What are the indications for penis enlargement?
Men have genitals of various sizes. Most of them are satisfied with the size of their own penis, others tend to think their masculinity symbol is too small.
About 80% of men suffer from inferiority complexes about their members solely due to a lack of information about the size of the male genital organs.
If the length of the penis is less than 2 cm, then 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 stretched or erect penis length 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 penis size.
Based on the general 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 absolutely sure that he has a statistically average size penis. A penis that is less than 9. 5 cm in length should be called a small penis. The term micropenis means a stretched penis length of no more than 2 cm.
What is the social aspect of a small penis?
At the end of the 20th century, the open attitude of the public consciousness to family issues, men's health and, of course, sexual issues, contributed to the fact that many sexually oriented advertising media of paramedics popularized the idea of increasing size. male genital organs, including through surgery. Today, in both specialized and popular medical literature, more and more information is emerging about the possibility of increasing the size of the penis in various ways, including surgery. Many popular and medical Internet sites have been created, entire sections devoted to surgical intervention on the penis are published. They explain in detail the advantages of this technique and the complications associated with penis enlargement surgery.
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 low self-esteem or even depression. This circumstance prompts a man to look for ways to increase the size of his penis which is very normal, in terms of anatomical parameters. And if a person has convinced himself that his sexual organs are too small, then there is no medical guarantee that otherwise it will bring results. In this man's mind, feelings of inferiority and low self-esteem predominate, which sometimes require treatment by a psychotherapist. However, it doesn't always provide the desired emotional boost.
You can draw the analogy of penis enlargement with the effect of increasing the size of a woman's breasts. Scientists have proven that women after breast augmentation significantly improve their sense of self-esteem and they get rid of long-term psychological disorders and depression. In this case, if a woman, for aesthetic reasons, undergoes implantation of a breast prosthesis or liposuction to enhance her own interests and the admiration of others, then why can't men, for the same reason, decide to have penis enlargement surgery?
In addition, it is known that more than 70% of women, when answering an anonymous question: "Of the several men who are similar and outwardly equally attractive, but with genitals of different lengths, who do they like? ", will choose a man withbig penis.
What are the methods of penis enlargement?
All methods used to conditionally increase the size of the penis can be divided into three groups - vacuum, traction and surgical. The first two groups are basically non-surgical methods and consist of long-term "training" of organ tissues for stretching.
Vacuum device (VU)- consists of two main components: a cylinder with one open end, into which the penis is inserted and a vacuum pump. WU works on the principle of a pressure gradient - air is expelled from the cylinder by a pump, a vacuum is created in the cylinder, as a result of which blood from the body flows into the penis and increases in size.
External stretching deviceare various extenders for permanent stretching of the penis in length. During 4-6 months of regular daily training, 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 this device after penis lengthening surgery. 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 peculiarity of fixing the cavernous body of the penis with supporting ligaments in the pubic joint. Supporting ligaments are the main object of intervention in penis enlargement surgery. This triangular screen of fibrous tissue connects to the fascia in the open. The ligament extends from the linea alba and the crest of the symphysis along the midline to the center of the penis. Furthermore, the ligaments diverge like a fan laterally, bend around the edges and, as it were, cover the base of the penis in its proximal part at the level of the transition of the cavernous body to the overhanging part of the penis.
All methods of penis enlargement surgery have several purposes: penis lengthening, penile thickening, a combination of penile lengthening and thickening, correction of erectile deformities with correction of penis size, correction of erectile dysfunction with penis enlargement.
Are there any indications for penis enlargement surgery?
Yes I have. Medical indications include: micropenis, epispadias, hypospadias, Peyronie's disease, cavernous fibrosis, consequences of penile injury. "Aesthetic indications" - hidden penis, excess adipose tissue in the pubic area.
Surgical lengthening of the penis is not a new topic, as previously it has become an additional goal in the treatment of various penile diseases. However, recently penile lengthening is 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, because of "locker room syndrome", when a man is embarrassed to be naked in a public bathroom, sauna, etc. believe 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 patient's aesthetic desire is an indication for surgery.
In 1986, scientists believed that "The ability for hypochondriacal fixation on one's genitals is exclusively male, and is by no means a female characteristic. "This condition 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 aesthetic surgery, the goal of which is to improve the normal shape of the organ. The desire of a man to increase the size of the penis is one of the main indications for surgery.
How to enlarge the penis?
Penis lengthening surgery method:
Penile suspensory ligament dissection– Ligamenotomy (old operation). In 1990, a Chinese surgeon developed a penile lengthening surgery, the ligamentotomy, which is the main and most versatile method of penis lengthening. The principle of this method is based on the elimination of the physiological curvature of the penis by crossing the supporting ligaments and releasing the corpora cavernosa to the level of the entry of the deep artery and subsequent fixation of the corpora cavernosa in a new position at the level of the severed supporting ligament. This technique makes it possible to achieve a penis elongation of up to 3-5 cm.
Implantation of the prosthesis with simultaneous transverse incision of the albuginea.It should be emphasized that the implantation of an isolated prosthesis in the cavernous body of the penis does not lead to an increase in penile length. The prosthesis is designed to provide organ rigidity for successful introjection in men with erectile dysfunction. The principle of the lengthening method with simultaneous implantation consists in placing a prosthesis of a decidedly larger length in the intracavernous space and performing a transverse corporotomy to lengthen the organ.
Implantation + lengthening with total mobilization of the penis foot.The effect is achieved due to the maximum removal of the proximal part of the cavernous body due to its complete mobilization, moving anteriorly and fixing the area of \u200b\u200bthe pubic joint. Such a significant displacement of the penis implies a junction of the deep arteries and a true cessation of the hemodynamic mechanisms of erection. The blood supply of the cavernous bodies is provided by the dorsal vascular bundles and the spongy bodies of the urethra.
