Frequently asked questions about Penis Enlargement
Read the answers given by Dr. Mihai Chertif to the most common questions of the patients of the Cosmedica clinic about the Penis Thickening procedure.
1. What does thickening the penis with its own fat entail?
– This procedure is part of the concept of regenerative medicine and is based on the natural abilities of their own tissues to contribute to the improvement of different regions of the body: face, breasts, buttocks, hands, intimate regions in men and women, scars, substance defects, etc.
It involves harvesting fat from a region where the fat is very redundant, processing it by special methods and then injecting it into the Dartos fascia.
2. How do I know if I am a good candidate for fattening my penis?
– For a start, you need an in-person consultation or an online consultation, through which we can assess your situation regarding fat deposits and the conformation of the penis and foreskin. Ideal candidates must be over 20 years of age, not have decompensated chronic diseases or require special treatment that may increase the risk of complications (anti-aggregants, anti-coagulants, cortisone, etc.), with sufficient deposits. large and suitable fat and a physiological conformation of the penis with a normally developed foreskin. Patients who are very well defined as muscle groups or those who are very weak are not good candidates. Regenerative medicine procedures will necessarily involve 2 techniques in the same operation: liposuction and lipofilling (fat injection) and each of the 2 must produce very good results. As plastic surgeons we are not allowed to destroy one tissue for the sake of another. This can happen in the case of patients who have a very low amount of fat and who consider that no matter how much they would not have enough for even 1 session to try to add a small volume. The problem in these cases is related to the place of fat collection after liposuction, which can remain with irregularities and deformities due to the low layer of fat in which the cannula will attack the tissue in an attempt to obtain as much fat as possible. We do not recommend this approach because it will only bring dissatisfaction and unsatisfactory results on both the liposuction area and the penis. The procedure will be optimal for the patient who has at least 2 areas where fat can be harvested because if a second session is needed, it will be possible to approach another area different from the first one. For this, we always establish a strategy with our patients during the consultation.
3. I read in several online publications that not all fat is maintained. This is true? How to proceed in this situation? Can anything be done to keep as much fat as possible?
It is very important that every plastic surgeon who performs these types of procedures knows very well what it entails because the results are closely related to several aspects:
• where is the fat harvested from? The areas where the fat has a high quality and texture are the super-internal thighs, the abdominal flanks and the internal region of the knees. However, experience has shown us that the areas where the fat layer has been or is very resistant to weight loss are the best. The fat that has resisted weight loss will be much more resistant in places where it ends up being injected.
• How is the fat harvested? The cannulas should be quite thick and have as many holes as possible, so that this process is as easy as possible, with as little pressure as possible and with a aspiration as low as possible so as not to destroy fat cells. This moment is one of the most important because a high suction pressure will destroy the viability of adipocytes, and their wall will be compromised. Therefore, relatively large cannulas, many holes and low pressure.
• How is the fat processed? There are many plastic surgeons who do not perform any procedure to separate the fat from the rest of the constituents, leaving it to separate naturally through the decantation process. For the penis thickening procedure, we consider that the decanting technique followed by the Coleman technique is the most indicated because the centrifugation is very easy due to the quantity and the relatively short time for it. In addition, many nodules and granulomas may be due to oily cysts or microcysts that may arise if the oil has not been removed by the decantation method. Therefore, if the fat has been decanted beforehand, after centrifugation, no oil will form, except a thin blade of almost transparent liquid, which will be removed to leave only the pure fat. In recent years, in addition to the Coleman technique, we have performed a special transfer of fat that turns it into fat with small particles – nano-fat. In this way it becomes softer and easier to distribute by massage, drastically reducing the possible occurrence of oily cysts or greasy lumps that can be annoying especially if they are large.
• How to inject fat? Grease should be injected with a cannula thin enough not to leave wide holes and not to create very large channels with at least 1 hole, using maximum syringes. 3 ml and with the lowest possible pressure. It all depends on the relationship between the cannula and the syringes, so that it is never injected under pressure.
• where is the fat injected at the level of the penis? For thickening of the penis it is good to inject under the superficial penile fascia to create volume and projection and subcutaneously only for contour if necessary.
The conclusion is that it is imperative that all the above parameters be made easy and easy so that the fat is not traumatized. Its maintenance rate depends a lot on this. However, even with all our efforts, there are some patients who feel that a larger amount has been lost than expected and so they want to resort to the second session, which is usually complementary and does not involve the same amount as first procedure. We recommend that all patients know that it is possible to opt for a second session, but never earlier than 6 months because the fat injected initially needs to stabilize. So we usually try to make a strategy for the future for the choice of fat harvesting areas, which should be different from one session to another, to avoid the processes of subcutaneous scarring after the initial liposuction.
4. What does it mean to thicken your penis with your own dermis?
– Thickening of the penis with its own dermis may be indicated when the patient is so weak or muscular that he has no fat at all that can be harvested. It involves the harvesting of 2 cutaneous-greasy flaps (skin and fat) from the internal faces of the arms, groin folds or buttocks, which are then deepidermized (a special electrical device is used that will remove only the superficial layer of the skin) and inserted perpendicularly. with the axis of the penis, over the buck’s fascia after the circumcision has been performed beforehand.
