Girth Enhancement

About the penis thickening procedure

Penis enlargement by injecting our own fat is a procedure that is part of the concept of regenerative medicine, which is based on the principle that we can improve the volume or quality of skin texture by using our own fat. This procedure requires precise techniques, both by collecting fat by liposuction, processing it by specific methods, and by injecting it at the level of the penis in order not to produce unsatisfactory aesthetic complications.

Penis thickening with its own fat has nothing to do with penis function. It is a purely aesthetic procedure. Therefore, any quality of erection and the period until orgasm will be neither improved nor abolished.

Ideal candidates

The ideal candidates are men who want an improvement in both the appearance of the penis in terms of girth and the quality of sexual contact, but who are sexually active, who do not have significant chronic diseases, decompensated, or in active and constant treatment with anticoagulants, antiplatelets. platelets, oral antidiabetics, insulin, chemotherapeutics, immunosuppressants, cortisone, etc.

The vast majority of patients who ask me for this procedure want to do it for their mental condition, because they want to feel better. Most of them explain to me about the insecurity they have when they have to undress in public (thermal baths, public showers in a spa or pool, solarium, sauna occupied by multiple couples, or when they have to undress in front of your partner and the penis is relaxed or even retracted). All these conditions come together in the form of the so-called locker room syndrome and the thickening procedure is thus an excellent option to address them in a simple and optimal condition.

Another category that wants to do this procedure are men who have some problems with the couple, which appeared especially after their partner gave birth naturally whether she needed an episiotomy or not, the perineal muscles around the vagina suffered a stretch, fibrosis and then a laxity that makes the vaginal duct wider. This situation causes discomfort during sexual intercourse and often, only the increase in the circumference of the penis can be enough to regain the pleasure and sensation during sexual intercourse that was before birth between the two partners. There are also situations in which not only the increase in the circumference of the penis is enough and then the option is for the partner to have a vaginoplasty. We can also offer you this treatment in excellent conditions. You can see more about vaginoplasty

Patients who are dissatisfied with the quality of sexual intercourse due to erectile dysfunction alone are not ideal candidates and need an evaluation by an andrologist, who can determine the technique or techniques recommended for them.

For mild erectile dysfunction, in addition to specific drug treatment, we perform a modern technique by injecting stem cells from our own blood, combined with a vacuum regime in the penis, produced by a specific device.

What I would like to mention is that these men need to understand the limitations of the penis enlargement procedure, what it can offer and what to expect as a result. We will discuss all these details in detail during the in-person consultation, which can be 1 day before the procedure or even months before it.

Before penis enlargement

I would like to reiterate the idea that although it is considered a procedure, penis thickening involves the techniques of collecting fat by liposuction, processing the fat and then storing it in the penis, I perform them in an operating room with 7 levels of filtration against bacterial contamination. with local anesthesia combined with deep sedation, isolation fields, with rigorous local disinfection and asepsis, with antibiotic administered preoperatively and postoperatively and with washing the fat with antibiotic. Moreover, I will recommend that you epilate on the intimate area 2 days before the intervention, not sooner or later, either with epilating cream or with a clipper, so as not to cause superficial lacerations with a blade. 3-4 days before the operation, I will tell you to start washing and also disinfect with an antiseptic solution (Betadine or Chlorhexidine) that you can use in the shower all over the chest to the knee. In this way we will reduce the amount of bacteria on the skin of these areas and thus, we further reduce the risk of infection. You will need a set of blood and urine tests that you can find in other sections of the site, but I will mention them in the confirmation message of the procedure. The first thing to do is to set the date of the intervention because all this training will depend on that day. In the confirmation message I will provide you with all the information related to how to prepare, how long before you do the tests and when you should come to the consultation, if it is to do the consultation online and you come from afar.

The bottom line is that while it may seem like a much simpler procedure, we are not playing it safe and we want to offer you the best and safest, because any small infection can compromise the outcome.

