What are the indications for penis enlargement?
Men have genitals of various sizes. Most of them are happy with the size of their penis, others tend to think that their symbol of male prowess is too small.
About 80% of men suffer from an inferiority complex of their member solely due to the lack of information on the size of the male genital organs.
If the length of the penis is less than 2cm, 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 an elongated or erect state of 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 penis size.
Based on data from the generalized literature, it can be concluded that an adult man 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. 5cm long should be called a small penis. The term micropenis means that the length of the elongated penis does not exceed 2 cm.
What are the social aspects of the small penis?
At the turn of the 20th century, the open attitude of the public conscience towards family problems, men's health and, of course, sexual problems, contributed to the fact that many paramedical and sexuality-oriented advertising media popularized the idea of increasing the size of the male genital organs, including surgically. Currently, both in the specialized and popular medical literature, there is more and more information on the possibility of increasing the size of the penis in various ways, including surgery. Many medical and popular Internet sites have been formed, entire sections devoted to penis surgeries have been published. They detail the benefits of these techniques and the complications associated with surgical penis enlargement.
Often, for many men who want to enlarge their penis, this organ is functionally and anatomically quite normal. At the same time, in some men, dissatisfaction with the appearance and size of their penis can cause a feeling of inferiority or 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 is convinced that his sexual organ is too small, no contrary medical insurance will bring results. A feeling of inferiority and low self-esteem prevails in this man's mind, sometimes requiring the need for treatment by a psychotherapist. However, he doesn't always give the desired emotional improvement.
You can draw an analogy of penis enlargement with the effect of increasing the size of the female breast. Scientists proved that women after breast augmentation significantly increased their sense of self-worth and got rid of psychological disorders and long-term depression. In this case, if a woman, for aesthetic reasons, undergoes breast implantation or liposuction to increase her own importance and the admiration of others, then why cannot a man, for the same reasons, decide to undergo to penis enlargement surgery?
Furthermore, it is known that more than 70% of women, answering an anonymous question: "Of several men similar and outwardly equally attractive, but with genitals of different lengths, who would they prefer? ", Would opt for a man with a large penis.
What are the methods for 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 tissues for stretching.
Vacuum devices (VU)- they consist 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 blood from the body rushes to the penis and increases in size.
External stretching devicesare various extenders for permanent lengthening of the penis in length. For 4-6 months of regular daily training, it is possible to increase the length of the penis by 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 intervention. The possibility of lengthening the penis with the help of surgical intervention lies in the peculiarities of fixing the corpora cavernosa of the penis with a supporting ligament to the pubic joint. The supporting ligament is the main object of intervention in penis augmentation surgery. This triangular sail of fibrous tissue connects to the deep fascia of Buka. The ligament extends from the linea alba and the top of the symphysis along the midline to the center of the penis. In addition, the ligament diverges laterally like a fan, folds around the edges and, as it were, covers the base of the penis in its proximal part at the level of the passage of the corpora cavernosa to the suspended part of the penis.
All surgical methods for penis enlargement have several goals: penis enlargement, penis thickening, a combination of penis enlargement and thickening, erectile deformity correction with penis size correction, erectile dysfunction correction with penis enlargement .
Are there any indications for surgical penis enlargement?
Yes. Medical indications include: micropenis, epispadias, hypospadias, Peyronie's disease, cavernous fibrosis, consequences of penile injury. "Aesthetic indications" - a hidden penis, an excess of fatty tissue in the pubic area.
Penis enlargement by surgery is not a new topic, as it was previously an additional goal in the treatment of various penile diseases. However, penis enlargement has only recently 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 external attractiveness, to improve the quality of sexual intercourse, to increase self-esteem, due to the "locker room syndrome", when a man is embarrassed to be naked in a communal shower, sauna, etc. Believing that I have a small penis.
The medical and functional indications for the augmentation are clear. But it should be emphasized that the last group (aesthetic indications) is the most numerous and at the same time the most controversial. In this group, the aesthetic wishes of the patients become indications for surgery.
In 1986, scientists believed that "the ability to consume a hypochondriac fixation on one's genitals is the exclusive property of men and is absolutely not characteristic of women. "It is this condition that can be interpreted as penile dysmorphophobia. In other words, penis dysmorphophobia is a man's dissatisfaction with the appearance, shape and size of his penis.
However, dysmorphophobia of the penis, 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 does the penis enlarge?
Penis Surgical Enlargement Methods:
Dissection of the suspensory ligament of the penis- ligamentotomy (long operation). In 1990, a Chinese surgeon developed a penis enlargement operation, the ligamentotomy, which is the primary and most versatile method of penis lengthening. The principle of the method is based on the elimination of the physiological curvature of the penis by crossing the supporting ligament and releasing the corpora cavernosa at 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 allows to obtain an elongation of the penis up to 3-5 cm.
Prosthesis implantation with simultaneous transverse incisions of the albuginea.It should be emphasized that the isolated implantation of prostheses in the corpora cavernosa of the penis does not lead to an increase in the length of the penis. Implants are designed to provide organ stiffness for successful introjection in men with erectile dysfunction. The principle of the simultaneous implant lengthening method consists in placing in the intracavernosal space obviously longer prostheses and performing transverse corporotomies to lengthen the organ.
