What are the indications for penis enlargement?
Men have genitals in different sizes. Most of them are happy with the size of their own penis, others tend to think that their symbol of male prowess is too small.
About 80% of men suffer from an inferiority complex about their member solely due to lack of information about the size of the male genitals.
If the length of the penis is less than 2 cm long, then this condition is called a micropenis and implies that the length of the erected penis will not be sufficient for normal sexual function.
If a man has a penis length in stretched or erected state from 2 to 9, 5 cm, then he does not have a micropenis, but a small penis. In this case, the value of 9, 5 cm should be considered as the lower limit of the average size of the penis.
Based on the generalized literature data, it can be concluded that an adult male who has an erect penis of 9, 5 cm or more in length can be quite sure that he has a penis of statistically average size. A penis smaller than 9, 5 cm long should be called the small penis. The term micropenis means that the length of the stretched penis is not more than 2 cm.
What are the social aspects of the small penis?
By the end of the 20th century, the open attitude of the public consciousness to family problems, men's health, and of course to sexual problems contributed to many paramedical, sexually oriented advertising media popularizing the idea of increasing the size of male genitals, including surgery. Currently, both in specialized medical and popular literature, more and more information is appearing about the possibility of increasing the size of the penis in a variety of ways, including surgery. A lot of medical and popular internet sites have been created, entire sections on surgical procedures on the penis have been published. They describe in detail the benefits of these techniques and the complications associated with surgical penis enlargement.
For many men who want to enlarge the penis, this organ is often functional and anatomically completely normal. At the same time, dissatisfaction with the appearance and size of their own penis in some men can cause a feeling of inferiority or even depression. This circumstance causes a man to look for ways to increase the size of his completely normal penis in terms of anatomical parameters. And if a person has convinced himself that his sexual organ is too small, no medical assurances to the contrary will yield results. In this man's mind, a feeling of inferiority and low self-esteem dominates, which sometimes requires the need for treatment by a psychotherapist. However, it does not always provide the desired emotional improvement.
You can draw an analogy of penis enlargement with the effect of increasing the size of the female breast. Researchers have proven that women after breast augmentation significantly increased their sense of self-worth, and they got rid of long-term mental illness and depression. In this case, if a woman for aesthetic reasons undergoes implantation of breast prostheses or liposuction to increase her own importance and the admiration of others, then why can a man not for the same reason decide to have a penis enlargement operation?
In addition, it is known that more than 70% of women, when answering an anonymous question: "Of several equally attractive and outwardly attractive men, but with genitals of different lengths, who would they prefer? ", They would choose a man witha large penis.
What are the methods of penis enlargement?
All methods used to increase the size of the penis can be conditionally divided into three groups - vacuum, traction and surgical. The first two groups are inherently non-surgical methods and consist of a long-term "training" of the organ's tissues to extent.
Vacuum units (VU)- consists of two main components: a cylinder with an open end into which the penis is inserted and a vacuum pump. WU works on the principle of a pressure gradient - air is removed from the cylinder by a pump, a vacuum is created in the cylinder, as a result of which the blood from the body rushes to the penis and it increases in size.
External stretching devicesare various extensions for permanent lengthening of the penis in length. For 4-6 months of regular daily exercise it is possible to increase the length of the penis from 1, 5 to 3 cm (without surgery). However, it is highly recommended to use these devices after surgical penis enlargement. In this case, the effect will be much greater.
Surgical procedure. The possibility of lengthening the penis by means of surgery lies in the peculiarities of fixing the hollow bodies in the penis with a supporting ligament to the pubic bed. The supporting ligament is the main object of intervention in penis enlargement surgery. This triangular sail of fibrous tissue connects the deep fascia of the bucca. The ligament extends from the linea alba and the top of the symphysis along the midline to the center of the penis. Furthermore, the ligament diverges like a fan laterally, bends around the edges and covers, so to speak, the base of the penis in its proximal part at the level of the transition of the cavity bodies to the hanging part of the penis.
All surgical methods for penis enlargement have several goals: penis enlargement, penis thickening, a combination of penis enlargement and thickening, correction of erectile deformity with correction of penis size, correction of erectile dysfunction with penis enlargement.
Are there any indications for surgical penis enlargement?