Thickening of the penis

Although there are some options for thickening the penis by injecting hyaluronic acid or inserting more or less patented devices or which are advertised a lot, fat remains the best option. Personally, I do not recommend anything other than fat, precisely because of the unpredictable and uncontrollable complications of variants such as hyaluronic acid or silicone implants that are sometimes used. Not infrequently I was forced to intervene urgently to perform the circumcision procedure for decompression of the foreskin because hyaluronic acid dislocated in the terminal part of the skin and produced paraphimosis, ie the inability to recalibrate the skin over the glans. In another situation we had patients who requested the removal of a semi-cylindrical implant that would have the role of thickening the penis, but it produced many complications such as erectile pain, asymmetrical shape, unsightly skin expansion, ulcers of the foreskin, etc.

From my experience so far, I can say that there is no procedure that offers perfection or emulates exactly the wishes of patients, but fat would be the only adjuvant that would give a result as natural and with the least complications, but that does not it means that they cannot occur if some steps are not strictly followed.

The procedure does not just mean removing fat from an area and then injecting it into the penis. It is good to know that this concept of regenerative medicine means that first you have to evaluate the area or areas where the fat will be harvested, because liposuction must also look the best. The first rule is not to spoil one area for the sake of another. In vain I obtained a satisfactory result at the level of the penis, if I left behind a region of the abdomen, flanks, lumbar areas or thighs with deformities, indentations, contour irregularities or asymmetries that make it almost impossible to stand on the beach or undress in public. Therefore, the layer of fat on the area where liposuction is performed must be evaluated and delimited very well in the region because even if it is in a fairly large amount, it is important that the appearance is uniform and no difference is observed on the area where liposuction compared to those where it was not done. For this reason, it is important for the doctor to know the liposuction technique very well and also to know the aesthetic units of the torso in order to offer a perfect blending of the areas so that the patient notices that he is slimmer. Therefore, along with the thickening procedure, the patient should also benefit from a sculpture of the abdomen or thighs. For this, liposuction must be associated with redistribution of fat, or so-called liposuction.

The first thing I want to mention is that this procedure of thickening the penis with fat is irreversible. This means that once the fat is stored at this level, it will first undergo a process of apoptosis (cell death), but then the vascularization in the area will begin to make its presence felt and nourish the fat cells so that after a minimum period 6 months we can get an idea about the percentage of fat that will be stored. It is very important to understand that my effort is to show you what this procedure can produce by the way I do it step by step through an explanatory video and images before and after from several patients through which you can get a very clear idea.

The second aspect I want to explain is that the penis is an extremely complex organ, consisting of 2 erectile cylindrical structures – corpora cavernosa – joined on the midline by a fibrous ridge, the spongy body that houses the urethra and glans (head of the penis ) which is in the distal part and which is in turn traversed by the urethra. All these structures are covered by 2 layers of fascia, the Dartos superficial fascia and the Buck deep fascia, which are further covered on the skin surface. Therefore, this organ can go from a relaxed state to an erectile state, having a series of several states between the 2. Therefore, the idea of ​​thickening the penis is the possibility to expand and enlarge the tire, represented by the 2 fascia. and leather. So the fat will be injected into these spaces and after it vascularizes, it will slide with the skin when the penis is detached or recalibrated. For this reason, it is important to understand that the fat layer must be stored as evenly as possible and distributed as correctly as possible so that the risk of it being displaced and the fat conglomerating in specific areas giving rise to oily nodules and cysts is as small as possible.

Therefore, I will explain further how to proceed in this process.

One of the most important aspects is related to the region where we decide to harvest fat. Let’s not forget that this procedure of thickening the penis or any other type of lipofilling in any other area, depending on the amount of fat we need, requires a liposuction to obtain it. This means that first we need to consider how we will perform liposuction there and especially what result we will get from it. It is imperative that we do not destroy one area for the sake of another. What good is a web site if it simply “blends in” with everything else out there?

Over the course of a year, I have had enough patients come from other clinics after undergoing various lipofilling procedures and who have been left with unsightly areas where fat has been harvested.
Even if the penis does not seem to need a lot of fat, my technique assumes that the injection itself is only with pure fat, without any blade of liposuction liquid. Therefore, depending on the amount of fat that exists on the area where you want to harvest, it is necessary to evaluate it to know how much fat should be harvested. As I always tell my patients: It doesn’t matter how much fat you harvest through liposuction, but how much you leave behind and especially how you leave it there. The bottom line is that whenever we talk about any lipofilling procedure, knowing that more than one may be needed, the area or areas where the fat is harvested must be very well evaluated in order to know which strategy to choose. Referring in this case to the penis, even if you do not need a lot of fat, by the fact that my interest is to inject only pure fat, to have at least 80ml in the case of an average penis size, it is necessary to have a substantial amount of fat in the region where we perform liposuction. When the patient has a good layer of fat, those 80ml of pure fat can be obtained quite easily, easily and with low risk of contour irregularities and deformities that may occur after liposuction. I will also explain further how liposuction should be performed.