It should be emphasized that complete mobilization of the corpora cavernosa leads to erectile dysfunction, due to inevitable damage to the pudendal nerve and deep cavernous arteries. Therefore, this method is only suitable for men with erectile dysfunction.
Release operation (Perovic operation).The authors of this technique recommend performing a complete separation of the organ into components - separation of the cavernous body as much as possible along the entire hanging part of the penis from the body and the spongy head, with complete mobilization of the dorsal neurovascular bundle. Between the end of the cavernous body and the head, a piece of the patient's costal cartilage or a synthetic implant is then implanted, taking into account the previously obtained and measured clearances. The elongating 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 elongation can be achieved up to 3-5 cm.
Penile thickening surgical methods:
Microsurgical tissue autotransplant, autofat-free subcutaneous injection, use of free deep-epidermal skin fat flaps, corporotomy with autotransplant and allotransplant replacement, use of rotated pedicle flaps, use of synthetic implants
Microsurgical tissue autotransplant. The microsurgical method of autotransplantation of a fascio-muscular or fascio-fat flap on a feeding vascular pedicle consists of subcutaneous wrapping of the penis with selected latissimus dorsi muscle fragments, followed by revascularization (applying a vascular anastomosis to maintain blood supply in the graft).
Free autofat subcutaneous injection.Most often, adipose tissue for implantation is obtained during liposuction of the suprapubic area. After special preparation of the evacuated fat, it is gradually introduced through a syringe along the entire length of the shaft of the penis through an incision in the subcoronary zone. In this case, it is necessary to carry out manual modeling - to evenly align the adipose tissue along the length of the organ.
Use of a free deep-epidermal skin fat flap.Cut one or two grafts in the donor area. Usually this is a gluteal fold or, less commonly, an inguinal fold. Depending on the size of the penis, each graft should be about 12-15 cm long and 5-12 cm wide, depending on whether one or two flaps are used. This flap is then implanted under the skin of the penis along the shaft.
Longitudinal corporotomy with replacement autotransplant (Austoni surgery).The principle of operation is to perform a longitudinal incision of the albuginea on the bilateral surfaces of the cavernous bodies of the penis, followed by replacement of the defect with an insert of autovein or other material.
Application of rotated stem flap. The widespread use of autologous tissue for penile thickening limits the lack of blood supply to the transplanted tissue. Free vascularized flaps are not always and everywhere possible to use, due to the technical features of the operation. In this regard, to thicken the penis, it seems very promising to isolate autografts with maintained blood flow, without the need for microvascular anastomosis.
Used to thicken organstechnique to isolate the rectus abdominis muscle fragment. The principle of operation is to isolate the twisted muscle fold from the anterior abdominal wall on the feeding leg, with the base at the base of the penis. The free end of the autograft on the vascular pedicle is performed under the skin of the penis and fixed in the coronal sulcus.
Another operating principle is to isolate two (Dabees surgery) or one rotated fascial fat fold from the subcutaneous tissue of the anterior abdominal wall.
Use of synthetic implants. The new direction of penile thickening is considered very promising, which consists in the implantation of specially designed synthetic implants under the skin of the organ. The principle of operation and the materials used are similar to breast augmentation in women. A solid hydrogel shell or implant is used to thicken the penis. This operation is distinguished by its programmed thickening results, a short stationary period, the absence of additional incisions for graft sampling, and the almost complete absence of complications.
In addition, a thickening method based on the technique of "growing" tissue transplantation on a soluble biopolymer carrier (matrix) has now been developed. This method is completely new and there are not enough clinical observations yet.
What are the results of penis enlargement?
The result of penis enlargement surgery. The degree of elongation is not a unified criterion, since the reasons leading to penis reduction are fundamentally different from each other. The standard outcome and success of the operation should be considered an organ elongation of 2. 5-3 cm or more.
There are no standard criteria for evaluating the effect of penile thickening, as much depends on the wishes of the patient and the possibility of the surgical technique. Uniform penile shaft thickening, without contour deformity and graft protrusion, was considered satisfactory and was a good result.
Are there any complications from penis enlargement surgery?
As with any surgical intervention, it can be accompanied by various negative consequences, so surgery on the penis is not without the risk of developing certain complications.
It is recognized that aesthetic surgery has two equal goals: good anatomic and functional results and patient satisfaction with the operation. The main barriers to achieving this are the development of various complications and the patient's negative assessment of the final outcome of the operation. The frequency of complications in aesthetic penile surgery depends on many factors, the determinants of which are the following: the formation of a realistic attitude in the patient to the possibility of surgical intervention; experience and skills of the surgeon; application of standard methods; compliance by the patient after surgery all the prescribed recommendations.
At the same time, a very unfavorable prognostic outcome of this operation is the mismatch between the patient's preoperative expectations about the "miracle" of the surgeon's scalpel and the results actually achieved during this operation. This may be due to unrealistic expectations or a deliberate negative judgment by the patient about the likely outcome. At the same time, from a surgical point of view, the postoperative outcome can be considered excellent.
In conclusion, it should be emphasized that the penis is a unique organ that performs 3 main functions: copulative (ensures sexual intercourse), reproduction (ensures childbearing) and provides urination. For a man, he is naturally chosen in the singular and singular. Therefore, paraphrasing the famous expression, ". . . live with them need it so that later it doesn't torment unbelievably . . . ". 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 there will be fewer disappointed, hurt, and unhappy men in the future, because a harmonious intimate life is one of the factors forming a healthy and socially active person.