Penoplasty (or phalloplasty) is a male surgical procedure which aims to increase the length (enlargement penoplasty) and / or the width (lengthening penoplasty) of the penis. Doctor Vincent Masson is one of the few plastic surgeons in Paris who specializes in penoplasty. This type of surgery is becoming more and more common and the requests for it more and more frequent.
What is the normal size of a penis?
Beaucoup d’hommes sont complexés par la taille de leur pénis. On considère que la taille habituelle d’un sexe en érection est de 12 à 18 cm. Il n’y a pas réellement de taille normale. La différence de taille entre le pénis au repos et en érection peut être très importante, en fonction du coefficient de dilatation des corps caverneux (éponges remplies de sang lors de l’érection). La taille du pénis, que ce soit la longueur ou sa largueur, n’influence pas à elle seule la qualité d’un rapport sexuel ni le plaisir du ou de la partenaire. Mais le fait d’être complexé par la taille de son sexe peut être un facteur de blocage psychologique évident et la correction de ce complexe améliore l’image de soi.
Many men are concerned about the size of their penis. The usual size of an erect penis is between 12 to 18 cm but in fact there is no real normal size. The difference in size between an erect and non-erect penis can be very large, depending on the expansion coefficient of the corpora cavernosa (sponges filled with blood during erection). The size of the penis, whether it is the length or its width, does not in itself influence the quality of sexual intercourse or the pleasure felt by the partner. However, having a complex regarding penis size can be an obvious psychological blocking factor in a man’s life and correcting it can certainly help him improve his self-image.
General principles of penoplasty
Many different descriptions are used: Coleman’s technique, fat transfer, liposculpture, adipose tissue transplant, lipomodeling, autologous fat reinjection, but all of these terms are actually synonymous. The principle is to take fat atraumatically from somewhere on the patient’s body using liposuction (often from the abdomen or the sides) and reinject it to the penis. It is a method that has existed for more than 20 years and is considered to be reliable and safe. The advantage of this technique is that the fat comes from the patient himself, so the method is natural and there is no foreign body placement. An alternative to reinjecting fat is the injection of hyaluronic acid (the results of which are not final and last on average 6 months to 1 year, unlike the injection of fat, the results of which are final).
The main technique consists of a section of the suspensory ligament of the penis.
Surgery to lengthen or widen the penis can be combined with another procedure such as testicular lifting or circumcision.
Before the operation
You have your first consultation with your plastic surgeon Dr. Masson because a careful clinical examination and precise questioning are essential. Dr. Masson will explain to you precisely how the procedure will take place and the results you can expect. You will be given an information sheet and a quote detailing the price of the procedure. A second consultation with your surgeon is essential before the operation in order to answer all your questions. The period between the first consultation and the operation is 15 days minimum (legal retraction period).
A pre-operative check-up (blood test) will be carried out a few days before the operation. You will have a consultation with the anesthetist at least 48 hours before the operation.
It is very important not to take medication that can induce bleeding (aspirin, anti-inflammatory drugs, blood thinners) within 10 days of the operation. Pubic shaving is recommended several days before surgery to reduce the risk of infection. Finally, tobacco considerably affects the results in terms of scarring and it is therefore advisable to quit smoking ideally 1 month before the procedure and for 1 month after.
Whether it’s for a lengthening or widening of the penis, you will be hospitalized in the morning and discharged either the same evening (outpatient surgery) or the next day. The anesthesia administrated is normally general but sometimes simply local with sedation. The duration of the operation is between 45 to 90 minutes.
Enlargement penoplasty: surgical technique
The fat is removed using a liposuction cannula on the belly, hips, love handles, thighs or other places depending on the patient’s morphology. One or two small incisions of 2 to 3 mm are necessary for the sample. The amount of fat removed is variable, on average though it is 200cc. The fat is then washed and centrifuged to remove the oil and keep only the good fat cells (stem cells). The fat thus prepared is reinjected to the penis between the skin and the corpora cavernosa using micro-incisions (less than 1 mm, and invisible). This process occurs many times in order to obtain a harmonious result. Regardless of the operative technique however, the injected fat never achieves a 100% take-up rate, there is always a part which will be absorbed and this depends on each patient. On average, according to international studies, 70% of the transplant will take. The surgeon anticipates this fat loss by overcorrecting, that is to say by placing more fat during the operation. Liposculpture is a definitive method, the injected fat that has not been absorbed will stay there for life. Maintaining a stable weight is recommended, as the transferred fat is sensitive to weight variations.
Elongation penoplasty: surgical technique
An incision is made above the penis, on the pubis at the level of the pubic hair and will have a Z, an inverted Y or a U shape depending on your anatomy. The suspensory ligament is cut. The length gain obtained depends on this ligament and can range from 2 to 5 cm.
Recovery after the operation
On the whole, the postoperative effects are not very painful. A treatment for pain will be systematically prescribed to you as well as a treatment aiming to decrease the intensity of erections for the first few days after the operation (this treatment is always reversible) so as not to damage the results of the penoplasty. The penis is swollen and blue (bruising) during the first few days after the procedure. The deflation is progressive. It is advisable to wear loose pants during this period. The fat collection areas can also be swollen and bruised for several days afterwards. There are no sutures to remove (absorbable threads) and no dressings to change. Showering is authorized the day after the operation. A few days off work (depending on the professional activity) is recommended and it is advisable to wait three weeks before resuming physical activities (sport, sexual intercourse).