The fat under the skin where the liposuction is done, has 2 layers:

• a deep one, located immediately above the muscles of the abdomen or thighs and
• a superficial one, which in turn has 3 layers: deep, medium and superficial.

When we do any liposuction, we have to harvest the whole layer deep and later, depending on the amount of fat and the type of liposuction we want, we can harvest from the deep and middle layer of the superficial one. What we do not want to do is harvest from the surface layer as long as we do not want to emphasize certain lines and spaces such as crescent lines or “champagne line” (median). When we want to do 3D liposculpture and thus emphasize the lines that demarcate the abdominal right and the external oblique we can and must harvest from the surface layer on those areas, but elsewhere if it reaches the surface layer, the risk of indentations, contour irregularities, deformities and the elevation is very high. One of these areas that is prone to these complications is the one around the navel.

So knowing all these things, I always make an accurate assessment of the regions where I can harvest fat and try to keep other regions intact where I can harvest in the future if necessary, because I do not want to come back to harvest again. on the area where we have already harvested in the past, just to avoid the risk of irregularities. This risk of irregularities increases considerably as the fat layer becomes thinner. So the thicker the layer of fat, the lower the risk of irregularities. During the consultation I discuss with the patient the idea that although I do not need a large amount of fat, even if the region where I do liposuction has a lot of fat, you would tend to say that you can harvest from a small area because there is a lot of fat and it is not necessary to lie down on a large area. On the contrary, I explain to them that I really want to stretch my liposuction over a large area, just so that there are no differences in the projection of the abdomen, flanks or lumbar areas, especially in profile. I have some patients who come to ask me for a revision of liposuction performed elsewhere, even for a minor lipofilling procedure and for which it was harvested only from the area below the navel and after a few months when the tissue no longer shows edema and the skin began to retract, there is a disturbing projection difference, especially in profile, between the area above and below the navel.

So, to end the discussion about the concept of liposuction, the rule is to evaluate the areas where we remove fat, to choose with the patient which area to harvest, which would be the area or areas left intact that can be used, how will shows the abdomen if it is harvested from a certain area by one or the other, the redness of the contour irregularities and the amount of fat that we can harvest in good or very good conditions. Personally, it doesn’t matter if I get to harvest extra, because I think it’s for the benefit of the patient and I don’t charge extra for it, because I never harvest progressively until I make sure I get exactly what I want, because it’s a waste of time and it is a completely tactless and professional approach.

Let’s move on to the concept of regenerative medicine and what is the strategy for processing and storing fat. As you can see above in my explanations, the fat that will be harvested by liposuction, will be collected in a sterile lipocollector from where it will be decanted through a special sieve so as to remove all residues of triglycerides, fatty acids, chylomicrons, blood, infiltrating fluid. The next step is to centrifuge this fat by a specific technique, because I want to change its composition and also make sure that I completely remove the last streaks of liquid that after the centrifugation will accumulate in the lower part of the syringes.

As you already know, the concept of regenerative medicine involves using the fat that we have in excess in some regions of the body and transfer it to other areas where we want to improve the volume, contour or both at the same time. It’s just that this process starts with liposuction, which will bring the fat through the syringes, free of vascularity and stored in the desired tissue, thinking that the blood vessels in that region will vascularize it. The problem is that wherever we store fat, no matter how well the tissue feeds it through its blood vessels, not everything will last. I explain this very important detail to all patients, no matter where they use the fat, whether it is on the face, breasts, back of the hands, buttocks, penis, legs, scars, etc. Another important aspect when it comes to the penis is that this organ is very special for several reasons:

• It is not a fixed body. The penis can change from a retracted state to one in maximum erection. Here we refer to the elasticity of the skin, the consistency of the corpora cavernosa, length, circumference, flexion, etc.
• The penis is a non-fat organ. In fact, I can say that it is the only tissue or organ where God has not put fat on us men. Believe me, so far I have not found fat in any man in whom I have performed circumcision or penis reconstruction procedures. There is simply no fat here. This means that the body has no memory to retain fat here. That’s why it’s good to know that the fat retention rate should be quite low. It’s just that it’s not like that. I can tell you this because I decided to write these lines in detail after an experience of over 700 cases and every patient I saw postoperatively, whether it was at 1 week or a few years, all had a layer of fat present under the skin of the penis. It is true that this percentage sometimes differs quite a bit, but I can confirm that I have not yet found anyone to have the procedure performed and not have any remaining fat percentage. The percentage that will be lost or kept will be between 30% and 70% of the injected amount.