5. Which do you think is better: thickening the penis with fat or thickening the penis with your own dermis?
– If the patient has enough fat for at least 1 session, by far the optimal procedure is the one with own fat. The differences are very big: if for fat the duration is 1 hour and the recovery is 1 day, with small 5mm holes where fat is harvested and injected and a rather low risk of complications, for the dermal procedure everything is at the opposite pole. Even if the fat injection procedure may involve another session for a period of time for a stable result because not all fat is maintained, it is good to know that it is the same for the dermis. Neither of the two transferred tissues has vascularity and they will have to form new blood vessels from the vessels in the fascia of the penis. The dermis will also have the same characteristics when it comes to vascularization and neo-formation vessels, which will make it just as susceptible to resorption. In other words, the dermis can be lost. In addition, the remaining scars, longer operative duration than fat, higher risks in both the short and medium and long term, make the dermal procedure optimal only for weak or muscular and highly motivated patients.
6. How do I prepare for the penis enlargement procedure?
– The procedure requires a set of blood and urine tests that will be recommended by your doctor. It also needs to be epilated 2 days before on the intimate area and possibly on the region or regions where the fat will be harvested and also on the same areas to make a decontamination of the skin 3-5 days before the procedure in the shower using disinfectant solutions. such as Chlorhexidine or Betadine.
7. What complications can occur after penis enlargement?
– As with any other operation, general complications may occur: Hematomas (accumulation of excess blood) – occur very rarely or bruising – if they occur they remit in a few days and no problems; Seromas – accumulations of excess lymph – occur extremely rarely and usually do not cause problems; Infection – occurs quite rarely, and local: Asymmetries – due to the possibility of dislocation of fat – occurs quite rarely. It is possible that after a few months, especially after the patient resumes his sexual activities, due to them, the penis and especially the fat suffer changes in the contour, but in principle this aspect happens very rarely. However, if it occurs, the best and easiest solution to solve it is to wait at least 1 year and then, if it is considered efficient, to repeat the thickening session, which can correct the deformities very easily.
As mentioned above, in recent years we have developed a technique for obtaining fat with small particles ( nano-fat ) precisely to reduce the risk of oily cysts and fatty nodules through a much more textured fine and thus a much easier distribution both by cannula handling and injection and by massage; Oil nodules / cysts – appear due to dislocation followed by fat conglomeration in a certain region – may occur, but are usually very small and can only be felt by very meticulous palpation, posing no aesthetic or functional; Edema of the foreskin- may occur in patients with a very long and thin foreskin, but they resolve without problems after the first month; Hyperpigmentation- may occur on the skin of the penis in some cases, but usually resolves after a few months, etc.
8. How much can you gain from the penis enlargement procedure?
– Usually after a session the circumference of the penis can increase in the first phase by 3.5-4 cm. The final result can be evaluated correctly after at least 6 months, when usually a result is obtained with a loss of 30-70% of the initial volume.
9. What is the recovery period and what does it mean after a fattening procedure with its own fat?
– The recovery period after the thickening procedure is 2-3 days. Practically the only discomfort can be related to the liposuction procedure and on the area or areas where it is practiced you will feel an embarrassment like “muscle fever”. This lasts for several days. Usually patients are active in the field of work and to see superior comfort after the thickening procedure we recommend that they have 5-7 days to relax and also see how to manage the position of the penis. Fat is a semi-solid and soft product that can be easily dislodged or moved if the tire is compressed from the outside or the penis is bent, flexed or tightened. Underwear should be as light as possible or even missing in the first 7-10 days. We recommend that patients have the opportunity to monitor the distribution of fat every 3-4 hours by positioning the penis in a comfortable and easy position. After about 30 days this diet is no longer so important because the fat begins to stabilize and certain positions that before could cause the dislocation of fat, now will not produce the same risks. If we take the example of a toothpaste or cream container: when the container is opened from its box, it looks perfect. From the moment it is pressed in different areas to use the content, its appearance changes and to return it to its original form, specific massages and directions of the content are needed. Our desire is to create a compound as soft as possible so that through the alternative massages during the injection procedure we can distribute the fat as symmetrically as possible so that the results are as good as possible, with a symmetrical penis and evenly distributed fat. The patient is taught how to perform those massages to maintain the distribution of fat, which are important in the first at least 30 days until the fat stabilizes.
10. What is the cost of the procedure for thickening the penis with its own fat? But the cost of thickening the penis with your own dermis?
– The cost of the fattening procedure with own fat depends on the amount of fat we have available and the areas we can approach.
The standard cost of a fattening procedure with our own fat would mean that we can harvest fat in very easy conditions from the anterior abdomen and starts from 1300 euros fully included with 1 day of accommodation and subsequent checks.
The cost of the thickening procedure with own dermis starts from 5000 euros fully included with 1-2 days of accommodation and subsequent controls.
11. What is the degree of patient satisfaction?
The latest statistical study performed in the Cosmedic Clinic on a sample of 100 patients, shows us a degree of satisfaction of 94%, both due to the lengthening procedure and the thickening procedure.
These results are due to the very efficient technique, but especially to the way patients are chosen and selected and the procedures for them. It is very important to understand the desire of each patient because we never impose a certain procedure. Usually, our recommendation is only for the thickening procedure because almost all patients have a penis of normal size in erection in length (over 11cm). In these situations, the thickening procedure in one session or maximum 2, performed at an interval of at least 6 months, should provide the desired result. For patients with a small penis (less than 11 cm in erection) we recommend performing all phaloplasty techniques and the thickening procedure in 2 stages.
Cosmedica Clinic conducted a sociological study on a sample of 1,000 women between the ages of 18 and 45, and the vast majority confirmed that a thicker penis, not necessarily a longer one, can provide greater pleasure during intercourse.
Dr.med. Priv. Mihai Chertif
Cosmedic Clinic
Baia Mare
Plastic Surgery & Aesthetics
