What is penoplasty?
Penoplasty, or phalloplasty, is a surgical technique involving the enlargement and lengthening of the penis. It improves the aesthetic appearance of the penis without the need for prostheses or visible scars. The size of the penis can have an impact on men's sexual performance, leading to complexes in their sex life as well as their social life (fulfilling oneself in a group, e.g. in a gym changing room, wearing a bathing suit, etc.).
When the size of the penis is unsatisfactory, phalloplasty is an option. The perception of size is often not the same from one man to another. When the penis is flaccid (at rest), it measures an average of ten centimetres in length and nine centimetres in circumference. When erect, the average penis is fifteen centimetres long and twelve centimetres in circumference.
Desires to increase penis size must remain realistic. Dr. Delobaux takes into account the patient's real motivations and expectations, to avoid disappointment when the final result is achieved. It's very important to have a serious, realistic motive that is decisive of the candidate's will.
Who are the candidates for aesthetic penoplasty?
Contrary to popular belief, penoplasty is no longer a taboo subject. It's a confidence-boosting procedure, and men are more interested in learning about the techniques and results.
The ideal candidate for cosmetic penoplasty should have the following characteristics:
- Clear patient psychology;
- Intimate discomfort: insufficient length or thickness, excessive retraction of the penis at rest;
- Social discomfort: locker room syndrome, swimsuit complex
- Complexity linked to the malformation: embarrassment in professional life, difficulty establishing relationships, feeling of devaluation, premonition of failure;
- The request can only be accepted after a thorough clinical examination to determine the various characteristics of the penis.
Contraindications:
There are some contraindications, particularly concerning general anaesthesia. This will be discussed with the surgeon, Dr. Alexis Delobaux, prior to the operation. As any medical procedure is not without risk, penoplasty is not without its risks, which can lead to the appearance of small modules in some cases.
In practice, penoplasty candidates are required to have a clearly realistic motivation.
Excessive focus on the penis, masking psychological disorders, requires the care of a psychotherapist.
What to do in case of functional problems?
Functional erectile dysfunctions must be seriously treated in parallel with any procedure, and are therefore only temporary contraindications.
Nevertheless, serious cases of dysmorphophobia constitute real contraindications, as this is a psychiatric condition that does not require surgery at all. In the majority of cases, "small penis syndrome or locker room complex cannot be considered psychological disorders except by practitioners who ignore the very essence of these patients' suffering".
The best proof of this is the satisfaction and well-being of the men who have benefited from this surgery in Dr Delobaux's practice.
In short, when a candidate for penoplasty suffers from erectile dysfunction, we don't immediately recommend enlargement penoplasty. His or her case must be carefully studied before any action is taken.
The penoplasty procedure
The surgical procedure can be performed under local anaesthetic or general anaesthetic on an outpatient basis, lasting between thirty and forty-five minutes.
Lengthening penoplasty should be combined with thickening. It will increase the diameter of the penis, both at rest and when erect.
The weight of the fat injected into the penis helps to increase the thickness of the skin tissue. However, both procedures can be performed at the same time.
Thickening penoplasty
Enlargement is performed using the
lipofilling involves reinjecting the patient's own fat extracted from the abdomen, pubis, inner or outer thighs, or buttocks. These areas are rich in adipocytes, which are not very sensitive to weight variations, and provide better long-term maintenance of the fat graft.
Dr Delobaux removes fat tissue without prior infiltration, using a suction cannula with a foam tip attached to a syringe to remove a quantity of fat varying between 40 and 80 cm3. The fat is then exported directly without decanting or centrifuging.
Fat is injected into the groove that separates the glans penis from the body of the penis (the balanopreputial groove). The surgeon injects small quantities of fat (0.5 cm3 on average) harmoniously into the base of the penis at the pubic angle.
Similarly, hyaluronic acid can be an alternative to fat injection. The procedure is quicker and the volumizing effect more imminent than lipofilling, but the result is provisional and injections need to be repeated every 18 months or so.
Lengthening penoplasty
Advances in intimate plastic surgery have enabled thousands of men to increase the size of their penises while lengthening their sex. This was the emergence of penoplasty. Penoplasty is a surgical procedure involving partial sectioning of the suspensory ligament linking the penis to the pubic bone. The erect penis remains unchanged.
To achieve this, Dr. Delobaux, the leading plastic surgeon in Bordeaux and a specialist in penoplasty, first makes a pubic incision of a few centimetres, then partially or totally cuts the penile suspensory ligament (the ligament connecting the penis to the pubis). This procedure makes it possible to externalize a segment of the internal penis while enlarging its size by 2 to 4 cm. It is therefore important to note that this lengthening is only visible at rest, and has little impact on the size of the penis when erect.
What is the usual postoperative course of penoplasty?
The medical team places a drain in the surgical area, which is removed the same evening or the day after the operation. In most cases, hospitalization lasts only one day (ambulatory): you can be discharged the same evening. If you live alone at home, you may need to stay overnight at the clinic for monitoring after general anaesthesia. Sutures are absorbable.
The post-operative course is very light:
- Urination resumes immediately.
- Sexual relations are only permitted after 30 to 45 days.
- Sports activities can be resumed 15 days after the operation, with the wearing of briefs.
- In the first weeks or months following surgery, the following symptoms are usually present:
- Edema (swelling) of the penis, which disappears naturally within a few days.
- Bruising, which fades within 21 days.
- Pain may be experienced at the surgical site, but this is significantly reduced by the systematic use of a local anaesthetic.
- The downtime is between 2 and 5 days. Results are immediately visible. However, the final result is obtained within 3 months, once the edema has completely disappeared.
The results
One year after phalloplasty, the penis gains approximately 2 to 4 cm in length and 2 to 3 cm in circumference. The natural appearance of the penis is maintained, as is its sensitivity. The patient experiences no pain or discomfort during intercourse or coitus.
Penis thickening: Results at rest and with erection
While the length of the penis remains unchanged over time, additional sessions of fat injections are often necessary to achieve the desired volume of thickening. After one session, the penis gains 2 to 3 cm in circumference. This increase in size can progress to 3 to 5 cm after 3 sessions. The patient is often informed of this evolution, so as to anticipate the final result and avoid disappointment after the first injection. Thickening is progressive, and is visible both at rest and during erection.
Penis lengthening: observed only at rest
Surgery does not alter the length of the corpora cavernosa involved in erection.
The price of phalloplasty
The price depends on the type of operation, anesthesia and length of stay.
For thickening alone, the fee starts at 3,000 euros, excluding clinic fees and anesthesia.
Conversely, when the procedure combines lengthening and thickening, the fee is set at 5,500 euros.