This percentage will remain the same after the second meeting. That is, the amount that will be kept after the second session will be associated with the one from the first session that has already been integrated and the circumference will increase. So the principle is based on the vascularization of fat, which basically means maintaining it in the long run, just as if that fat behaved in the region where I originally harvested it. Take for example the area of ​​the anterior abdomen, adjacent to the navel. Let’s say that as a result of losing weight through proper diet and regular physical activity, that area has become much slimmer and you thought it was good to lose weight there. The moment you lowered your guard and started to gain weight, you noticed that the tissue grew in volume again. This means that that fat only decreased in volume when you lost weight, it does not mean that it was eliminated. It will be removed by liposuction, which is the only effective way to get rid of unwanted fat. So the fat that you have reduced in volume and increased by alternating diet periods with those in which you have unfortunately gained weight, will behave exactly the same when it becomes vascularized by the vessels under the skin of the penis. . You will see that you will have days or periods when you notice that the penis looks bigger and others when it looks smaller, this being quite strange in the first phase, but it is the idea that that fat once kept there, will suffer processes Ballooning depending on how hydrated you are and may increase in size if you gain weight or may decrease in size if you lose weight.

This fat yield rate is based on several principles, just like when you want to plant an orchard or you want to plant a lawn in your yard. You will look for a good source, because the trees or lawn seeds are of good quality, you will prepare your land very efficiently and you will do exactly the same for each of them as a way of planting and then help to survive (irrigation, fertilizer, protection against pests etc). The same is true of fat. I will look for a tissue in which the fat has resisted or resists very well the weight loss processes because I want the same thing to happen with its transfer and its vascularization. Usually these areas are the anterior abdomen, the abdominal flanks, the lumbar areas, the supero-internal thighs or the internal area of ​​the knees. The fat harvesting process must be a precise one that will involve aspirating it with a very low pressure, through cannulas as large as possible, so that the fat cells are as little or not at all traumatized. The cannulas I usually use are 3 or 4 mm and if we think about it, they will aspirate fat lobes with the same diameter. Decanting and separating the fat from the rest of the useless tissues is the next step, after which it is continued with the specific centrifugation and then, the next step, very important is that once we have obtained the pure fat that will have a diameter of 2 or 3 mm, to we turn it into a compound called microgrease. This is done by passing the pure fat obtained through the steps described above, through a special filter with a diameter of 1.2 mesh to reduce its diameter and turn it into fat with small particles. I want this to happen precisely because the skin of the penis is thin and the space in which I will inject the fat is not very generous. At the same time, I want to have a final compound that is soft, malleable, easy to store by injection, so as not to produce nodules, oily cysts or contour irregularities. The injection is made at the level of the penis with a cannula of 1.4 or 1.6 mm in diameter. Therefore, if we sit and think a little, if I did not process the fat in this way, the risk of having to inject under pressure would be very high. One of the principles of fat injection or any filler product is that it can be stored and distributed evenly, regularly, constantly and symmetrically over the entire area of ​​tissue concerned. What I don’t want is to store fat in separate areas in the form of conglomerates on the idea that massaging them would be enough. How wrong!

If I’ve got 2mm or 3mm diameter grease after spinning through the passage of a 1.6mm or even 1.4mm cannula, I’m sure I’ll have to inject under pressure, especially if I have resistance in the tissue, from various reasons (scars, dermal retractions, fibrosis secondary to other products injected there in the past, secondary or tertiary session, etc.), which can lead to fat accumulation in the form of conglomerates that have all the chances to give rise to nodules. Therefore, the technique of obtaining microgas is essential. Let’s not forget that the skin of the penis is thin and the method of fat processing depends a lot on the final result.

