What are the indications for penis enlargement?
Men have genitals of different sizes. Most of them are happy with the size of their penis, others tend to think that their symbol of masculine aptitude is too small.
About 80% of men suffer from an inferiority complex for their member only due to lack of information about the size of the male genitals.
If the length of the penis is less than 2 cm in length, 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 penis length lying down or erect 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 generalized data of the 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 penis of statistically average size. A penis less than 9. 5 cm long should be called the small penis. The term micropenis means that the length of the outstretched penis is not more than 2 cm.
What are the social aspects of the small penis?
In the late 20th century, the open attitude of public awareness towards family problems, men's health and, of course, sexual problems, contributed to the fact that many sexually oriented paramedical advertising media popularized the idea of increasing size. of the male genitals, including surgery. Currently, in both the specialized and popular medical literature, more and more information is emerging about the possibility of increasing penis size in various ways, including surgery. Many medical and popular websites have been created, entire sections dedicated to penile surgery have been published. They describe in detail the advantages 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, for some men, dissatisfaction with the appearance and size of their penis can cause a feeling of inferiority or even depression. This circumstance pushes 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 medical guarantee to the contrary will bring results. In the mind of this man dominates a feeling of inferiority and low self-esteem, which sometimes requires the need for treatment by a psychotherapist. However, it does not always deliver the desired emotional improvement.
You can draw an analogy of penis enlargement with the effect of increasing the size of the female breast. Scientists have proven that women after breast augmentation significantly increased their sense of self-worth and were freed from long-term psychological disorders and depression. In this case, if a woman, for aesthetic reasons, undergoes breast prosthesis implantation or liposuction to increase its importance and admiration of others, then why can not a man, for the same reasons, decide to do apenis enlargement surgery??
In addition, it is known that more than 70% of women, when answering an anonymous question: "From some similar and equally attractive men on the outside, but with genitals of different lengths, who would they prefer? "to choose a man with a large penis.
What are the methods of penis enlargement?
All methods used to increase penis size can be conditionally divided into three groups - vacuum, traction and surgical. The first two groups are essentially non-surgical methods and consist of a long-term "training" of the organ tissues for stretching.
Vacuum equipment (VU)- consists of two main components: a cylinder with an open edge, 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 alignment equipmentare different extenders for permanent extension 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 is highly recommended after surgical penis enlargement. In this case, the effect will be much greater.
Surgical intervention. The possibility of penis lengthening with the help of surgical intervention lies in the peculiarities of fixing the cavernous bodies of the penis with a supporting ligament at the pubic node. The supporting ligament is the main object of intervention in penis enlargement surgery. This triangular sail of fibrous tissue connects to the deep fascia of the Bread. The ligament extends from the linea alba and the apex of the symphysis along the midline to the center of the penis. Further, the divergent ligament like a lateral fan, bends around the edges and, as it were, covers the base of the penis in its proximal part at the level of passage of the cavernous bodies to the hanging part of the penis.
All penis enlargement surgical methods have several purposes: penis lengthening, penis thickening, combination of penis lengthening and thickening, correction of erectile deformity with correction of penis size, correction of erectile dysfunction with enlargement of the penis.
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 damage. "Aesthetic indications" - a hidden penis, an excess of adipose tissue in the pubic area.
Penis enlargement with surgery is not a new topic, as it has previously been an additional goal in the treatment of various penile diseases. However, only recently has penis lengthening been performed as an aesthetic procedure for an anatomically correct and functional penis.
In most cases, men want to increase the size of the penis for the following reasons: to increase external attraction, to improve the quality of sexual intercourse, to increase self-esteem, due to the "dressing room syndrome", when amale is ashamed to be naked in a shared shower room, sauna, etc. believing he has a small penis.
The medical and functional indications for augmentation are clear. But it should be noted that the latter group (aesthetic indications) is the most 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 for comprehensive hypochondriac fixation in the genitals is the exclusive property of men and is not absolutely characteristic of women. "It is this condition that can be interpreted as dysmorphophobia of the penis. 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 conflict with 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:
Suspension of the penile suspending ligament- ligamentotomy (long operation). In 1990, a Chinese surgeon performed an operation to lengthen the penis, ligamentotomy, which is the main and most comprehensive method for 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 releasing the cavernous bodies to the level of deep artery entry into them and the subsequent fixation of the corpora cavernosa to a new position at the level of the severed supporting ligament. The technique allows you to achieve penis lengthening up to 3-5 cm.
