Phalloplasty Surgery for Penis Enlargement: Summary and Steps

Surgical enhancement of the penis is currently in its early developmental stages. Although some surgeons claim otherwise , the truth is that surgical enhancement, while providing some measure of penile girth enhancement, has no effect on penile length, other than perceived length. That is to say that the surgery, as it is now performed, does not actually lengthen the corporal bodies, which comprise the core of the penis. Surgery to enhance the size of the penis is sometimes compared to breast augmentation surgery. This is not a valid comparison as penile enhancement surgery has not nearly reached the level of predictability in results as that of breast augmentation. It is more accurate to say that penile enhancement surgery can be expected to produce an incremental in perceived penile length and that gains in penile girth, are very often accompanied by some distortion in the natural shape of the penis.

The two aspects to penile enhancement surgery – length and girth or thickening – each have their own particular pitfalls and difficulties.

Procedures for Increasing Penis Length

Current surgical technique cannot actually lengthen the corporal bodies of the penis. This is because the core of the penis consist of a matrix of smooth muscle and vasculature surrounded by a tough elastic envelope. These corporal bodies are then actually complicated or intricate vascular organs that expand and lengthen ad the vessels and sinuses within fill with blood during an erection. There is no known surgical material that can actually lengthen these corporal bodies. However, surgery can reposition the corporal bodies such that the penis may “appear” longer than its flaccid state. On erection however, the positional change brought about by surgery no longer results in any increase length perceived or otherwise.

Procedures for Increasing Penis Girth and Width

Increasing penile girth or thickness is another story. Here, various materials are placed in the space between the expensile corporal bodies and surrounding skin layers of the penile shaft. Various materials are use including fat injection, dermal grafts where strips of skin taken from other parts of the patients body are placed in! this space. Various non-biologic materials have been used. Currently the most satisfactory material in use is a collogen matrix tissue which is essentially a biologically, inactivated facial material derived from cadavers. It is human tissue chemically reduced to its basic material structure and then fashioned into various sizes of patched or strips. These strips may be combined to provide a form of bulking sheeting which is placed under the penile skin and sutured to the corporal bodies of the penis. This definitely enhances the girth of the penis. However, a trade off is inevitable in that the bulking strips during the course of healing will form a bond the ! corporal bodies along the points where the strips touch the corporal bodies. This in effect, will prevent the length wise expansion of the penis during erection, along the area of contact because the graft material does not stretch. Circumferential expansion or girth expansion during erection is less effected because the strips only contact the corporal bodies on a limited amount of a circumferential surface. Some penile length with erection can be regained after initial healing by wearing weights or using other devices that stretch the corpora that is not in contact with the grafted material, there by causing lengthening of the penis in the flaccid state. However, erectile length probably will not be any longer than the erectile length prior to surgical grafting. Another less formidable problem with penile girth enhancement is maintaining a natural shape to the appearance of the penis. This can be difficult because the graft material must be completely even, completely uniform and no grafting material, whether it be dermal graft or alloderm is capable of being fashioned completely to conform to the contour of the corporal body. This is because these materials by their very nature are variable in their width. And although they can be trimmed, slight shifting during the healing can produce some irregularity in the contour along the shaft of the penis.

Finally there is the ratio of the circumference or thickness of the shaft to the size or thickness of the end of the penis called the ‘glans’ of the penis. If the shaft of the penis is made to be larger in circumference this will produce a perceived diminution in the size in the glans of the penis which may no longer be as large as the circumference of the shaft of the penis contrary to the normal usual situation. This problem has been addressed by injecting various materials into the glans in attempt to enlarge it. This procedure is relatively recent and it is unclear whether the materials that have been used will remain in place or will be dissolved and absorbed by the body as are fat and collagen injections in other parts of the body.