Although it may seem trivial or simple at first glance, the technique of storing fat in the penis is not very simple precisely because no penis is the same. If we are to make a classification, we could divide them into several types:

• by skin length

 1. Circumcised penis

It happens quite rarely, but there are men who have foreskin so short that you would tend to think they are circumcised. Circumcision means that the skin covering the glans has been removed by a surgical procedure. In fact, this is not the case, because they only have a very short foreskin. In these situations the injection technique is quite simple and the fat can be injected to the end of the foreskin without any risk.

2. Short foreskin penis

The vast majority of men have a foreskin with a normal length and development, which is why fat injection can be done almost to its terminal part. When I say this, I mean that it is advisable that the layer of fat does not reach the final portion of the foreskin precisely because its expansion will be very easy and thus decaling in the short and medium term will be more difficult. This is normal and happens even if the fat layer is not injected right up to the terminal portion of the foreskin, but then the terminal skin may remain thicker and thus decapitation may become more difficult. On the other hand, there are some patients who do not mind this and want the terminal portion of the skin that covers a smaller glans to compensate for the effect of the volume because it will help them during sexual intercourse.

3. Penis with hypertrophic foreskin

In the case of men who have a very long foreskin, sometimes excessive, it is good to know that this will not give them an advantage. First of all, it will make the decaling process difficult for them and at the same time it will keep the glans area moist all the time because that skin, once thickened, will expand and cover the glans in a severe way. Any inflammation or infection in the region during the period when the decalotation cannot be performed, will only complicate the situation. In addition, this excess skin can cause discomfort during intercourse because all the skin with the fat underneath it can accumulate in a larger amount to the base of the penis during sexual intercourse, causing the partner to say that he feels only the thicker area. to the base. Moreover, the quality of the friction between the corpora cavernosa and the walls of the vagina can decrease precisely because the skin being of a long length, does not facilitate complete movement. This can be counteracted by using a lubricant or condom to make everything slide very easily. Another solution to this condition is circumcision.

• by skin thickness

 1. Thick skin penis

Patients with thick or very thick skin have a low risk of any lumps or conglomeration of fat forming. This is because the skin is thicker, the possibility of the fat layer to dislodge very easily is quite low. On the other hand, if the skin is quite thick, its expansion will be more difficult and at the same time, the amount of fat injected will be lower than a penis with a thin skin, but this should not be a disadvantage. from my point of view. In the end, my interest is to give an aesthetic and uniform result, so that the penis looks normal, only to be thicker than before the procedure.

 2. Intermediate skin penis

Most patients have a good skin consistency, in which it is neither too thick nor too thin. It is strange how I describe it in general, but it is based on experience after a considerable number of cases. I could say that they represent a standard, so the procedure must produce a specific result, ie a good one, without deformities and also with a good possibility of skin expansion.

 3. Thin skin penis

This category of patients has an advantage in that in their case a large amount of fat can be injected, but the skin is thin, any irregularity or deformity of the contour can be seen or felt quite easily. The fat in their case must be processed very carefully to obtain a compound of soft microgrease and very easy to inject. Any injection under pressure in their case can produce nodules, which sometimes with the whole massage, cannot be dispersed. In addition, any compression or flexion of the corpora cavernosa can result in dislocation of the fat and attempts to reposition it as it was originally may be doomed to failure. Therefore, I explain to patients who are in this situation to know how to protect this layer to maintain it as I placed it. This situation should not be seen as a disadvantage, but it should be understood and only more care will be needed. in the postoperative period for at least 1 month. When the skin is thin, the blood vessels and the contour of the corpora cavernosa and especially of the glans can be seen very well underneath. It is important for the patient to know that this aspect will be changed postoperatively permanently because the layer of fat that will be preserved will make some blood vessels, especially the superficial dorsal vein, not be so easily distinguished. In addition, the impressions and contours of the corpora cavernosa and glans will be covered by the layer of fat and thus, the appearance of the penis in this regard will be slightly changed. All these details must be known by the patients before the intervention, understood and accepted.

