Penile Augmentation
We’ve all seen the ads:
- a vacuum cylinder that helps “expand your penis to maximum potential.”
- a pill, derived from natural sex hormone research, “designed to actually enlarge the penis and induce and maintain multiple, long-term erections.”
Come-ons like these rarely offer scientific proof, yet many men spend money on such products hoping for penile enlargement.
They are falling prey to two misconceptions:
1) They have a smaller than average penis;
2) non-surgical penile enlargement is safe and effective.
MISCONCEPTION #1: THE SMALL PENIS
Men in general have a distorted view of what’s normal for penile size. The fact is, “average” was not defined until recently. A study published in the September 1996 Journal of Urology concluded that average flaccid penile length was 8.8 cm (3 1/2 inches), and average erect length was 12.8 cm (5 inches). Also, according to many women’s magazine surveys, “size doesn’t matter,” but many men remain fixated on the ideal of the 8- to 10-inch penis.
Occasionally a perception of inadequate penile length is a manifestation of underlying feelings of inadequacy in general. In these instances, psychological counseling may prove helpful.
MISCONCEPTION #2: YOU CAN INCREASE PENILE SIZE WITHOUT SURGERY
There are no proven non-surgical methods of penile enlargement. Vacuum devices simply cause engorgement by drawing blood into the penis. While these devices are very useful tools in the management of erectile dysfunction (ED), they do not progressively enlarge the penis. No natural pill has any ability whatsoever to enhance penile size. Even Viagra does nothing to permanently affect penile size. Topical testosterone cream used in childhood can increase penile size by accelerating the effects of puberty, but there is no proof that testosterone cream applied to the adult penis enhances penile size.
There has been much controversy in the newspapers and magazines recently about surgical procedures to augment both the length and width of penises (enhancement phalloplasty). The controversy is based on the fact that many physicians feel that patients are being charged enormous prices for a procedure that has no scientific validity.
Most urologists, including a specific conference held at the 1994 American Urological Association national meeting in San Francisco and the Society for the Study of Impotence, have taken the stance that men with a normal and functioning penis have little or no justification for trying to augment the size or length of their penis. On the other hand, the physicians, both urologists and plastic surgeons, that are doing the operation, claim that the procedure is safe and effective and have had excellent results.
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| PENILE LENGTHENING operations require a skin incision at the base of the penis as it joins the body just below the pubic bone. The incision is continued down to the shaft of the penis where a special band or 'suspensory' ligament holds the penis up to the pubic bone. By cutting the suspensory ligament, the penis is allowed to fold down, thereby adding some length to the non-erect penis.
GIRTH ENHANCEMENT Presently, the only treatments available for girth enhancement are insertion of dermal graft, or injection of fat under the penile skin. Both methods have severe drawbacks, and possible risks and complications. These include lengthy operating time and patient recovery period, severe pain and discomfort at the site of the graft removal and/or the liposuction, formation of hard lumps and nodules under the penile skin, penile deformity resulting from partial absorption of the fat, and formation of large scar at the site of removal of the graft. Any of the aforementioned complications requires further multiple surgical procedures and patient inconvenience. I use a patented sub cutaneous penile implant (ELIST PROSTESIS) made of a proprietary silicone material, designed specifically for treatment of impotency and penile enhancement. |
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PENILE LENGTHENING
Genital size has been a source of anxiety for men throughout history. It has various social and psychological ramifications, such as social maladjustment, fear of relationships, and lack of self-confidence. Many men feel a need to enlarge their penis in order to improve their self-esteem, or to satisfy and impress their partners. 'Phallic identity'-the tendency of males to seek their identity in their penis, with an emphasis on the belief that bigger is better-and 'phallocentrism'-the idea that the penis is central to identity and symbolically empowered-are deeply embedded myths that are likely to persist.
Historically, lengthening procedures have been attempted for patients, usually children, with particularly short penises with hopes of gaining some length of the flaccid penis. There are no historical conditions for which girth enlargement has ever been used. The question and controversy, of course, is whether the penis is actually really longer. The physicians who are promoting these procedures claim that the penis may increase in length from 1 to 3 inches, with the average being 2 inches. Using the same techniques, the physicians who claim poor results suggest no more than 1/4 inch is gained in length in most patients. The truth, as often is the case, lies somewhere in the middle. The controversy is probably not whether the penis is actually lengthened as most interviewed feel that there actually some length gain, but whether the modest gain in cosmetic length warrants the risk of the surgery.
