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BEFORE YOUR SURGERY
In the week before, you should not take any medications containing aspirin (acetyl salicylic acid), since these products affect the bloods clotting mechanism and therefore may lead to excessive bleeding during and after surgery, hence resulting in increased bruising. Taking high doses of vitamin E preparations, eating large amounts of garlic and consuming alcohol can also produce the same result and should be avoided. If pain medication is necessary, we recommend you take ibuprofen/paracetamol.
It is in your own best interests to quit smoking, at least two weeks before and until 2 weeks after surgery. It is well known that smoking causes narrowing of the blood vessels, which leads to a decreased blood supply to the skin, thus slowing and interfering with the healing process.
Be sure to inform your surgeon of any medications you take, as well as possible allergies including (drug, latex, plasters and so on).
Your surgeon will decide whether preliminary examinations are necessary, such as blood tests, an electrocardiogram, or x-rays of the lungs. If this is the case, these tests should be performed several weeks before the surgery.
If you are having lengthening of the penis, it is best to shave your pubic area before your operation.
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THE PROCEDURE
Penoplasty can increase the size of the penis by increasing either length or girth/width or both. To increase the length, an incision will be made above the base of the penis. Through this we can release the penile suspensory ligament, thus allowing the penis to be brought forward, thereby lengthening it externally by typically 1-2 inches. Men with prominent pubic fat pads will gain more length; if for example they have a 2 inch fat pad, and 1.5 inches is removed, the additional 1.5 inch gain will be supplemental to the extension gained by releasing the suspensory ligament. This increase in length is in the flaccid position only and some men may find that the angle of the erection may be slightly lower. Many men have circumcision performed at the same time, as this avoids swelling of the foreskin, which can last for several weeks.
The increase in girth, involves a small amount of liposuction of the stomach or thigh areas to collect fat, followed by re-introduction of the fat by injection along the shaft of the penis. The usual increase in girth (circumference) is between 1 to 2 inches. The fat injection procedure avoids incision scars and because it is a simpler technique, the recovery time is shorter. Furthermore, the benefits of abdominal liposuction will enhance the patient's appearance. Possible post-operative fat re-absorption and nodule formation can be minimised by limiting the amount of fat injected at one time. The girth enlargement is restricted to be slightly bigger than the tip. The enlargement of the penis will be evident in both the flaccid and erect states.
To ensure a natural appearance, we increase both the length and girth at the same time, although it is possible to have either only the lengthening or enlargement (girth). The functioning will be completely normal both in terms of erection and urination.
Penoplasty is a day case procedure, and will be performed at our Harley St clinic under local anaesthetic with IV sedation (this is not a General Anaesthetic). You will completely pain free, and will not remember anything about the procedure. The operation usually takes between 45 minutes and 1 1/2 hours, depending on whether you have enlargement, lengthening or both.
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AFTER THE PROCEDURE
In the case of lengthening, you will have deep dissolving sutures in the underlying muscle and tissue and some skin sutures as well as staples to the pubis. With the enlargement, you will have only one small suture to the abdomen (where we collected the fat) and one further suture to the base of the penis (where the fat was injected), as well as some strapping across the abdomen for one week. You will remain at the clinic for about 2 hours, to allow us to monitor your recovery from the sedation. It is necessary to arrange for someone to come and collect you, as you are not permitted to drive or take public transport for 48hrs after having sedation.
During the first two or three days after the surgery you may experience a slight amount of discomfort but this is normally controlled with oral pain relief. You may experience a small amount of bruising and some surgical swelling, which will subside after approximately two weeks. Massaging your penis using Vaseline is recommended each day to resolve the asymmetry of the penis and prevent lumps occurring.
You will need to return to the clinic after one week to have your bandages and sutures removed by the nurse. In the case of lengthening, you return again in a further week for removal of the sutures and staples to the pubis. At the follow-up visits you will be examined to ensure that the healing process is proceeding satisfactorily. Further post-operative visits may be scheduled at your convenience to ensure that both yourself and the surgeon are totally satisfied with your results.
One week's holiday is recommended after surgery for rest and recuperation before returning to work. A 3-4 week break from aerobic exercise is recommended and sexual activity can normally be resumed after one month, however it can take 3-6 months to achieve maximum length gained from elongation.
After surgery LCAS recommend the use of penile extenders which are available to purchase from our practice.
All surgery carries risks and uncertainties
Like all operations, Penoplasty is not without complications, they are rare but can occur. These include infection, bleeding, collection of blood under the skin, known as haematoma or blood clot; however this occurs in less than 1% of patients and drains and heals spontaneously.
In some cases with enlargement surgery the penis may be asymmetrical or lumps may occur due to the position of the fat. Gentle massage should normally resolve this problem.
There is no known effects of sexual performance
Your key sexual organ is your brain and nobody can predict how you will react after surgery. We have however, found that most men feel more confident about themselves and this can enhance their love making.
Penoplasty is now well established cosmetic procedure, having been performed for the last 10 years. It is both a safe and effective procedure and, with no foreign material or implants introduced, the complications are rare. The London Centre of Aesthetic Surgery alone performs approximately 200 per year and is a recognised centre of surgical excellence in the UK.
If you have any further questions or queries about this procedure, please feel free to call and speak to either Dr Roberto Viel, Dr Maurizio Viel or any of our nurses. Please note that it is necessary to attend a consultation prior to your operation, this is also the case with existing patients, it may also be necessary to have repeat blood test.
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