• according to the disposition of the corpora cavernosa

 1. Penis with cavernous bodies with a symmetrical thickness at both the base and the glans

2. Penis with thicker corpora cavernosa towards the central and terminal part and thinner at the base

In these cases, I explain to the patients that in order to obtain the best possible symmetry, it will be necessary to store more fat at the base of the penis, than on the central and terminal portion. However, because I recommend that the penis remain seated postoperatively, the scrotum is in a vertical position, facing downwards, there is a possibility that the fat layer may settle due to gravity to the central and terminal portion and thus the area at the base remains slightly thinner. If a very large amount of storage is attempted here in this area, the risk of forming nodules and oily cysts is quite high if the patient does not massage the skin in a constant and regular manner.

3. Penis with thicker cavernous bodies at the base and narrower towards the end

In the case of this type of penis, the fat must be stored in greater quantities on the central and terminal areas and the chance to obtain a good symmetry with the preoperative state is quite good, precisely because the fat will tend to settle more efficiently in these areas due gravity.

 4. Straight-axis cavernous penis

 6. Penis with erect curved cavernous bodies

I can say that this percentage of patients is very low, but nevertheless, when such a patient wants a thickening procedure of the penis, I explain the high risk of the fat layer being displaced exactly on the area where the narrowing of the corpora cavernosa occurs. . This will happen during the erection and unfortunately we cannot counteract this situation. Urological operations performed to correct a curvature of the corpora cavernosa are quite invasive and the risk of a degree of impotence is very high. When the patient has no problems during sexual intercourse and may have a good or fairly good quality of vaginal penetration, I do not recommend such procedures to correct the curvature. A condition of this kind can be Peyronie’s disease, which is represented by the appearance of a placard and implicitly a retraction of the penile aponeurosis in erection, which produces a dorsal curvature (most often) of the corpora cavernosa. It is believed that fat stem cells may help with this retraction of penile sponeurosis, and it is possible that fat injection in conjunction with blood stem cell (PRP) injection, collagenase, and traction techniques with special devices may help with this condition. fat once disposed, can be dislocated in an extremely high percentage. This detail must be understood and accepted by the patient, because the appearance of the penis, at least in a relaxed state, can be totally unsightly.

Anesthesia

As you can see from the concept of liposuction and how to approach the situation related to lipofilling (fat injection) in the descriptions above, it is good to know that anesthesia is directly related to them. To begin with, I remind you that although at first glance the penis does not require a large amount of fat, it all depends on how the patient is disposed of fat. Even for the toughest patients, I will harvest from a fairly large area. Indeed, if the patient is significantly obese, fat can only be harvested from the subumbilical abdominal floor without any obvious difference, but in these cases I recommend that patients consider changing their lives through diet and sports and lose weight before to do something on the penis. After all, we have to see the forest before we can see the trees in it. However, the patient may say that until he or she reaches an ideal weight, he or she will begin to enlarge the penis by injecting fat, but if he or she enters a rigorous weight loss program, it is very possible that he or she will lose more than normally from the amount of fat already injected in the penis and then you have to see which is the best thing for him. I discuss all these aspects in detail with my patients and thus try to make myself understood, because my interest is to have satisfied patients because they understood the concept and so they realize that I am much more interested in the result than just doing procedures at as many as possible.
Based on these principles, the anesthesia I recommend for the penis thickening procedure is deep sedation. It is an intravenous anesthesia and helps with 2 criteria:

• The patient is relaxed, without pain and without memory of a procedure that would have produced moments of discomfort of any kind
• even if in the modified Klein solution that I routinely use in the liposuction procedure to be able to harvest fat as easily as possible I add anesthetics, when you want or need to collect fat from a large area, this local anesthetic it is not enough not to create discomfort of any kind and then this kind of sedation is very effective. I explained in the liposuction concept described above why I want to harvest from as large an area as possible, especially when the patient is not very fat and in this way, deep sedation intravenous anesthesia is very effective. Moreover, let’s not forget that anesthesia is not enough only on the area or areas where we harvest fat, but also on the penis, especially in the terminal area. Local anesthesia of the penis is done by an approach at the base of the penis, which is injected by palpation technique or using ultrasound-guided technique, which instills a quantity of 5-10ml of anesthetic, in depth, between the corpora cavernosa and bone. pubis, which will end up bathing the deep dorsal nerve, which is a component of the deep dorsal vasculonervous bundle. In addition to this technique, a circumferential block at the base of the penis is often needed, especially on the ventral area, with the instillation of a local anesthetic on this area, to cover the terminal area, especially the ventral one. If a large area where fat is harvested is needed, it is very difficult or almost impossible to perform the procedure only with local anesthesia, because in this case you need a very large amount of local anesthetic, which can lead to dosages. toxic, very dangerous.
• Another advantage that deep sedation anesthesia has is that the patient relaxes and this means that the penis will be relaxed, with stretched skin and soft corpora cavernosa, without any degree of retraction or erection, which will help a lot in storing fat.