Yes I have. Medical indications include: micropenis, epispadias, hypospadias, Peyronie's disease, cavernous fibrosis, consequences of penis damage. "Aesthetic indications" - a hidden penis, an excess of adipose tissue in the pubic bone.
Penis enlargement during surgery is not a new topic as it has previously been an additional goal in the treatment of various diseases of the penis. But only recently has penis enlargement been performed as an aesthetic procedure for an anatomically correct and functioning penis.
In most cases, men want to increase the size of the penis for the following reasons: to increase the external attraction, to improve the quality of sexual intercourse, to increase self-esteem due to the "dressing room syndrome" when a man is embarrassed to be nakedin a shared shower, sauna, etc. in the belief that he has a small penis.
The medical and functional indications for augmentation are clear. But it must be emphasized that the last group (aesthetic indications) is the most numerous and at the same time the most controversial. In this group, the patients' aesthetic desires become indications for surgery.
In 1986, scientists believed that "the ability of all-consuming hypochondriac fixation on one's genitals is the exclusive property of men and is by no means characteristic of women. " It is this condition that can be interpreted as penile dysmorphophobia. In other words, penile dysmorphophobia is a man's dissatisfaction with the appearance, shape and size of his penis.
However, penile dysmorphophobia, as an indication for surgical treatment, is not contrary to the principles of aesthetic surgery, the purpose of which is to improve the shape of a normal organ. A man's desire to increase the size of the penis is one of the main indications for surgery.
How is the penis enlarged?
Methods of surgical penis enlargement:
Dissection of the hanging ligament of the penis- ligamentotomy (Long surgery). In 1990, a Chinese surgeon developed a penis enlargement surgery, ligamentotomy, which is the most important and versatile method of penis enlargement. The principle of the method is based on eliminating the physiological curvature of the penis by crossing the supporting ligament and releasing the corpora cavernosa to the level of entry into them of the deep arteries and subsequent fixation of the corpora cavernosa in a new position at the level of the severed supporting ligament. The technique makes it possible to achieve elongation of the penis up to 3-5 cm.
Implantation of prostheses with simultaneous transverse sections of albuginea.It should be emphasized that the isolated implantation of prostheses in the cavernous bodies of the penis does not lead to an increase in the length of the penis. The prostheses are designed to provide organ rigidity for successful introjection in men with erectile dysfunction. The principle of the simultaneous implantation elongation method is to place prostheses of obviously greater length in the intracavernous space and perform transverse corporotomies to elongate the organ.
Implantation + extension with total mobilization of the legs on the penis.The effect is achieved due to the maximum removal of the proximal part of the cavernous bodies due to their complete mobilization, movement anteriorly and fixation in the area of the pubic bed. Such a significant displacement of the penis involves the intersection of deep arteries and the actual closure of the hemodynamic erection mechanism. The blood supply to the cavity bodies is carried out by the dorsal vascular bundle and the spongy body in the urethra.
It should be emphasized that the complete mobilization of the corpora cavernosa leads to erectile dysfunction due to the inevitable damage to the pudendal nerves and deep cavernous arteries. Therefore, this method is only suitable for men with erectile dysfunction.
Disconnection operation (Perovic operation).The author of this technique recommends performing a complete separation of the organ into components - separating the cavernous bodies as much as possible along the entire length of the hanging part of the penis from the spongy body and head with complete mobilization of the dorsal neurovascular bundle. Between the ends of the cavernous bodies and the head, pieces of the patient's coastal cartilage or a synthetic implant are then implanted, taking into account the obtained and previously measured free distance. The elongation effect is achieved due to the natural elasticity and ability to stretch the spongy body of the urethra and elements of the neurovascular bundle. Penis extension can be achieved up to 3-5 cm.
Methods for surgical thickening of the penis:
Microsurgical tissue autotransplantation, subcutaneous injection of free auto-fat, use of a free deep-epidermal sebum flap, corporotomy with replacement auto-transplant and allotransplant, use of rotated pedicle flaps, use of a synthetic implant
Microsurgical tissue autotransplantation. The method of microsurgical autotransplantation of fascio-muscular or fascio-fat flaps on a delivery vascular pedicle consists in subcutaneous wrapping of the penis with a selected fragment of the latissimus dorsi muscle, followed by revascularization thereof (use of vascular anastomoses to maintain the blood supply).