Approximately one-third of the penis is inside the body, and is internally attached to the undersurface of the pubic bone by a ligament. Penis lengthening involves the release of that ligament. Release of this ligament allows the penis to protrude on a straighter path, further outward to give more length.
GIRTH ENHANCEMENT
The girth enhancement (increase in width) as mentioned above comes from using a patented, FDA approved sub cutaneous penile block (ELIST PROSTHESIS) made of a proprietary silicone material.
The prosthesis device especially designed so that:
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1. It can achieve enlargement in both radial and lateral direction of the penis. 2. The design of the prosthesis and the location of the implant in the penis do not interfere with the structural integrity and normal functions of the penis. 3. The operation is reversible, i.e., the implant could be removed (for whatever reason) without permanent damage to the structure of the penis or its function. 4. The procedure does not leave any perceptible scars or compromise in any way the aesthetic look of the penis or other parts of the patient's body. 5. It’s results are permanent, or at the very least, permanency is achieved without any further surgical procedures, discomfort or undue expense to the patient. |
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Click below to see more "before and after"
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| BEFORE | AFTER |
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How someone's perceptions of his penile size affect his life?
Some patients are troubled by concerns that their penis is not large enough to satisfy their partner or themselves. They are usually ashamed to have others view their penis, especially in the flaccid state. Such concerns might cause social anxiety or some other clinical problem, such as erectile dysfunction. The concern over the size of the penis, when such concern becomes excessive, might affect the self-steam also.
A man could have the most confidence in the world; he could be a complete success personally, financially and in all the other areas that are of importance to him. But if he thinks that his penis size is under average, or even average for that matter, suddenly everything else in his life pales in comparison to his underachieving penis.
A thorough assessment, normalizing the worry and then exploring the treatment options in detail with the man, is essential to allow the matter to be consolidated satisfactorily within the male ego.
What is the average penis size?
Determining the average penis size for a group of males is more complicated than you might imagine. Unfortunately most information about average penis size comes from popular culture and not science.
The results from three studies of penis size where the measurements were taken in a laboratory setting give the following ranges:
- Average penis length (flaccid/not erect): from 3.4 inches to 3.7 inches (8.6 cm to 9.3 cm)
- Average penis length (erect): from 5.1 inches to 5.7 inches (12.9 cm to 14.5 cm)
- Average penis girth (circumference when erect): from 3.5 inches to 3.9 inches (8.8 cm to 10 cm)
A penis that falls substantially below these values is referred to as a Micropenis or Inconspicuous Penis. Although this generally does not prevent a man from being sexually active this condition may have psychological effects especially when teased by peers.
Does Penis size matter?
Yes, penis size does matter. After asking 300 women and 300 gay men over 18 year from different ethnicities, we found out that 82% of these women and 95.8% of these gay men were content with a penis that was big enough to satisfy them, which averaged at about 8 inches.
What may cause Inconspicuous Penis?
There are a number of conditions that are characterized by a penis that is small or appears to be small. Additionally, penile retraction can occurr following a spinal cord injury called Webbed Trapped Micropenis.
Help is Available! New plastic surgery procedures of the penis are now available that can give the penis additional length and a more normal appearance. There are several plastic surgery procedures that will correct a penile deformity.
The latest addition to the treatment options is the insertion of a patented silicone block under the penile skin that can be contoured by the surgeon to create a custom implant to aid in the reconstruction process.
Are there risks and possible complications associated with surgery?
Like any surgery there are possible risks and complications with the plastic surgery procedures of the penis. These will be explained to you in full detail by the surgeon during the consultation.
When can sexual activity be resumed following surgery?
Approximately 3 to 4 weeks after surgery.
How long does the operation take?
Is the procedure being done under general anesthesia?
No. It is being done under local anesthesia.
Do I have to stay in the hospital after the surgery?
No. You may stay in the hospital just for 2 hours.
Is there a high patient satisfaction rate from surgery?
Does the surgery affect the sexuality especially erectile function?