In conclusion, the most effective anesthesia is deep sedation combined with local anesthesia. This is not a general anesthesia, but quite close to it, the only difference being that the patient is not intubated, but the airway flow is maintained and continuous administration of hypnotic and analgesic. It requires a preoperative check of the medical history of diseases, treatments or allergies and most importantly, it is mandatory that the patient does not consume food or liquids in the morning of the procedure. It is the most widely used type of anesthesia in modern cosmetic surgery.

After thickening of the penis

From the classification mentioned above, one of the details that I mention to all patients in a very explicit way and as extensive as possible, is how to get over the first postoperative stage. Let’s not forget that the skin of the penis is soft and the fat is the same. After all, we want to obtain after processing the fat, a soft compound, semi-solid or semi-liquid, malleable, in the form and consistency of a cream, which being stored correctly and evenly, will have to be cared for by the patient for a while. , until it will be stabilized.

This period in which the fat will stabilize requires care from the patient, which I recommend as follows:

• have a period of a few days postoperatively in which he does not go to work or is not involved in certain special social commitments or which involves a certain type of physical effort, because he will be able to know how to use his clothes, positions and effort in the coming period
• Wear loose or loose-fitting underwear if this may involve hard stitches, which can cause compression of the penis and the entire layer of fat
• Do not use tight and tight clothing (molded pants, suit, tuxedo, tailcoat, etc.) until the fat is not stabilized, because there is a risk of dislocating it
• to let the penis sit over the scrotum and at the same time in a vertical position with the glans facing downwards
• Do not apply the penis to the abdomen with the gland facing the umbilicus, as it will create a crease (fold) at the base of the penis that will split the layer of fat and produce an unsightly appearance
• not to have sexual contact and not to look for erections for at least 4 weeks, optimally 6 weeks
• Do not sleep on your stomach for at least 4 weeks
• Check the position and appearance of the penis several times a day to make sure everything is normal and the fat layer is looking good, and if you notice a slight change due to the position, try to position the penis in a opposite position, to counteract this
• Massage according to my instructions at least 2 times a day, morning and evening, 5-10 minutes, using any gel, cream or lubricant so that there is no friction between the dry skin of the penis and the dry skin of the hands. li>
• Massages should be vigorous, but not aggressive or harsh, pressing or squeezing the skin too hard, as the layer of fat may become dislocated
• The period that you have to take care of this diet is at least 1 month or until the fat layer stabilizes. This will be noticed by the patient when the fat layer no longer shows wrinkles or any changes in the surface.

In conclusion, I recommend that patients do not have at least 1 month the need or obligation to participate in certain important social events (parties, weddings, baptisms, etc.) where they will have to wear tight and tight clothing, not to go on vacation or to not be involved in certain sports activities with excessive physical exertion.

Another recommendation is not to go to the gym, sauna, solarium and not to sweat, at least 2 months, because they can destroy an important part of the freshly injected fat, which has not yet been completely vascularized. On the other hand, I had a significant number of patients who, being athletes, reported to me that at 1-2 weeks postoperatively they returned to the gym or kickboxing and honestly, I did not notice a greater loss in the case than in other patients, but I have probably exposed these indications more for theoretical reasons.

Another very important recommendation is to quit smoking. As mentioned in the previous descriptions, smoking is an extremely harmful factor when it comes to fat injection and thus, patients who do not smoke or quit smoking will have a significant boost in terms of subdermal vascularity, which will help to a higher degree of fat retention.

Postoperatively, the patient receives a prescription with antibiotics, analgesics, dressings and disinfectant solutions for areas where fat has been collected and areas where it has been stored and a gel or cream that can be used for specific massages. These massages are extremely important and they must be performed in a correct and constant regime, until the fat will be stabilized.