Implant + lengthening with total mobilization of the legs of the penis.The effect is obtained thanks to the maximum removal of the proximal part of the corpora cavernosa thanks to their complete mobilization, moving anteriorly and fixing in the area of the pubic joint. Such a significant displacement of the penis implies the intersection of deep arteries and the effective closure of the hemodynamic mechanism of erection. The blood supply to the cavernous bodies is carried out by the dorsal vascular bundle and the spongy body of the urethra.
It should be emphasized that 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.
Decoupling operation (Perovic operation).The author of this technique recommends to carry out a complete separation of the organ into components - separation of the corpora cavernosa as much as possible along the entire length of the pendant part of the penis from the corpus spongiosum and from the head, with complete mobilization of the dorsal neurovascular bundle. Between the ends 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 stretching effect is obtained thanks to the natural elasticity and ability to stretch the spongy body of the urethra and the elements of the neurovascular bundle. The lengthening of the penis can be achieved up to 3-5 cm.
Penis surgical thickening methods:
Autotransplantation of microsurgical tissues, subcutaneous injection of free self-fat, use of a free flap of deep epidermal skin fat, corporotomy with replacement autograft and allograft, use of rotated pedicled flaps, use of a synthetic implant
Autotransplantation of microsurgical tissues. The method of microsurgical autotransplantation of bundle-muscular or bundle-fat flaps on a vascular pedicle in feeding consists in the subcutaneous coiling of the penis with a selected fragment of the latissimus dorsal muscle, followed by its revascularization (application of vascular anastomosis to maintain the inflow of blood in corruption).
Subcutaneous injection of free body fat.Most often, the fatty tissue for implantation is obtained during liposuction from the suprapubic region. After a special preparation of the evacuated fat, it is gradually introduced through a syringe along the entire part of the penis shaft through an incision in the subcoronary area. In this case, it is necessary to perform manual modeling, straightening the adipose tissue evenly along the organ.
The use of a fat free flap of the skin deep in the epidermis.Cut one or two grafts in the donor area. This is usually the gluteal or, less commonly, inguinal folds. Depending on the size of the penis, each graft should be approximately 12-15cm long and 5-12cm wide, depending on whether one or two flaps are used. These flaps are then implanted under the skin of the penis along the entire shaft.
Longitudinal corporotomies with replacement autotransplantation (Austoni operation).The principle of the operation consists in making longitudinal incisions of the albuginea on the bilateral surfaces of the corpora cavernosa of the penis, followed by the replacement of the defects with inserts of an autovena or other material.
Application of rotated pedunculated flaps. Widespread use of autologous tissues for penile thickening limits the lack of blood supply to the transplanted tissue. Free vascularized flaps are not always and everywhere usable, due to the technical characteristics of the interventions. In this regard, to thicken the penis, it seems very promising to isolate an autograft with preserved blood flow, without the need for microsurgical vascular anastomosis.
Used to thicken an organtechnique to isolate a fragment of the rectus abdominis muscle. The principle of the operation consists in isolating a rotated muscle flap from the anterior abdominal wall on a feeding leg, 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 to the coronal sulcus.
The principle of another operation is to isolate two (Dabees operation) or a flap of fascial fat rotated from the subcutaneous tissue of the anterior abdominal wall.
The use of synthetic prostheses. A new direction of penile thickening is considered very promising, which is to implant a specially designed synthetic implant under the skin of an organ. The principle of the operation and the materials used are similar to those for breast augmentation in women. A solid hydrogel shell or implant is used to thicken the penis. The operation is distinguished by a planned thickening result, a short stationary period, the absence of further incisions for graft sampling and the virtual absence of complications.
In addition, a thickening method based on the technique of transplanting own "grown" tissues on a soluble biopolymer support (matrix) has now been developed. The method is completely new and there are still not enough clinical observations.
What are the results of penis enlargement?
The results of surgical penis enlargement. The degree of lengthening is not a unified criterion, since the reasons that lead to a reduction of the penis are fundamentally different from each other. The standard and successful result of the operation should be considered an organ lengthening of 2. 5-3 cm or more.
There are no standard criteria for evaluating the effect of penile thickening, as much depends on the patient's desire and the possibility of the surgical technique. Uniform thickening of the shaft of the penis, without deformity of the contours and swelling of the graft, is considered satisfactory and a good result.
Are there any complications of penis enlargement surgery?
Just as any surgical procedure can be accompanied by several negative consequences, penis surgeries are not without the risk of developing specific complications.
Cosmetic surgery is known to have two equivalent goals: good anatomical and functional results and patient satisfaction with the operation. 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 penile cosmetic surgery depends on many factors, the determining factors of which are the following: the formation of a realistic attitude in the patient regarding the possibilities of surgery; 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 poor prognostic outcome of the operation is the discrepancy between the patient's preoperative expectations 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 evaluation 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 single organ that performs 3 main functions: copulative (ensuring sexual intercourse), reproductive (ensuring pregnancy) and providing for urination. For a man, it is identified by nature in the singular and therefore, paraphrasing the well-known phrase, ". . . Living together they need it so that it is not excruciatingly painful. . . ". And if in the future men will be able, if necessary, to freely correct the size of their reproductive organs, as we now correct bad teeth, then in the future there will be much less disappointed, embittered and simply unhappy men, since a harmonious intimate life is one. of the constituent factors of a healthy and socially active person.