Since 1971, penile-lengthening surgery has been offered to men with severe shortening due to congenital abnormalities (abnormalities present from birth), surgery (for penile cancer or Peyronie’s disease) or trauma (accidental or deliberate amputation).
Cosmetic surgery to increase penile girth, or thickness, began in the USA in the late 1980s.
Techniques for cosmetic lengthening were described in 1990. More than 10,000 men have had such surgery, but reliable information about results and complications have not been published in a peer-reviewed journal (a journal where the quality and content of the research is checked by independent experts). Given the number of operations performed, this fact is both astounding and worrying.
Penile lengthening: the most common technique to lengthen the penis is to cut its suspensory ligament then perform plastic surgery to provide additional skin to cover its new length. The results are difficult to judge, as surgeons have not collected data in a systematic manner. The results of the only reliable study indicate that dividing the suspensory ligament alone results in an average increase of 0.5cm (around 0.25in) in length, while skin advancement increases the length gain to 1.6cm (around 0.75in). These figures do not compare well with the claims made by some clinics. Some people, undoubtedly, do better than average, while others do worse.
The suspensory ligament does have a role, in that it helps keep the penis pointing upwards during erection. After it has been divided, that support is no longer present. After surgery, some men find that they have gained a small increase in flaccid length, but the erect penis is about the same size and now points towards the floor!
Increasing penile girth (thickness): this treatment may be performed with a lengthening procedure or on its own. There are two techniques in common use:
- injection of liposuctioned fat, from the abdominal wall or thighs, into the dartos fascia, under the skin of the penile shaft.
- placing grafts of dermis (a layer of tissue from under the skin surface that is well supplied with blood vessels) and fat from the groin or buttock area within the penile shaft.
- Scrotalisation of the penis, in which the penis appears to arise from the scrotum
- ‘Dog-ears’ at each end of the operation scar.
- Sloughing of the skin used to increase penile length (the skin has a poor blood supply and therefore dies, leaving a deep, ulcerated area).
- Loss of girth due to fat reabsorption.
- Nodule formation, if the implanted fat does not disappear uniformly. The penis can be left with a deformed appearance, with irregular fatty lumps all over it.
The results following injection of liposuctioned fat can be deeply disappointing. Up to 90 per cent of the fat can disappear within a year. Grafts seem to do rather better, but there is no reliable published data on long-term results.
Complications following surgery
At least one person has died from bleeding after augmentation surgery. Apart from the risks of infection and bleeding, specific complications exist for each procedure.
Resource: NetDoctor [Accessed: 10th June, 2008], http:http://www.netdoctor.co.uk/menshealth/facts/penissize.htm