Because the desire for a bigger penis is both a preoccupation and a source of concern for many men, the penis enlargement "market" has flourished. So what are all the options? What works and what doesn't? There are literally hundreds of advertisements and articles on penis enlargement, and your email inbox probably suffers as a result. They talk about the amazing, "unbelievable" results that can be achieved, but the only honest word here is "unbelievable.
The vacuum draws blood into the penis and makes it swell. Another surgical technique known as a dermal implant can increase girth and length. Bju International-Supplement. Therefore we decided to inject a modestly superior quantity to take into account its predicted partial resorption. According to Dr. Get the facts about what to expect from male-enhancement pills, pumps, exercises and surgeries. A small number of subjects experienced complications including seroma, scarring, and infection. Are condoms the right size?
Swingers nth qld. Message sent successfully
Advertising revenue supports our not-for-profit mission. Anxiety is everywhere, floating freely through the air, passing from person to person like a virus on the wings of a sneeze. Photo courtesy of Shutterstock. How to choose hanger for enlargement penis. Start by slowly contracting the PC muscle until you feel you can't contract it any more. Fla doc uniforms on a sample of 1, guysthe average self-reported erect penis length is 5. Question 8. A penis is considered abnormally small only if it measures less than 3 inches about 7. A single copy of these materials may be reprinted for noncommercial personal use only. Natural penis enlargement exercises and techniques consist of a series of massages and stretches, which have All about penile enlargwment practiced for over years. How to start sex with a girl correctly? The more blood that goes to your penis, the better and faster your recovery and growth as there are more building blocks All about penile enlargwment to the targeted area. Water-Based Penis Pumps.
Back to Sexual health.
- Penis size can be a sensitive issue for many men.
- Penis enlargement is a popular topic on the Internet, for obvious reasons.
- The device is FDA-cleared for cosmetic enhancement.
- Big Penile vs Bodybuilding!
- Join hundreds of men who have already gained stronger and bigger erections and more satisfying sex life thanks to all-natural penis enlargement exercises.
- Anxiety is everywhere, floating freely through the air, passing from person to person like a virus on the wings of a sneeze.
Penis size is a common source of anxiety. This has fueled a multimillion-dollar penis enlargement, or male enhancement, industry. This article will look at the effectiveness and side effects of penis enlargement methods.
It will also discuss average penis length and girth, and when a person may wish to see their doctor. Most people who consider penis enlargement treatments have normal-sized penises, meaning that they are adequately sized for sexual activity and urination. Manufacturers claim that products, including pills, creams, and stretching devices, can increase penis size. Some people also consider surgery. However, the Urology Care Foundation points out that nearly none of these methods work.
Traction devices aim to increase the length of the penis by stretching the penile tissue. A person places a weight or small extending frame on the flaccid penis to gently lengthen it. According to a scientific review from , penile extenders are the only evidence-based technique for lengthening, and the results may not be inferior to penile surgery. Several studies have investigated the effects of traction devices, with varying results. Some results suggest that the devices can lengthen the penis by as much as 1—3 centimeters cm.
In most of these trials, participants wore the devices for between 4 and 6 hours a day. In one, they wore the devices for 9 hours a day. Researchers are also investigating whether using traction devices before or after penile surgery could improve outcomes.
The evidence concerning traction devices is, however, limited. Determining their safety and effectiveness will require more research, and the Urology Care Foundation currently does not support their use. A vacuum device contains a tube that fits over the penis. Pumping out air creates a vacuum that draws blood into the penis, causing it to swell. People usually use vacuum devices to treat impotence , or erectile dysfunction. No strong scientific evidence suggests that they can increase penis size.
Many different pills and creams promise to increase penis size. They tend to contain various vitamins , minerals, herbs, or hormones. Penile augmentation involves injecting fat cells into the penis.
The aim is to increase girth, or width, as well as length, in some cases. The procedure carries risks. Side effects may include swelling and distortion of the penis. If a side effect is severe, the penis may require removal.
Another method of penile augmentation involves grafting fat cells from elsewhere in the body onto the penis. This is less invasive and can add an average of 2. However, the organ can lose 20—80 percent of the new volume within 1 year of surgery, so people may need multiple surgeries to achieve the desired result.
The second main type of surgery is suspensory ligament release. This ligament anchors the penis to the pubic area and provides support during an erection. If a surgeon cuts the ligament, this changes the angle of the penis, which can make it look longer. On average, suspensory ligament release can increase flaccid penis length by between 1—3 cm , but patient and partner satisfaction rates tend to be low. The lack of support during an erection can make penetration difficult. Like the Urology Care Foundation, the American Urological Association state that penile augmentation surgery is neither safe nor effective.
