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 masculinity is too small.
About 80% of men suffer from inferiority complex in relation to their member only due to lack of information about the size of the male genitalia.
If the length of the penis is less than 2 cm, then this condition is called micropenis and means that the length of the erect penis will not be sufficient for normal sexual function.
If a man has a length of the penis in a stretched or erect 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 the lower limit of the average size of the penis.
Based on the summarized literature data, it can be concluded that an adult man who has an erect penis with a length of 9, 5 cm or more can be absolutely sure that he has a penis of average statistical size. A penis less than 9. 5 cm long should be called a 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?
At the end of the 20th century, the open attitude of the public consciousness towards family problems, men's health and, of course, sexual problems, contributed to the fact that many paramedical, sexually oriented advertising media promoted the idea of increasing the size of the male genitalia. , including through surgery. Currently, both in the specialized medical and popular literature there is more and more information about the possibility of increasing the size of the penis in various ways, including surgery. Many medical and popular Internet sites have been created, and entire sections have been published on penile surgery. 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 cause feelings of inferiority or even depression. This circumstance makes a man look for ways to increase the size of his perfectly normal anatomically penis. And if a person is convinced that his genitals are too small, then no medical assurances to the contrary will not lead to results. This man's mind is dominated by feelings of inferiority and low self-esteem, which sometimes necessitates treatment by a psychotherapist. However, this does not always give the desired emotional improvement.
You can make an analogy of penis enlargement with the effect of increasing the size of a woman's breast. Researchers have shown that women significantly increase their self-esteem after breast augmentation and get rid of long-term psychological disorders and depression. In this case, if a woman for aesthetic reasons undergoes breast implants or liposuction to increase their own importance and the admiration of others, then why the man for the same reasons can not decide to have penis enlargement surgery?
It is also known that more than 70% of women, when answering an anonymous question: "Of several similar and outwardly equally attractive men, but with different genitals in length, who would prefer? ", they would choose a man with a big penis.
What are the methods for penis enlargement?
All methods used to increase the size of the penis can be divided into three groups - vacuum, traction and surgery. The first two groups are essentially non-surgical methods and consist of long-term "training" of the tissues of the stretching organ.
Vacuum devices (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 pressure gradient - the air is removed from the cylinder with a pump, a vacuum is created in the cylinder, as a result of which blood from the body rushes to the penis and it increases in size.
External stretchersare different extenders for permanent stretching 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, the use of these devices after surgical penis lengthening is strongly recommended. In this case, the effect will be much greater.
Surgical intervention. The possibility of penis lengthening with the help of surgery 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 enlargement surgery. This triangular sheet of fibrous tissue connects to the deep fascia of Buka. The ligament extends from the linea alba and the tip of the symphysis along the midline to the center of the penis. In addition, the ligament deflects like a fan laterally, bends around the edges and seems to cover the base of the penis in its proximal part at the level of the transition of the corpora cavernosa to the hanging part of the penis.
All surgical methods for penis enlargement have several purposes: penis lengthening, penis thickening, a combination of penis lengthening 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 penile injury. "Aesthetic indications" - hidden penis, excess adipose tissue in the pubic area.
Penis lengthening through surgery is not a new topic, as it was previously 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 improve external attractiveness, to improve the quality of sexual relations, to increase self-esteem due to "locker room syndrome", when a man is ashamed to be naked in a shared shower, saunaetc. , believing that he has a small penis.
The medical and functional indications for augmentation are clear. But it should be emphasized that the latter group (aesthetic indications) is the most numerous and at the same time the most controversial. In this group, the aesthetic desires of patients become indications for surgery.
In 1986, scientists believed that "The ability to absorb hypochondriac fixation on the genitals is the exclusive property of men and is absolutely not characteristic of women. " This condition can be interpreted as dysmorphophobia of the penis. In other words, dysmorphophobia of the penis isdissatisfaction of the man 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, which aims to improve the shape of a normal organ. The man's desire to increase the size of the penis is one of the main indications for surgery.
How does the penis enlarge?
Methods for surgical lengthening of the penis:
Dissection of the suspensory ligament of the penis- ligamentotomy (long operation). In 1990, a Chinese surgeon developed penile lengthening surgery, ligamentotomy, which is the main and most universal method of penis lengthening. 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 the deep arteries and subsequent fixation of the corpora cavernosa in a new position at the level of torn supporting ligament. The technique allows to achieve penis elongation up to 3-5 cm.
Implantation of prostheses with simultaneous cross-sections of albuginea.It should be emphasized that the isolated implantation of prostheses in the corpora cavernosa of the penis does not increase 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 method of elongation with simultaneous implantation consists in placing prostheses with obviously greater length in the intracavernous space and performing transverse corporatomies in order to lengthen the organ.