Subcutaneous injection of free auto grease.Most often, adipose tissue is obtained for implantation during liposuction from the suprapubic region. After special preparation of the evacuated fat, it is gradually introduced through a syringe along the entire stalk kettle of the penis through an incision in the subcoronary zone. In this case, it is necessary to perform manual modeling - straightening the adipose tissue evenly along the body.
The use of a free deep-epidermal sebum flap.Cut out one or two grafts in the donor area. Usually these are gluteal or, less commonly, groin folds. Depending on the size of the penis, each transplant should be approx. 12-15 cm long and 5-12 cm wide, depending on whether one or two flaps are used. These flaps are then implanted under the skin of the penis along its entire shaft.
Longitudinal corporotomies with replacement autotransplantation (Austoni surgery).The principle of surgery is to perform longitudinal incisions of albuginea on the bilateral surfaces of the hollow bodies of the penis, followed by replacement of defects with inserts from an autovenous or other materials.
Use of rotated pedicured flaps. The widespread use of autologous tissue to thicken the penis limits the lack of blood supply to the transplanted tissue. Free vascularized flaps are not always and everywhere possible for use due to the technical features of the operations. In this regard, to make the penis thicker, it seems very promising to isolate an autograft with preserved blood flow without the need to perform microsurgical vascular anastomoses.
Used to thicken an organtechnique for isolating a fragment of the rectus abdominis muscle. The principle of the operation is to isolate a rotated muscle flap from the anterior abdominal wall on a feeding bone with a base at the root of the penis. The free end of the autograft on the vascular pedicle is performed under the skin of the penis and fixed by the coronal sulcus.
The principle of another operation is to isolate two (Dabees operation) or a rotated fascial fat flap from the subcutaneous tissue in the anterior abdominal wall.
The use of synthetic implants. A new direction for penis thickening is considered very promising, which consists of implanting a specially designed synthetic implant under the skin of an organ. The principle of surgery and the materials used are similar to those for breast augmentation in women. A shell or a solid hydrogel implant is used to make the penis thicker. The operation is characterized by a programmed result of thickening, a short inpatient period, the absence of additional sections for graft sampling and the practical absence of complications.
In addition, a thickening method has now been developed based on the technique of transplanting "grown" own tissue onto a soluble biopolymer carrier (matrix). The method is completely new and there are not yet enough clinical observations.
What are the results of penis enlargement?
The results of surgical penis enlargement. The degree of enlargement is not an overall criterion, as the reasons for a reduction of the penis are fundamentally different from each other. Standard and successful outcome of the operation should be considered as an organ extension of 2, 5-3 cm or more.
There are no standard criteria for assessing the effect of penile thickening, as much depends on the patient's desire and the possibility of surgical technique. Uniform thickening of the penis shaft without deformities of the contours and bulging of the graft is considered to be satisfactory and a good result.
Are there any complications with penis enlargement surgery?
Just as any surgical procedure can be accompanied by various negative consequences, so surgeries on the penis are not without the risk of developing specific complications.
It is known that aesthetic surgery has two similar goals: good anatomical and functional results and patient satisfaction with the surgery. The main obstacle to achieving this is the development of various complications and the patient's negative assessment of the final results of the operation. The frequency of complications in aesthetic surgery of the penis depends on many factors, the crucial factors of which are the following: the formation of a realistic attitude in the patient to the possibilities of surgical intervention; the surgeon's experience and skill; use of standard methods; adherence to the patient after the operation of all prescribed recommendations.
At the same time, a very unfavorable prognostic outcome of the operation is the discrepancy between the patient's preoperative expectations of a "miracle" from the surgeon's scalpel and the result actually obtained during this operation. This may be due to an unrealistic expectation or a deliberately negative assessment by the patient of any outcome. At the same time, the postoperative result from a surgical point of view can be considered excellent.
In conclusion, it should be emphasized that the penis is a unique organ that performs 3 main functions: copulating (ensuring intercourse), reproductive (ensuring fertility) and providing urination. For a man, he is separated by nature in the singular and therefore paraphrases the familiar phrase, ". . . Live with they need it so that it would not be unbearably painful later. . . ". And if men in the future will be able, if necessary, to freely correct the size of their reproductive organs, as we now correct ugly teeth, then there will be much less disappointed, embittered and simply unhappy men in the future, as a harmonious intimatelife is one of the constituent factors for a healthy and socially active person.