A study , which included 15, men from around the world, determined that:. The authors estimated that 5 percent of men have an erect penis longer than 16 cm. In another 5 percent, the erect penis would be shorter than around 10 cm. Expert, evidence-based advice delivered straight to your inbox to help you take control of your health.
The medical community only deems surgery necessary if a person has a condition called micropenis. This term describes a penis that is 7. Penis enlargement surgery can cause several side effects, including swelling and infection. These can be so severe that the penis requires removal. In addition, overusing a vacuum pump can damage penile tissue, which can lead to weaker erections.
Negative feelings about penis size can inhibit a person's enjoyment. Most penis enlargement methods do not work, but counseling can help by building self-esteem and correcting distorted ideas related to body image. A person with a condition called penile dysmorphophobia disorder PDD may benefit from talking with a doctor. There are two types of the disorder, but both involve consistently underestimating the size of one's own penis, while overestimating the sizes of those belonging to others.
This can lead to feelings of depression , sexual anxiety, and sexual dysfunction. Some people with the disorder find it difficult to get or maintain an erection, and they experience a lack of sexual satisfaction.
PDD is a form of body dysmorphia. This classification describes an all-consuming preoccupation with what a person perceives to be a flaw in their appearance. People with this condition are often so concerned that others will consider their penis to be small that they do not want to get undressed around people.
Many men are anxious about their penis size, and this has fueled a huge market for enlargement products and techniques. However, limited evidence suggests that any of these methods are effective, and many come with serious risks. Table of contents Does it work? What size is the average penis? We take a close look at average penis size, contributing factors, and what men and women think about penis size.
According to one study, the averge erect penis is Stay in the know. Expert, evidence-based advice delivered straight to your inbox to help you take control of your health Sign Up.
Are there any side effects or risks? Castle EP expert opinion. Return to step 6 and continue until you reach the desired number of repetitions. Dietary supplements don't require approval by the Food and Drug Administration, so manufacturers don't have to prove safety or effectiveness. Pay attention not to burn your skin. How to Fall Asleep in 10, 60, or Seconds. Watermelon — Watermelon contains a chemical named citrulline that helps increase blood flow throughout your body and relax the blood vessels.
All about penile enlargwment. Significance of penis
Penis Enlargement: What Works and Why
In this article we report the results of a retrospective study of cases of cosmetic elongation, enlargement and combined elongation and enlargement phalloplasty. This was consistent with an IIEF-5 improvement of 6. This study is clinically relevant due to the large cohort of patients included and because it is the first study to use an inverse periosteal-fascial suture not described previously as part of the surgical methodology.
Male genital image is correlated, albeit not in a necessarily linear manner 1 , to overall body image, psychosocial variables and sexual health 2 ; in turn, sexual health is correlated to genital image 3. Concern over genital endowment has archaic roots 4 , 5.
It typically emerges during adolescence 6 , 7 and is triggered more by comparison among men than by the fear of not satisfying the partner 8.
We present a retrospective study of cases of phalloplasty performed between and Furthermore, these measurements were rarely conducted on statistically adequate samples. The availability of regulatory data per defined population would be essential not only for diagnostic and therapeutic purposes, but also to reassure patients who display feelings of inadequacy 1 , 7 , 9 , 10 and to manufacture correctly sized prophylactics Penis size is an anthropometric measurement 12 and is correlated to anthropometric measurements such as height, weight and body mass index BMI 12 , These measurements are intercorrelated 13 and they are polygenic traits subject to multifactorial influences All methods and procedures were carried out in accordance with the principles contained in the Declaration of Helsinki.
They came to our centre in Milan Italy for a cosmetic phalloplasty between and [cosmetic elongation 21 , enlargement 33 and combined elongation and enlargement ].
The stretched penis length SPL is considered a trustworthy approximation of the penis length during erection 1. The 5-item International Index of Erectile Function IIEF-5 is a validated diagnostic test that we administered to all the patients included in this study.
All patients signed the informed consent to undergo the procedure and for the video to be published. Measurement was always performed in the same room, by the same operator and using the same flexible measure after a brief introductory interview, performed to put the patient at ease.
The measurement was performed before the ultrasound scan to avoid variations caused by changes in temperature. The measurement of the length was performed according to Mondaini et al. The length of the penis is defined as the linear distance along the dorsal side of the penis between the pubo-penile junction and the tip of the glans, either in the flaccid or stretched states.
