Personal concept - Dr. Mihai Chertif

Since 2012, when we started to perform penis enlargement procedures in a constant and at the same time progressive way due to the high requirements of our patients, we tried to develop a very clear algorithm for what the surgical indication means. Cosmetic surgery procedures or operations require an indication. This is not the case with other specialties where most of the time operations are necessary, in a scheduled or emergency mode, that is, when you know that some chronic problems will have to be solved anyway, sooner or later. In cosmetic surgery, personally, I believe that the indication, which is made following a local and general clinical examination, associated with the patients’ wishes, must always be followed. In other words, it is not good for patients’ desire to always take precedence, especially if they have not been very well informed about the chosen technique, the recovery period and the possible complications. This is the rule that I consider common sense when it comes to choosing any cosmetic surgery!

In the beginning, when I didn’t have much experience with phalloplasty procedures, we performed all the available techniques for each patient who requested such an operation: dorsal elongation, ventral elongation, thickening with their own fat and in case of those who needed, we associated the three and with suprapubic liposuction. Because these techniques were not very well known and their results did not stand the test of time, I decided to order a sociological study to see the opinion of women when it comes to penis size. The study was conducted on 1,000 sexually active women between the ages of 18 and 55 who had constant intimate relationships with stable or transient partners and a history of more than 3 partners over time. The question for them was: what matters more: the length or the circumference of the penis? Over 85% answered that CIRCUMFERENCE is the one that matters the most. This is because the length is almost always normal, except for patients with micropenia (small congenital penis, in which the erect length would be less than 10 cm).

Since you are going to a cosmetic surgery clinic, it is very important to understand that these procedures in the field of intimate surgery must be addressed so that there is a medical indication. The techniques in our arsenal propose an aesthetic approach for improving the appearance of the penis and the adjacent region. If it is to make a comparison with women who want to enlarge their breasts with implants or to change the appearance of the breasts through a lifting or reduction procedure, it is very important and in these cases to have a medical indication for what that patient wants.

In the case of men who want to enlarge their penis, the medical indication implies a small congenital penis, the existence of the locker room syndrome or a mismatch of the couple from a sexual point of view. Unlike women who have fairly well-contoured and projected breasts, an augmentation with implants would be an inappropriate choice for men, except in situations where the penis is much above average size, an improvement in appearance and also a regain or increase of respect. of itself is welcome.

From an anatomical point of view, the erect penis has a length between 11 and 15 cm. These dimensions are considered normal because the vagina has the same length. If the partners are normally developed, most of the time the difference is made by the circumference of the vagina. Very often after the physiological births (transvaginal birth) the muscles around the vagina suffer a considerable distension that can lead to a relaxation of it. At the same time, the vaginal cavity will become larger and wider, especially when the maximum arousal is reached during sexual intercourse. From now on, the same partner may no longer offer the same pleasure to his partner.

80% of men have a relatively small penis in a relaxed position that reaches a large size in erection making this difference between the 2 states very large. 20% of men have a fairly large penis in a relaxed position that will not increase much in erection, being very close in size to the penis of those whose difference between relaxed state and erection is very large.

So the vast majority of these men can suffer from locker room syndrome.

This means that when they take a shower at a gym or a pool, they are ashamed to sit naked in the presence of other men due to a slightly smaller penis in a relaxed position.

For these 2 conditions mentioned above (partners who at one point are not as compatible as they were before due to the relaxation of the walls of the partner’s vagina after birth or those suffering from locker room syndrome) penis enlargement is the solution ideal. This increase in circumference actually means the thickening procedure. These patients do not have a small congenital penis and for them this procedure is the most appropriate. The thickness of the penis can increase by 3-4 cm immediately after the procedure.

Thickening the penis with its own fat I would say is the best way to improve the aesthetic appearance and also increase the quality of intimate contact.

Cosmetic procedures for penis enlargement have nothing to do with penis function. The function of the penis is given by the capacity, quality and duration of the erection and the period until the orgasm is reached. In other words, erectile dysfunction or ejaculation disorders cannot be treated. Whatever sexual performance the patient presents, the aesthetic procedures will neither improve nor abolish them. However, a larger penis will certainly be able to provide a higher quality than the preoperative period during sexual intercourse, as long as the partner has no dysfunction.

Patients who are born with a small congenital penis, which has an erect length of less than 10 cm and less than 8 cm in circumference, are candidates for both the thickening and elongation procedures. In these situations, it is considered that any gain, no matter how small, can provide the benefit that the patient is looking for.