The areas to be disinfected are very small in size and will have an absorbable suture, which usually falls off on its own within the first 7 days. If it does not fall, it can be easily removed. On the areas where the fat is harvested, we are talking about a hole of about 5-7mm that will be closed with a suture so that the remaining liquid underneath does not come out and stain the dressings and clothes and at the same time, under these sutures I inject fat, to prevent their undercutting. At the level of the holes where I inject fat, I will want to close them with a suture, to prevent the appearance of fat, which can occur, either due to erections or involuntary compression of the penis.

On the area or areas where we performed the fat collection by liposuction, the patient will receive a special corset that he will have to wear, 4-6 weeks. This will help the skin to shrink effectively. Additional in which I did not harvest a large amount of fat, I do not indicate them as mandatory. In situations where the patient wants a complete 360 ​​degree abdominal liposuction associated with abdominal etching (accentuation of the abdominal muscles – six-pack, eight-pack, crescent lines, midline) and additionally a thickening of the penis, I indicate to all patients to use the services of professional body remodeling centers.

This whole process is standardized after years of work and previous experiences, so that everything is as easy as possible for you, both from the trip to us and back home. So, don’t forget, we are with you until the end! We are waiting for your opinion on the final result, from all points of view.

Complications

As with any other procedure or surgery, penis enlargement can have some complications if things are not taken seriously. Let’s start with the idea that penis enlargement is a procedure, not surgery. I mean it’s not an operation, because there will be only 4 small holes where we will extract and then inject the fat. So everything is done underneath and I just see under the skin or just feel where the cannula that sucks the fat, or the one with which I infiltrate the fat, crosses. Nothing is under direct view and this requires experience to deliver optimal results.

What I want to convey to you is that although we are only talking about a procedure, I perform it through a preparation that I mentioned to you above and that I take things very seriously.

In general, any fat injection is safe or very safe, but here we are talking about an extremely sensitive organ that especially changes its appearance, position and conformation, it is extremely important that everything works well or very well.

For starters, it’s good to know that I have a lot of experience when it comes to liposuction, because I perform between 150 and 200 liposuctions a year, whether we are talking about an individual liposuction or one combined with fat injection. However, I want to remind you that I always strive for everyone not to have contour irregularities or deformities under the skin after liposuction and that this is very unlikely to happen, but you should know it. The small incisions where I will insert the cannulas I will close most of the time with some very thin sutures and then at the end, I will inject a little nano-fat, so that they do not remain uneven, but nevertheless, for & nbsp; for a few months, they will be red. This is the normal process of scarring and eventually they will turn white. That means they matured then. When I see my patients years after the operation, I can barely figure out where they were, because they are almost imperceptible. During maturation, you can use silicone gels, silicone patches or any other specific creams to help the healing process.

II will explain and show you exactly how to proceed after harvesting the fat and then how to do all its processing and from all these actions, you will realize for yourself that the risk of infection is very low, but you must know that it can occur. Fat is a great way to develop an infection, but you won’t have any problems if you follow my advice. However, we will keep in touch both immediately and later and you will be safe.

If we are talking about other types of complications, it is good to address those related to the disposition and subsequent symmetry of the fat at the level of the penis, about which you can or have already read in the previous descriptions. I will explain and show you again during the consultation the principles according to which I do this procedure, by the way I harvest the fat, with a process and how I inject it, just to be able to arrange it in a way that the fat layer will remain uniform under skin. All you have to do is follow my instructions so that some complications such as the dislocation of the fat layer do not happen.

therwise, you can rest assured, because when you read these lines, there is already a personal history of over 700 patients who have already benefited from this procedure and have not had such problems.

Costs

The cost is fixed and you can always find it updated in the Tariffs section of the site.

All I want to mention is that this fixed cost is related to my ability to harvest your fat in good or light conditions. If you are very slim and I think I will not be able to harvest enough fat or we will risk those contour irregularities and deformities after liposuction with the price of being able to harvest enough, it is very likely that I will recommend you either try to gain weight or drop the procedure.

If I believe that I am able to harvest enough fat in good or relatively good condition but this will require me to address multiple areas (anterior abdomen, abdominal flanks, lumbar and thigh areas), the cost can increase, sometimes substantially, because the harvesting process will be long lasting and then the anesthesia will require additional costs, also due to the extended period. However, do not worry, because you will know everything in advance and you will not have any unpleasant surprises in this regard.