The circumference of the penis was measured at rest at mid-shaft. In all cases we found that the measurements were coherent with the morphometric values of reference of adult men according to Wessels and Ponchietti 9 , 12 and this information was shared with the patients. A meeting between the patients and the anaesthetist occurred separately. At the end of the general examination, patients received instructions to be followed the night before and the morning prior to the surgical operation.
Information regarding the phalloplasty discussed with the patients during their general examination. The cosmetic phalloplasty candidate is a healthy and potent man with no congenital or acquired abnormalities or urogenital diseases.
In this study, exclusion criteria were:. This may depend, at least in part, on the concept that enlargement phalloplasty is less invasive than lengthening phalloplasty.
The time that elapsed between the first examination and the surgical procedure was 2—6 months. The choice of anaesthesia for cosmetic phalloplasty must be in line with the criteria of clinical adequacy, minimum invasiveness and rapid discharge.
Among the different choices of anaesthesia, a vast array of scientific documentation 15 exists to support the decided clinical advantages of sedation methods associated with local and loco-regional anaesthesia techniques.
On the basis of such scientific support, we have opted for the following anaesthesia protocol:. Induction: Fentanyl 0. Prior to the operation, the patients were photographed while standing.
The operation began after disinfection of the skin, with the harvesting of the adipose tissue. This was performed by explanting fat bilaterally from the thighs if the patient was tendentially thin and from the periumbilical region if the patient was normo-weight or overweight and from the suprapubic region if there was any localised adiposity. This latter area of harvesting permitted, in certain cases, the reduction of the suprapubic adipose panniculus suprapubic lipectomy rendering the point of insertion of the penis deeper and visually increasing the length of the external portion of the penis see supplementary file.
Thereafter infiltration of the donor site was performed with a tumescent solution. That volume was comprised of infiltration material which was then removed by decantation first and centrifugation later. Such a process of purification is of primary importance since it determines the percentage integration of fat in the penis.
In our surgical centre we first performed the decantation through sedimentation of each 10 cc syringe in such a way as to put the harvested material through an initial process of purification. Each syringe was filled with fat again and each time the infiltration material was removed, repeating the decantation by sedimentation process many times.
The suprapubic area was incised using the inverted V technique V-Y Plasty , which is more preferable than the Z technique or other techniques since it guarantees a better aesthetic result 16 and is widely used in plastic surgery Fig.
This was followed by a complete section of the suspensory ligament of the penis, taking care to adequately section the lateral ligaments as well. Only in this way it is possible to obtain the best achievable results. The suspensory ligament of the penis is a deep structure that joins the cavernous bodies of the penis to the pubic symphysis; its section entails the forward translation of the internal portion of the penis with the consequent increase in the length of the visible penile volume.
In order to avoid post-surgical scar retraction of the ligament, inverse periosteal-fascial sutures were used. This technique ensured that the most superficial ligamentous tissues, which had been sectioned, were inverted into the newly formed cavity and then anchored with nylon stitches in the deepest portion of the periosteum of the pubic symphysis.
A first deep layer of suture was performed using a slow resorption material suturing the ligament in a longitudinal direction. In effect, the ligament was initially sectioned horizontally and then sutured longitudinally thereby obtaining a postero-anterior increment in length that supported the increment obtained through the section of the deep ligaments.
We used a technique similar to that employed by Brisson, His technique allowed him to obtain a valid increase in the length of the external part of the penis and, at the same time, avoid scar-retraction phenomena that in the past nullified the increase obtained after a few weeks. Moreover, this quick and simple technique avoided the use of materials foreign to the organism, such as spacers of various kinds. A second layer of sutures was then performed always longitudinally using resorbable sutures.
Finally, the cosmetic closure of the cutaneous cut was performed using resorbable intradermal sutures V-Y plasty. The inverse periosteal-fascial suture is intended to prevent the post-operative scar retraction of the dissected suspensory ligament. Once the severing of the suspensory ligament is completed, a non-resorbable suture is applied. When tightening the suture knot, an introflection inversion of both bands towards the sloping point of the pubis is obtained. It thus fills the space formed by the section of the suspensory ligament and allows for the forward sliding of the penis.
This technique prevents the post-operative retraction of the suspensory ligament, a frequent cause of surgical failure, and ensures a permanent and gratifying result. Once the penile elongation operation had been performed, the test-tubes containing the purified adipose material were extracted. They typically contained three layers: the most superficial was oily, the middle contained the purified fat and the lower was made up of blood and infiltration material The inferior and superior layers were eliminated and the purified material was implanted.
