What are the indications for penis enlargement?
Men have genitals of 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 with respect to their member solely because of the lack of information about the size of the male genital organs.
If the length of the penis is less than 2 cm, this condition is called micropenis and implies that the length of the erect penis will not be sufficient for normal sexual function.
If a man has a penis length in a stretched or erect state of 2-9. 5 cm, he does not have a micropenis, but a small penis. In this case, the value of 9. 5 cm should be considered the lower limit of the average penis size.
Based on the data of widespread literature, it can be concluded that an adult male who has an erect penis of 9. 5 cm or more in length can be absolutely sure that he has a statistically average sized penis. A penis less than 9. 5 cm long should be called the small penis. The term micropenis means that the length of the stretched penis does not exceed 2 cm.
What are the social aspects of the small penis?
At the end of the 20th century, the open attitude of the public conscience to family problems, men's health and, of course, sexual problems, contributed to the fact that many sexually oriented paramedical advertising media popularized theidea of increasing the size of the male genitalia, including surgically. Currently, both in specialized and popular medical literature, more and more information appears about the possibility of increasing penis size in various ways, including surgery. Many medical and popular Internet sites have been created, whole sections devoted to surgical procedures on the penis are published. They describe in detail the benefits of these techniques and the complications associated with surgical penis enlargement.
Often, for many men who want to enlarge the penis, this organ is functionally and anatomically completely normal. At the same time, in some men, dissatisfaction with the appearance and size of their own penis can lead to feelings of inferiority and even depression. This circumstance prompts a man to look for ways to increase the size of his perfectly normal penis, in terms of anatomical parameters. And if a person has convinced himself that his sexual organ is too small, then no contrary medical insurance will bring results. In the mind of this man, a feeling of inferiority and low self-esteem dominates, which sometimes necessitates the need for treatment by a psychotherapist. However, this does not always give the desired emotional improvement.
You can make an analogy with penis enlargement with the effect of increasing the size of the female breast. Scientists have proven that women after breast augmentation significantly increase their self-esteem and get rid of long-term psychological disorders and depression. In this case, if a woman, for aesthetic reasons, undergoes the implantation of breast prostheses or liposuction to increase her own importance and the admiration of others, then why can't a man, for the same reasons, decide to have penis enlargement surgery??
Moreover, it is known that more than 70% of women, answering an anonymous question: "Among several similar and outwardly equally attractive men, but with genitals of different lengths, who would they prefer? "they would opt for a man with a big penis.
What are penis enlargement methods?
All methods used to increase penis size can be conditionally divided into three groups - suction, traction and surgery. The first two groups are inherently non-surgical methods and consist of long-term "training" of the tissues of the organ for stretching.
Vacuum devices (VU)- consist of two main components: a cylinder with an open end, in 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 blood from the body rushes to the penis and its size increases.
External stretching devicesare various extenders for the permanent stretching of the penis in length. During 4-6 months of regular daily training, it is possible to increase penis length by 1. 5-3 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 intervention. The possibility of lengthening the penis with the help of surgery lies in the peculiarities of fixing the cavernous bodies of the penis with a supporting ligament to the pubic joint. The supporting ligament is the main object of intervention in penile augmentation surgery. This triangular veil of fibrous tissue connects to Buka's deep fascia. The ligament extends from the linea alba and the top of the symphysis along the midline to the center of the penis. Further, the ligament diverges laterally fan-shaped, bends at the edges and, as it were, covers the base of the penis in its proximal part at the level of the transition from the cavernous bodies to the hanging part of the penis.
All surgical penis enlargement methods have several purposes: penis enlargement, penis thickening, combination of penis lengthening and thickening, correction of erectile deformity with correction of penis size, correction of erectile dysfunctionwith 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 penile lesion. "Cosmetic indications" - a hidden penis, excess fatty tissue in the pubic area.
Surgical penis enlargement is not a new topic, as it was previously an additional goal in the treatment of various penile diseases. However, it is only recently that penis enlargement has been performed as a cosmetic procedure for an anatomically correct and functional penis.
In most cases, men want to increase penis size for the following reasons: to improve external attractiveness, to improve the quality of sexual relations, to increase self-esteem, due to "locker room syndrome", when a man is embarrassed to be naked in a communal shower room, sauna, etc. believing he has a small penis.
The medical and functional indications for augmentation are clear. But it should be emphasized that this last group (aesthetic indications) is the most numerous and at the same time the most controversial. In this group, the aesthetic wishes of patients become indications for surgery.
In 1986, scientists believed that "the hypochondriac all-consuming ability to fixate on one's genitals is the exclusive property of men and is absolutely uncharacteristic 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, does not contradict the principles of cosmetic surgery, the purpose of which is to improve the shape of a normal organ. A man's desire to increase penis size is one of the main indications for surgery.
How is the penis enlarged?
Methods of surgical penis enlargement:
Dissection of the suspensory ligament of the penis– ligamentotomy (long operation). In 1990, a Chinese surgeon developed a penis enlargement operation, ligamentotomy, which is the main and most versatile method of penis enlargement. The principle of the method is based on the elimination of the physiological curvature of the penis by crossing the supporting ligament and freeing the cavernous bodies at the level of entry into them of the deep arteries and the subsequent fixation of the cavernous bodiesin a new position at the severed supporting ligament. The technique allows to obtain an elongation of the penis up to 3-5 cm.
Implantation of prostheses with simultaneous transverse incisions of the tunica 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 rigidity to the organs for successful introjection in men with erectile dysfunction. The principle of the method of lengthening with simultaneous implantation consists in placing prostheses of much greater length in the intra-cavernous space and performing transverse corporotomies in order to lengthen the organ.
