious — I love the size, I enjoy showing it off, and that translates into more self-confidence ‘in the boudoir’. Some of the drawbacks are that I have to be a little more conscientious about how I dress for work, and that some people are turned-off by the appearance (someone on here once called me “ugly and unnatural” — but I lived with a ‘pretty’ dick for 33 years and now I have a big one instead. ;) )

mindseye,
What procedure was used for your girth? Where did you have it done? How much was the cost? What have been some of the reactions of the ladies? I appreciate your contribution. Is there anything that you have learned from this experience that you would avoid in hindsight?
I appreciate your contribution. Here’s the link with photo evidence mindseye posted.

Mindseye’s 7 inch girth

I’ve got a ton of questions if you got a the time!

What is your BPEL and how much did the silicone surgery cost? At this point, do you still feel your erect state feels totally natural and hard as it was before? Does the silicone move around? Do you still do PE with the silicone implants for girth?

Crashhex wrote:

Silicone injections; I’ve had a total of 500cc injected. 250cc in the shaft, and 250cc in the scrotum. (By comparison, a can of soda is 355cc.)

Mexico; the procedure is not currently approved in the US (there are people who’ll do it, but I preferred to have mine done by a real doctor, just in case).

$1500, plus airfare and hotel.

I’d have to say that the most common reaction I get from other guys is an open-minded curiosity along the lines of, “wow, that’d kind of cool, but I’d never go through with it myself.” Of course, I get a few reactions that are more extreme (both negative and positive).

Gosh, I don’t learn from my experiences. :) Overall, I’m happy with the outcome — I used to wear a PA, so I was already accustomed to the fact that some people might respond negatively; I’ve gotten pretty good at ‘screening’ those people out. I wouldn’t recommend it as a shortcut to natural PE, though, if you want to keep your ‘look’.

Chitownstud4u wrote:

About 5.75” (though I generally round up to 6 online. ;) ), $1500.

I can feel a little difference right at the injection site, but it’s not something that other people are likely to notice. For guys who get a lot of silicone, so that there’s more silicone than dick, the erections start to feel like they’re wrapped in ‘Nerf’ — a little spongy on the outside. The silicone doesn’t ever enter the corpora cavernosa, so the actual erection is unchanged.

For a few days after surgery, the silicone is fluid — and the doctor will discuss this and the aftercare required. After a couple of days, the silicone settles into place and ‘bonds’ itself to your tissue. (It actually does ‘bond’ to you, making removal difficult later on.)

Eh, off and on. I’ll confess that I’m not as diligent as most of the members here (I admire those of you who can stick to a program and see results!) — but I still do some PE.

I’m having a real hard time deciding what to go with, Silicone done in Mexico, Dermal Fat Grafts done by this guy “penisdoctor.com” in Florida or maybe the Alloderm grafting by maybe Dr. Whitehead.

The Silicone is by far the cheapest and seems to be quite effective too, the Fat grafts are apealing to me because it’s my own body tissue being utilized and the Alloderm grafts seem to be the “most” effective, in regards to permenance and texture.

However, the Silicone is probably more risky and artificial, the Fat grafts may not be as effective as the Alloderm grafts, and honestly, the Alloderm grafts are a bit nasty considering they’re harvested from dead people.

I’m leaning on the Silicone injection, I know you’ll all be surprised by that but, there’s nothing in Mexian blood that makes them less compitent.

What do you all think?
Fat graft seems nice too.

Fat grafting will cost you more for the same amount of gains, and there’s a risk of reabsorption that’s not possible with silicone, but the results are somewhat more ‘natural’ looking and feeling. Silicone, because it’s less expensive, has an appeal among guys who are trying to get to extreme ‘circus sideshow’ sizes. I know of a guy, for example, with an 11.5” girth, thanks to silicone — achieving the same results with fat grafting would be prohibitively expensive for almost anyone.

I don’t know much about Alloderm.