Implantation + lengthening with total mobilization of the legs of the penis.The effect is achieved by maximum removal of the proximal part of the corpora cavernosa due to their full mobilization, movement forward and fixation in the pubic area. Such a significant displacement of the penis implies the crossing of deep arteries and the actual exclusion 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 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.
Dissociation operation (Perovic operation).The author of this technique recommends performing a complete separation of the organ components - separation of the corpora cavernosa as much as possible along the entire length of the hanging part of the penis from the spongy body and head, with full mobilization of the dorsal part. neurovascular bundle. Pieces of the patient's coastal cartilage or synthetic implant are then implanted between the ends of the corpora cavernosa and the head, taking into account the obtained and previously measured free distance. The effect of elongation 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. Penis lengthening can be achieved up to 3-5 cm.
Methods for surgical thickening of the penis:
Microsurgical tissue autotransplantation, subcutaneous injection of free fat, use of free deep epidermal skin-oily flap, corporotomy with replacement autotransplantation and allotransplantation, use of rotated pedicle valves, use of synthetic implant
Microsurgical tissue autotransplantation. The method of microsurgical autotransplantation of fascio-muscular or fascio-fatty valves of the feeding vascular leg consists in subcutaneous wrapping of the penis with a selected fragment of the latissimus dorsi muscle, followed by its revascularization (application of vascular anastomoses to maintain blood supply).
Subcutaneous injection of free fats.Most often, adipose tissue for implantation is obtained by liposuction from the suprapubic region. After special preparation of the evacuated fat, it is gradually introduced through a syringe along the entire stem part of the penis through an incision in the subcoronary area. In this case it is necessary to perform manual modeling - straightening adipose tissue evenly along the body.
The use of free deep epidermal skin-oily coating.Cut one or two grafts in the donor area. These are usually the gluteal 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 valves are used. These valves are then implanted under the skin of the penis along its entire shaft.
Longitudinal corporatomies with replacement autotransplantation (Austoni operation).The principle of the operation is to make longitudinal incisions of the albuginea on the bilateral surfaces of the cavernous bodies of the penis, followed by replacement of defects with autovenous inserts or other materials.
Application of rotating valves with handles. The widespread use of autologous tissues to thicken the penis limits the lack of blood supply to the transplanted tissue. Free vascularized valves are not always and everywhere possible due to the technical peculiarities of the operations. In this regard, for penis thickening, it seems very promising to isolate an autograph 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 valve from the anterior abdominal wall of the feeding leg, with a base at the root of the penis. The free end of the auto graft on the vascular pedicle is held under the skin of the penis and fixed in the coronal sulcus.
The principle of another operation is to isolate two (Dabees operation) or one rotated fascial fat valves from the subcutaneous tissue of the anterior abdominal wall.
The use of synthetic implants. The new direction of penis thickening is considered very promising, which consists in the implantation of a specially designed synthetic implant under the skin of an organ. The principle of action and the materials used are similar to those for breast augmentation in women. A shell implant or hard hydrogel is used to thicken the penis. The operation is characterized by a programmed result of thickening, a short stationary period, the lack of additional incisions for graft sampling and the actual absence of complications.
In addition, a thickening method has now been developed based on the technique of transplanting "grown" own tissues onto a soluble biopolymer carrier (matrix). The method is completely new and there are still not enough clinical observations.
What are the results of penis enlargement?
Results of surgical penis enlargement. The degree of elongation is not a single criterion, as the reasons leading to the reduction of the penis are radically different from each other. The standard and successful result of the operation should be considered to lengthen the body by 2, 5-3 cm or more.
There are no standard criteria for assessing the effect of penis thickening, as much depends on the patient's desire and the possibility of surgical technique. The uniform thickening of the shaft of the penis, without deformations of the contours and protrusion of the graft, is considered a satisfactory and good result.
Are There Complications To Penis Enlargement Surgery?
As with any surgery, it can be accompanied by a variety of negative consequences, so penile surgery is not without the risk of developing specific complications.
It is known that cosmetic surgery has 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 cosmetic surgery of the penis depends on many factors, the determinants of which are the following: the formation of a realistic attitude in the patient to the possibilities of surgical intervention; experience and skills of the surgeon; application of standard methods; observance 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 expectations for a "miracle" from the surgeon's scalpel and the actual result achieved in this operation. 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 performs 3 main functions: copulative (providing sexual intercourse), reproductive (providing birth) and providing urination. For man, he is distinguished from nature in the singular and therefore, paraphrasing the well-known phrase, ". . . live with them, they need it so that it is not painfully painful later. . . And if in the future men will be able, if necessary, to freely adjust the size of their reproductive organs, as we now correct ugly teeth, then there will be far fewer frustrated, angry and just unhappy men in the future, as harmonious intimatelife is one of the constituent factors of a healthy and socially active person.