Phalloplasty for small penis enlargement with laser

Phalloplasty for small penis enlargement with laser

 

More and more men are looking for information on how to lengthen the penis , even if in many cases we cannot really speak of a small penis, at least from a strictly clinical point of view.

Micropenis is defined as  a penis at birth with normal morphology and normal external urethral meatus, but  less than 1.9 cm in length , the final result of an androgen deficiency during the maternal period of pregnancy.

This altered androgenic secretion may be the consequence of an alteration of the hypothalamus pituitary axis (hypogonadotropic hypogonadism) or gonadal (hypergonadotropic hypogonadism) and may be associated with genetic alterations which must always be investigated.
A favorable response usually occurs with both local and systemic hormone therapy initiated early.

This pathology is less frequent in the ” adult ” individual, nevertheless many adults turn to the andrologist for the inadequate size of their penis complaining of the  psycho-sexual problems  related to them.
From the statistical elaboration of the published works concerning penile size by age and race, it was highlighted that in Italy the   average  normal length  of the penis in erection is  15 cm  (range between 12 and 17 cm), we are talking about a  small penis  if the range is  between 7 and 12 cm , the  micropenis  is generally  below 7 cm of length.

The really small penis, but also in some cases at the lower limits of the norm, can create that condition called Penile Dysmorphophobia, that is the non-acceptance of one’s own size that causes  relational discomfort , not only towards the other sex, but also towards of the same sex (locker room syndrome ect.), for similarity with the female sex we can say that it is the same relational-aesthetic discomfort experienced by women with small breasts.

The  hidden penis, on the  other hand, belongs to the “false” penile brevities, in fact, especially in overweight individuals, the penis is of normal shape and size, but it is not very evident, “hidden” that is by the suprapubic adipose tissue which is in excess and incorporates the root of the penis at the pubic level, so it is the tissues surrounding the organ that determine in this case an abnormal appearance.
In addition to  not insignificant psychological discomfort, the hidden penis can also cause  annoying relapsing urinary infections.
In most cases, suprapubic lipectomy is performed, i.e. the removal of excess suprapubic fat to make the hidden penis re-emerge.

Penis enlargement laser phaloplasty

The so-called ” penis enlargement surgery is obtained  by dissecting the suspensory ligament of the penis , which in normal conditions allows the penis to adhere to the pubic bone; in this way an “internal” portion of the penis is externalized which increases the length of the pendulous portion of the penis itself ( increase of about 20%  compared to the initial ” length “).

Penis lengthening: how to lengthen the penis with the surgical technique

1 ) A suprapubic V-shaped skin incision is made, with VY skin advancement pubo-plastic (V-shaped incision and Y suture to also create a skin elongation), the use of the laser allows to perform the incision with extreme precision , resulting in reduced intraoperative bleeding and faster healing ( laser-cutaneous plastic );

2 ) Subsequently  the suspensory ligament is isolated and sectioned with a  laser , which has a variable length between 2 and 5 cm

3 ) The next phase, as described in the literature, involves the infrapubic implantation of a  pubo-cavernous spacer  generally made of silicone, to avoid the rapprochement between pubis and penis and stabilize the elongation thus obtained, thus avoiding linked recurrence to scar retraction with re-approach of the dissected surfaces;

4 ) In the case of a hidden penis, the excess adipose tissue is removed by  suprapubic ultrasonic liposculpture , which allows a further increase in the penis lengthening obtained with the previous technique.

Penis enlargement (phalloplasty)

As far as penis enlargement is concerned, a subfascial implantation is performed (below the Colles fascia) of a patch that can be represented either by lyophilized human dermis obtained from a donor or by porcine dermis (INTEXEN), non-resorbable remodeling tissue, consisting mainly of acellular collagen, natural, chemically unaltered and biocompatible.

Penis enlargement with pig dermis

Surgical technique

1 ) Baso-penile subcoronal or suprapubic skin incision;
2 ) Subsequent penile degloving along a subdarticular avascular plane;
3 ) Suture of the patch to the Buck band along the entire length and circumference of the penis;
4 ) Placement of a small suction drain;
5 ) Postectomy;
6 ) Semi-compressive containment dressing.

This surgery, also called  “incremental phalloplasty with porcine dermis” , guarantees an excellent aesthetic result with an increase of about 25-30% compared to the initial measurement of the penile “circumference”, thus improving the sense of self-confidence and self-esteem in male who feels aesthetic discomfort due to inadequate penile size.

Penis enlargement with autologous fat

It is also possible to obtain penile enlargement using autologous fat (from the same patient) taken from other sites, generally at the pubic or abdominal-pubic level where it is in excess.

Surgical technique

1 ) removal of adipose tissue by lipoaspiration;
2 ) purification of fat by centrifugation in such a way as to limit its reabsorption and guarantee better results;
3 ) insertion of the fat (lipofilling) under the penile skin through thin cannulas introduced through very small incisions in the suprapubic area.

 


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