The purified adipose material contained in the 10 cc syringes was decanted using a specific connector into 2. The purified fat was then implanted into the subdartoic space taking care of the tunnel using the cannula and arranging the implant symmetrically. The space addressed was relatively avascular and, as a result, the formation of localized haematomas was rarely observed.
In the few cases where hematomas were observed, bandaging was applied. Therefore we decided to inject a modestly superior quantity to take into account its predicted partial resorption. In fact, statistically at least 30 days are needed for the implant to be consolidated and the fat integrated and it is useful to limit the movement of the fat during this period using the elastic bandage.
At the end of the operation a modestly compressive dressing was applied to the supra-pubic area and ice locally. The patient was discharged that evening with directions for medical therapy at home and adequately informed of the recovery period. In particular, the patient was urged to abstain from intense physical activity for 30 days and from sexual and masturbatory activity for 60 days. Following the surgical procedure, length at rest significantly increased at 2 Stretched length significantly increased at 2 Circumference at rest significantly increased at 2 Cosmetic phalloplasty significantly improves penis length at rest A , stretched length B , circumference at rest C and 5-item International Index of Erectile Function IIEF-5 score D at 2, 6 and 12 months post-surgical procedure.
Line represents median. We found that cosmetic phalloplasty significantly improves length at rest, stretched length, circumference at rest and IIEF-5 score at 2, 6 and 12 months post-surgery.
Associated with a cutaneous V-Y plasty, ligamentolysis is the main and most common method of surgical elongation of the penis 19 , 29 — Omission of the cutaneous plasty contrasts the result achieved from the release of the ligament because it impedes the advancement of the shaft Detachment of the suspensory ligament and the pubic symphysis, which is obtained through ligamentolysis, causes a forward movement of the cavernous bodies and allows the penis to reach its maximum extracorporeal projection.
Nevertheless, the operation produces a visible and available increase in the length of the penis as expected by the patient. Several techniques have been proposed in order to impede retraction of the sectioned ligament and therefore nullify the surgical result.
They include positioning of the fat obtained from the spermatic funniculi between the suspensory ligament and the pubic symphysis 19 , 37 , use of silicone spacers 38 , the application of weights 38 and postsurgical penile stretching In a previous study, the post-surgical use of extensors, for at least three consecutive months, resulted in an increase of length of no more than 1.
The current methods of fat transfer were popularised and extensively described by Sydney Coleman 18 , 41 , 42 who in began to transplant fat in iatrogenic deformities from liposuction and subsequently in the face. AFT is today a widely tested procedure, appreciated by patients and very widespread among plastic surgeons even for reconstructive surgery 43 — 49 despite no consensus has been reached regarding the best technique or its success rate.
The fat injection is the most common technique of penile girth enhancement. The fat harvested from the patient is implanted into the subdartoic space with the objective to symmetrically and uniformly increase the circumference of the penis In our experience, cosmetic phalloplasty has evolved in time moving in a direction of increased safety.
The substitution of silicone spacers with inverse periosteal fascial sutures, which we have already described, and the use of autologous fat have marked the end of rare but significant complications that in the past led to reoperation.
Patients who undergo combined elongation and girth enhancement phalloplasty are particularly satisfied compared to those who undergo a single operation which is probably linked to the availability of an overall greater penile volume In line with other authors, we believe that, even in its relative simplicity, cosmetic phalloplasty requires a profound knowledge of anatomy and surgical technique and that the selection of candidates is a fundamental and essential element together with scrupulous gathering of information regarding not only the operation and the obtainable results, but also post-surgical conduct since resuming of sexual activity prior to 60 days after the operation can compromise the results.
While confirming that cosmetic phalloplasty very rarely produces spectacular results and that there is an objective necessity to improve the stability of the fat in time, we retain that the data from our centre show that the surgical technique we utilise is safe, repeatable and produces concrete and measurable results.
The limited literature regarding cosmetic phalloplasty consists of studies performed using diverse surgical techniques and candidate selection criteria which include patients who should in fact be excluded e. If we consider the lack of universally shared morphometric values, we see how this niche of cosmetic surgery suffers from an inevitable lack of methodological rigour.
In the present study we show the efficacy of cosmetic phalloplasty in a large cohort of patients up to 1-year follow-up. In addition, we describe in detail inclusion and exclusion criteria for patient selection and technical aspects of our surgical procedure which ensure reproducibility of our findings and should be adopted in future clinical studies of cosmetic phalloplasty.
We are confident that this study will encourage other authors to publish their experiences with cosmetic phalloplasty and that the method we have described in this article will contribute to the consolidation of a standard for this type of surgery.