Implantation + lengthening with total mobilization of the legs of the penis.The effect is achieved due to the maximum removal of the proximal part of the cavernous bodies due to their complete mobilization, moving forward and fixing in the area of the pubic joint. Such a large displacement of the penis involves the intersection of deep arteries and the effective shutdown of the hemodynamic mechanism of erection. The blood supply to the corpora cavernosa is provided by the dorsal vascular bundle and the spongy body of the urethra.
It should be emphasized that the complete mobilization of the cavernous bodies leads to erectile dysfunction, due to the inevitable damage of the pudendal nerves and the deep cavernous arteries. Therefore, this method is only suitable for men with erectile dysfunction.
Unhitching operation (Perovic operation).The author of this technique recommends carrying out a complete separation of the organ into components - separation of 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 thedorsal neurovascular bundle. Between the extremities of the corpora cavernosa and the head, pieces of the patient's costal cartilage or a synthetic implant are then implanted, taking into account the free distance obtained and previously measured. The elongation effect is achieved due to the natural elasticity and the ability to stretch the spongy body of the urethra and the elements of the neurovascular bundle. The elongation of the penis can be achieved up to 3-5 cm.
Methods of surgical thickening of the penis:
Microsurgical tissue autotransplantation, subcutaneous injection of free autofat, use of a flap of free deep epidermal cutaneous fat, corporotomy with replacement autotransplantation and allotransplantation, use of rotationally pedicled flaps, use of a synthetic implant
Microsurgical tissue autotransplantation. The method of microsurgical autotransplantation of fascio-muscular or fascio-fat flaps on a vascular supply pedicle consists of subcutaneous coiling of the penis with a selected fragment of the latissimus dorsi muscle, followed by its revascularization (application of vascular anastomosesto maintain the blood supply in the graft).
Subcutaneous injection of free autofat.Most often, fatty tissue for implantation is obtained during liposuction of the suprapubic region. After a special preparation of the evacuated fat, it is gradually introduced using a syringe along the entire shaft of the penis through an incision in the subcoronary area. In this case, it is necessary to perform manual modeling - straightening the fatty tissue evenly along the organ.
The use of a free epidermal deep cutaneous fat flap.Cut out one or two grafts from the donor area. These are usually the gluteal folds or, less commonly, the inguinal folds. Depending on the size of the penis, each graft should be approximately 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 operation).The principle of the operation is to make longitudinal incisions of the tunica albuginea on the bilateral surfaces of the cavernous bodies of the penis, followed by replacement of the defects with inserts from an autovein or other materials.
Application of pedicle flaps in rotation. The widespread use of autologous tissue for penile thickening limits the lack of blood supply to the transplanted tissue. Vascularized free flaps are not always and everywhere usable due to the technical characteristics of the procedures. In this respect, to thicken the penis, it seems very promising to isolate an autograft with preserved blood flow, without it being necessary to perform microsurgical vascular anastomoses.
Used to thicken an organtechnique for isolating a fragment of the rectus abdominis muscle. The principle of the operation consists in isolating a rotating muscle flap from the anterior abdominal wall on a feeder leg, with a base at the root of the penis. The free end of the autograft on the vascular pedicle is made under the skin of the penis and attached to the coronal sulcus.
The principle of another operation is to isolate two (Dabees operation) or one flap of rotating fascial fat from the subcutaneous tissue of the anterior abdominal wall.
The use of synthetic implants. A new direction of penis thickening is considered very promising, which involves implanting a specially designed synthetic implant under the skin of an organ. The principle of the operation and the materials used are similar to those of breast augmentation for women. A shell or solid hydrogel implant is used to thicken the penis. The operation is distinguished by a planned thickening result, a short stationary period, the absence of additional incisions for graft removal and the virtual absence of complications.
In addition, a thickening method based on the technique of transplanting own "grown" tissues onto a soluble biopolymer support (matrix) has now been developed. The method is completely new and there are not enough clinical observations yet.
What are the results of penis enlargement?
The results of surgical penis enlargement. The degree of elongation is not a unified criterion, because the reasons leading to penis reduction are fundamentally different from each other. The standard and successful result of the operation should be considered organ lengthening by 2. 5-3 cm or more.
There are no standard criteria for evaluating the effect of penis thickening, because everything depends on the desire of the patient and the possibility of surgical technique. A uniform thickening of the penis shaft, without deformities of the contours and bulging of the graft, is considered satisfactory and a good result.
Are there any complications from penis enlargement surgery?
Since any surgical intervention can be accompanied by various negative consequences, therefore, operations on the penis are not without the risk of developing specific complications.
We know that cosmetic surgery has two equivalent objectives: good anatomical and functional results and patient satisfaction with the operation. The main obstacle to achieving this goal is the development of various complications and the patient's negative assessment of the final results of the operation. The frequency of complications in plastic surgery of the penis depends on many factors, the determinants of which are as follows: the formation of a realistic attitude in the patient towards the possibilities of surgical intervention; experience and skill of the surgeon; application of standard methods; compliance by 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 expectation of a "miracle" from the surgeon's scalpel and the actual result obtained during this operation. This may be due to an unrealistic expectation or a deliberately negative assessment by the patient of any possible outcome. At the same time, from a surgical point of view, the postoperative result can be considered excellent.
In conclusion, it should be emphasized that the penis is a unique organ that fulfills 3 main functions: copulatory (ensuring sexual intercourse), reproductive (ensuring procreation) and ensuring urination. For a man, he is singular by nature in the singular and therefore, paraphrasing the well-known phrase, ". . . live with it, they need it so it won't be excruciatingly painful later . . . ". And if in the future men will be able, if necessary, to freely correct the size of their reproductive organs, as we now correct ugly teeth, then there will be many fewer disappointed, embittered and simply unhappy men in the future, since a harmonious intimate life is one of the constituent factors of a healthy and socially active person.