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 power is too small.
About 80% of men suffer from the inferiority complex around their member exclusively due to the 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 enough for normal sexual function.
If a man has a stretched or erect penis length 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 the lower limit of the average penis size.
Based on generalized 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 completely sure that he has a statistically average size penis. A penis smaller than 9. 5 cm should be called a small penis. The term micropenis means that the length of the stretched penis does not exceed 2 cm.
What are the social aspects of a small penis?
At the end of the 20th century, an open public awareness of family issues, men's health and, of course, sexual problems, contributed to many paramedical, sexually oriented advertising media popularizing the idea of increasing size. male genital organs, including surgery. Currently, both in the specialized medical and popular literature, there is more and more information about the possibilities of increasing the size of the penis in various ways, including surgery. Many medical and popular websites have been created, and entire columns dedicated to surgical interventions 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 their 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 leads a man to look for ways to increase the size of his perfectly normal, in terms of anatomical parameters, penis. And if a person is convinced that his genitals are too small, then no medical beliefs that say otherwise will bring results. This man's consciousness is dominated by feelings of inferiority and low self-esteem, which sometimes requires treatment by a psychotherapist. However, it does not always give the desired emotional improvement.
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 significantly increased their self-esteem after breast augmentation and got rid of long-term mental disorders and depression. In this case, if a woman undergoes breast implants or liposuction for aesthetic reasons in order to increase her importance and the admiration of others, then why would a man not decide to have penis enlargement surgery for the same reasons?
In addition, it is known that more than 70% of women, if they answered an anonymous question: "Of several similar and outwardly equally attractive men, but with genitals of different lengths, who would you prefer? ""decided for a man with a big cock.
What are the methods of penis enlargement?
All methods used to increase the size of the penis can be conditionally divided into three groups - vacuum, traction and surgery. The first two groups are inherently non-surgical methods and consist of long-term "training" of the stretching tissue.
Vacuum devices (VU)- consist 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 pump removes air from the cylinder, creates a vacuum in the cylinder, as a result of which blood from the body rushes towards the penis and it increases in size.
External stretching devicesare various extenders for permanent stretching of the penis along the length. For 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 recommended to use these devices after surgical lengthening of the penis. 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 on the pubic joint. The supporting ligament is the main object of intervention in penis enlargement surgery. This triangular nucleus of fibrous tissue merges with Bukin's deep fascia. The ligament extends from the line of the alba and the tip of the symphysis along the midline to the center of the penis. Furthermore, the ligament diverges laterally like a fan, bends around the edges and, so to speak, covers 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 of penis enlargement have several goals: penis lengthening, penis thickening, a combination of penis lengthening and thickening, correction of erectile deformity with correction of penis size, correction of erectile dysfunction by penis enlargement.
Are there any indications for surgical penis enlargement?
If I had. Medical indications include: micropenis, epispadias, hypospadias, Peyronie's disease, cavernous fibrosis, consequences of penile injury. "Aesthetic indications" - hidden penis, excess fatty tissue in the pubic area.
Penis lengthening with surgery is not a new topic, because it used to be an additional goal in the treatment of various diseases of the penis. However, only recently has penis extension 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, improve the quality of sexual relations, increase self-esteem, due to "locker room syndrome", when a man is ashamed to be naked in a shared shower, sauna, etc. to have a small penis.
The medical and functional indications for 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 desires of the patients become an indication for surgery.
Scientists believed in 1986 that "the ability of comprehensive hypochondriac fixation on one's genitals is the exclusive property of men and is absolutely not inherent in women. " This is a 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, dysmorphophobia of the penis, as an indication for surgical treatment, is not contrary to the principles of cosmetic surgery, the purpose of which is to improve the shape of a normal organ. A man's desire to enlarge his penis is one of the main indications for surgery.
How does the penis enlarge?
Methods of surgical penis lengthening:
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 versatile method for lengthening the penis. The principle of the method is based on eliminating the physiological curvature of the penis by crossing the supporting ligament and releasing the cavernous body to the level of deep arteries entering them and subsequently fixing the cavernous bodies in a new position to the level of the ruptured supporting ligament. The technique enables the achievement of penis extension up to 3-5 cm.
Implantation of dentures with simultaneous transverse incisions of the albuginea.It should be emphasized that the isolated implantation of prostheses into the cavernous bodies of the penis does not lead to an increase in 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 extension with simultaneous implantation consists in placing prostheses of obviously greater length in the intracavernous space and performing transverse corporotomies in order to extend the organs.