How much extra length may be obtained?
The ultimate length gain achieved varies among patients and is the result of several factors. Firstly, the length gain achieved is related to the size of the penis. Usually, the larger the penis is externally correlates with a larger penis internally that can be advanced resulting in a larger length gain. Secondly, the body build of the patient is important. Overweight patients may have an accumulation of fat in the pubic region that may cover part of the penis and thereby adversely affect the length gain that is seen.
Thirdly, the use of penis stretching devices (in case of lenghtening only) following the surgery is felt to be extremely important in achieving the best possible length gain. Patients who use the device daily generally have seen larger results than patients who use the device rarely or not at all.
The surgical procedure in combination with the use of daily penile stretching exercises For a period of at least 3 to 6 months have resulted in length gains of 1 to 2 inches in the flaccid state for most patients. Length gains in the erect state appear to be somewhat less.
BECAUSE OF THESE VARIABLES, THE EXACT LENGTH GAIN WHICH RESULTS CANNOT BE REDICTED AND THERFORE NO GUARANTEES OF EXACT RESULTS CAN BE MADE.
How much extra width may be obtained?
This depends to which procedures has been performed.
How long after surgery can I have sex?
Are the results of penile lengthening permanent?
Are the results of penile widening permanent?
Is help available without surgery?
There are several unproven, non-surgical techniques for penile lenghening. The medical community does not recommend these techniques and since no studies have been made it is impossible to tell how effective these techniques are or what the risks might be. There is no non-surgical technique that produces permanent penile widening.
What are the risks of surgical penile lengthening or widening?
Unfortunately no reliable data are available regarding the complication rates. A few reports indicate that release of the suspensory ligament can decrease the angle of elevation of the erect penis. Paradoxical penile shortening can also occur, as a result of spontaneous reattachment of the ligament to the pubis bone. Skin advancement can cause unnatural hair growth proximal to the penile stump. Utilizing a large flap can impair blood supply, leading to poor wound healing, possible dehiscence, and in some cases hypertrophic scarring.
How expensive is treatment?
See the section on Payment Information for complete details.
Will insurance cover these treatments?
If you have a truly small penis - in medical terms this is called micro penis - and the length measures less than three and two thirds inches in the erect state, and the width measures less than three and a half inches in circumference in the erect state; or if you have had previous penile surgery, Peyronie's disease, an aggressive circumcision, other genital trauma, or a neurogenic bladder that caused penile shortening then insurance will probably pay for the surgery of penile lengthening. However, insurance will not cover the costs of these procedures when done purely for cosmetic reasons. Insurance will not cover penile widening.
BATHING
Take shower on the morning of the surgery with BETADINE (It can be found in most of drug stores over the counter) with special attention to the genital and perianal area. Please gently scrub abdomen, penis, scrotum, thighs and buttocks with Betadine. . Please wash for at least 10 minutes and make sure you thoroughly rinse the entire area after washing. This helps to decrease the infection during the operative procedure.
MEDICATIONS
Avoid Aspirin or Aspirin products for 14 days, including Anacin, Ascriptin, etc. Some forms of Excedrin and many forms of Alka Seltzer contain aspirin. Similarly, avoid Persantine, Plavix and other "blood thinners", but get permission first from the doctor who prescribed it and have him personally speak with me. All these agents promote bruising or bleeding.
FOOD
DO NOT eat or drink anything after midnight of the day before the surgery and on the morning of the surgery.
SMOKING
Smoking should be stopped for 1 month prior to surgery and not resumed until at least 2 months after surgery.
CLOTHING
Please remember to bring loose-fitting sweat pants and boxer shorts.
TRANSPORTATION
If your procedure calls for general, epidural, or spinal anesthesia, or if you require IV sedation, you cannot drive for 24 hours, and you should plan for transportation or we can arrange this for you.
PREOPERATIVE STUDIES
All required tests will be done in our office. If any special test or medical clearance is required by Dr. Elist or the Surgery Center before the surgery (e.g. in those patients with some underlying diseases), the order will be sent to the patient in advance to get the medical clearance from his primary physician.
POSTOPERATIVE INSTRUCTIONS:
Post operative instructions will be E-mailed or faxed to each patient individually.
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