What result can you expect following a penoplasty?
In the case of penis enlargement, a period of three months is necessary in order to assess the final result (scarring, absorption of fat, dissipation of the edema). The enlargement obtained at rest is on average 2 to 3 cm in circumference and a little less in erection (1 to 2 cm). The glans is not affected by this change (its size is the same as before the penoplasty). The erection is not affected and the scars are invisible. The penis retains a natural appearance, the result is final subject to the absence of significant weight loss. Sexual partners do not see any traces of the surgery.
As part of the extension process, a period of 1 month is necessary in order to assess the result. The scar can be red for 3 to 6 months (but easily hidden in the hair). The penis is lengthened by 2 to 5 cm on average at rest, depending on your anatomy and the strength of the ligament that is cut. The result is final. Please note a very important fact: that the lengthening is apparent only at rest and not during an erection. That is to say that the length of the erect penis will remain the same after the procedure as it was before, whatever the surgical technique and the surgeon. A second very important fact: the fact of cutting the suspensory ligament of the penis decreases the verticality of the erection. This almost never causes discomfort during intercourse but must be understood and accepted before the penoplasty is carried out. The quality of an erection is not changed however.
What are the potential complications ?
In the case of enlargement penoplasty:
- Irregularities, subcutaneous nodules (small balls), and asymmetry may appear. This is generally not bothersome (on the contrary this can often increase the pleasure of your partner during coitus) and they are normally able to be corrected quite simply.
- Hypocorrection. The patient considers that the gain in diameter is not sufficient and wishes to have a second procedure. This is not really a complication per se. Seeing the result of the operation, it is not uncommon for patients to ask for a second similar procedure in order to further increase the size of their penis.
Whether for extension or enlargement penoplasty:
As with all operations, although rare, the following complications may occur: hematoma, infection, delayed healing, unsightly scarring, edema that persists longer than normal, skin necrosis, and transient sensitivity or erection problems.
Can any other procedures be associated with a penoplasty?
Depending on the demand, a scrotum lift (testicle lift), circumcision or liposuction can be associated with enlargement penoplasty.
How much does a penoplasty cost?
The price of the penoplasty will be given to you during your consultation with Doctor Masson, your cosmetic surgeon in Paris. Prices start from 6000 euros. See the costs of treatments in Paris.
Augmentation or enlargement penoplasty by injection of hyaluronic acid
The principle of this technique is the same as for the enlargement penoplasty by fat injection: increase the size of the penis at rest and during erection. The gain in diameter obtained ranges from 1 to 3 cm with this method of injecting hyaluronic acid. The size of the glans is not changed. The advantage is that this technique can be performed in the office by Doctor Vincent Masson without any anesthesia and that no fat sample is taken (there is no liposuction). Post-operative pain is a little less than when injecting fat. The bruising is identical and the scars are the same (micro-incisions). The potential post-operative complications are also the same. Hyaluronic acid is a product found naturally in the human body. Its synthetic form is usually used to fill in wrinkles or fine lines and increase facial volumes but it also gives good results for the penis. The technique has existed now for more than 10 years. It is mainly used by doctors, not surgeons. The main disadvantage of the technique is that the result is not final unlike lipofilling (fat transfer). The fat that is injected into the penis remains for life (except if there is a massive weight loss) while hyaluronic acid is an absorbable product, that is to say that it will disappear over time. The effect lasts between 6 and 12 months on average, exceptionally sometimes longer, regardless of the technique used or the product. It is therefore necessary to repeat the operation every year. For this reason, the requests for this procedure are much rarer than for the technique of penis enlargement by fat injection.
Summary sheet for Penoplasty
Before the operation:
- Two consultations with your surgeon, Dr. Masson, are needed in order to receive a quote, an informed consent form, and an information sheet.
- Respect of the legal deadline of 15 days between the first consultation and the penoplasty operation (reflection period).
- The carrying out of a preoperative assessment and taking of medical photographs.
- Shaving of the operation area several days before.
- A consultation with the anesthesiologist.
- Quitting smoking and the taking of aspirin, anti-inflammatories or anticoagulants several days before the operation.
- Entry in the morning and exit in the evening or the next morning from the hospital.
- Local anesthesia with sedation or general anesthesia.
- Duration of the operation: 45 min to 1h30.
After the operation:
- Rest for a few days (depending on the profession).
- No sport or sexual intercourse for a minimum of 3 weeks.
- Pain relieved by classic analgesics, and erections reduced by a specific treatment for a few days.
- Wearing loose clothes, a shower every day, no dressing or threads to remove.
- The penis will appear blue and swollen for several days.
- Final result: after 3 months for enlargement and 1 month for extension. The result is final and will last a lifetime.e
- Expected gains: 2 to 3 cm at rest and 1 or 2 during erection for enlargement and 2 to 5 cm at rest for elongation.