Implantation + extension with complete 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 complete mobilization, forward movement and fixation in the pubic joint area. Such a significant shift of the penis implies the crossing of deep arteries and the actual shutdown of the hemodynamic mechanism of erection. The supply of blood to the corpora cavernosa is performed by the dorsal vascular bundle and the spongy body of the urethra.
It must 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.
Separation operation (Perović operation).The author of this technique recommends complete separation of organs into components - separation of 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 the dorsal part. neurovascular bundle. Pieces of the patient's costal cartilage or synthetic implant are placed between the ends of the cavernous bodies and the head, taking into account the free distance obtained and previously measured. The effect of elongation is achieved due to the natural elasticity and 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 of surgical thickening of the penis:
Microsurgical autotransplantation of tissues, subcutaneous injection of free automasti, use of free deep-epidermal skin-fat flap, corporotomy with replacement autotransplantation and allotransplantation, use of rotated flaps on pedicels, use of synthetic implant
Microsurgical autotransplantation of tissues. The method of microsurgical autotransplantation of fascio-muscular or fascio-fatty flaps on the feeding vascular pedicle 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 to the graft).
Subcutaneous injection of free automasti.Most often, adipose tissue for implantation is obtained during 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 zone. In this case, it is necessary to perform manual modeling - even straightening of adipose tissue along the organs.
Use a free deep epidermal layer of skin and fat.Cut one or two grafts in the donor area. These are usually gluteal or, less commonly, inguinal folds. Depending on the size of the penis, each transplant should be about 12-15 cm long and 5-12 cm wide, depending on whether one or two folds are used. These valves are then implanted under the skin of the penis along the entire axis.
Longitudinal corporatomy with replacement autotransplantation (Austoni surgery).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 defects with inserts from the autovenous or other materials.
Application of rotating valves with pedicels. The widespread use of autologous tissues to thicken the penis limits the lack of blood flow to the transplanted tissue. Free vascularized valves are not always and everywhere possible to use, due to the technical characteristics of the operations. In that sense, for penis thickening, it seems very promising to isolate an autograft with preserved blood flow, without the need to perform microsurgical vascular anastomoses.
It is used to thicken the organtechnique for isolating a fragment of the rectus abdominis muscle. The principle of the operation is to isolate the rotated muscle lobe from the anterior abdominal wall on the feeding leg, with the 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 on the coronal sulcus.
The principle of the second operation is to isolate two (Dabees operations) or one rotated fascial fat flap from the subcutaneous tissue of the anterior abdominal wall.
Use of synthetic implants. The new direction of penis thickening is considered very promising, which consists of the implantation of a specially designed synthetic implant under the skin of the organ. The principle of the operation and the materials used are similar to those for breast augmentation in women. A shell or solid hydrogel implant is used to thicken the penis. The operation is characterized by a programmed result of thickening, a short stationary period, the absence of additional incisions for graft sampling and the virtual absence of complications.
In addition, a thickening method based on the technique of transplanting "grown" own tissue 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 unique criterion, because the reasons that lead to penis reduction are significantly different from each other. An extension of the organ of 2. 5-3 cm or more should be considered a standard and successful result of the operation.
There are no standard criteria for assessing the effect of penis thickening, because a lot depends on the patient's wishes and the possibility of surgical technique. Uniform thickening of the penis shaft, without contour deformities and graft bulges, is considered a satisfactory and good result.
Are there any complications of penis enlargement surgery?
Just as any surgical intervention can be accompanied by various negative consequences, so operations on the penis are not without the risk of developing specific complications.
It is known that cosmetic surgery has two equal goals: good anatomical and functional results and patient satisfaction with surgery. The main obstacle to 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, of which the deciding factors are: the formation of a realistic attitude of the patient about the possibilities of surgical intervention; surgeon's experience and skill; application of standard methods; adherence by the patient after surgery to all prescribed recommendations.
At the same time, a very unfavorable 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 achieved during this operation. , the postoperative result can be considered excellent.
In conclusion, it is necessary to emphasize that the penis is the only organ that performs 3 main functions: copulative (ensuring sexual intercourse), reproductive (providing birth) and providing urination. For a man, he is by nature singled out in the singular and therefore, paraphrasing a well-known phrase, ". . . living with them they need it so that later it would not be terribly 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 ugly teeth, then in the future there will be far fewer disappointed, bitter and simply unhappy men, since a harmonious intimate lifeis one of the constitutive factors of a healthy and socially active person.