Implantation of prostheses with simultaneous cross-section of albuginea.It should be noted that isolated implantation of prostheses in the cavernous bodies of the penis does not lead to an increase in penis length. Prostheses are designed to provide organ stiffness for successful introjection in men with erectile dysfunction. The principle of the elongation method with simultaneous implantation consists in placing prostheses of significantly longer length in the intracavernous space and performing transverse corporotomies in order to lengthen the organ.
Implantation + extension 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, anterior movement and fixation in the area of the pubic node. Such a significant displacement of the penis implies the intersection of the deep arteries and the actual 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 noted that complete corporate mobilization 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.
Detachment operation (Perovic operation).The author of this technique recommends performing a complete separation of the organ into components - the separation of the cavernous bodies as much as possible along the entire length of the hanging part of the penis from the body and the sponge head, with full mobilization of the back. neurovascular clutch. Between the edges of the cavernous bodies and the head, parts of the patient's rib 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 length of the penis can be reached up to 3-5 cm.
Surgical methods of penile thickening:
Autotransplantation of microsurgical tissues, subcutaneous injection of free auto-fat, use of a free deep epidermal varnish with oily skin, corporotomy with replacement autotransplantation and allotransplant, use of rotated pedicle sheets, use of a synthetic implant
Autotransplantation of microsurgical tissues. The method of microsurgical transplantation of fascio-muscular or fascio-adipose flaps in a nourishing vascular pedicle consists of subcutaneous wrapping of the penis with a selected fragment of the latissimus dorsi muscle, followed by its revascularization with applicationblood in grafting).
Free subcutaneous injection of free car fat.Most often, adipose tissue for implantation is obtained during liposuction from the suprapubic region. After special preparation of the evacuated fat, it is gradually inserted through a syringe along the entire part of the penile stalk through an incision in the subcoronary area. In this case, it is necessary to perform manual modeling - the direction of adipose tissue evenly along the body.
Using a free deep epidermal flap with oily skin.Cut one or two grafts in the donor area. Usually these are gluteal folds or, more rarely, inguinal folds. Depending on the size of the penis, each transplant 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 axis.
Longitudinal corpotomy with replacement autotransplantation (Austoni operation).The principle of the operation is to perform longitudinal incisions of the albuginea on the bilateral surfaces of the cavernous bodies of the penis, followed by the replacement of the defects with inserts by an autovene or other materials.
Application of rolled sheets by foot. Extensive 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 for use, due to the technical features of the operations. In this regard, to thicken the penis, 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 muscular flap rotated from the anterior abdominal wall to a food leg, with a base at the root of the penis. The free end of the autograph on the vascular pedicle is performed under the skin of the penis and fixed to the coronary neck.
The principle of another operation is to isolate two (Dabees operation) or a fatty fat flap rotated by the subcutaneous tissue of the anterior abdominal wall.
Use of synthetic implants. A new direction of penis thickening is considered very promising, which consists in placing a synthetic implant specially designed under the skin of an organ. The principle of surgery and the materials used are similar to those for breast augmentation in women. A hard hydrogel shell or implant is used to thicken the penis. The operation is distinguished by a programmed obesity result, a short stationary period, the lack of additional incisions for transplant sampling, and the virtual absence of complications.
Moreover, a thickening method based on the technique of transplanting its own "grown" tissues into a soluble biopolymer carrier (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?
Results of surgical penis enlargement. The degree of elongation is not a unified criterion, as the reasons leading to penis reduction are fundamentally different from each other. The standard and successful result of the operation should be considered an organ elongation of 2, 5-3 cm or more.
There are no standard criteria for assessing the effect of penile obesity, as much depends on the patient's desire and the possibility of surgical technique. The uniform thickness of the shaft of the penis, without contour deformations and graft swelling, is considered satisfactory and a good result.
Are there any complications of penis enlargement surgery?
Just like any surgical intervention can be associated with various negative consequences, so surgeries on the penis are 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 achieve this is the development of various complications and the negative evaluation of the patient for the final results of the operation. The frequency of complications in cosmetic penis surgery depends on many factors, the determining factors of which are: 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 surgery of all the recommendations described.
At the same time, a very unfavorable prognostic result of the surgery is the mismatch between the patient's preoperative expectations for a "miracle" from the surgeon's scalpel and the result actually achieved during this surgery. This may be due to an unrealistic expectation or a deliberate 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 noted that the penis is a unique organ that performs 3 main functions: copulative (ensuring sexual intercourse), reproductive (ensuring the birth of children) and urination. For a man he is isolated from nature in the singular and therefore, paraphrasing the familiar phrase, ". . . Live with them need not to be extremely 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 far fewer men who are disappointed, grieved, and simplyunhappy in the future, as a harmonious intimate life is one of the constituent factors of a healthy and socially active person.