The purpose of penis thickening is to enhance an important masculine attribute that gains increasing attention in today’s society. Generally, penis enlargement surgeries seem to be more infrequent than assumed from the high prevalence of male individuals. There are reports of penis thickening procedures, like penile dermal fat or fascia grafting, and the multi-step method using soft biocompatible polyethylene glycol microgels and lipofilling. The commercially available material for invasive injection is similar yet differs slightly from the above microgel because of the larger molecular size. The filler method using self or synthetic materials is the technique of choice in many countries. The reasons for the increasing demand, as well as the doubts about safety of penis thickening surgery, are, on the one hand, multitarget ideologies and, on the other hand, valuable reports about surgical results.
Penile thickening injections are increasingly popular for a variety of reasons. Complete or partial insertion loss of corporal implant treatment for misled patients plays a significant role in penile surgery considerations too. Penile fat transfer and penis filling using fat grafting methods are included in such surveys. The use of human fat and commercial hyaluronic acid synthesis in patients who had the injection, along with enzymatic degradation materials, are other substitute methods. It was stressed in a presentation that most cases are based excessively on individual dissatisfaction with physical status from primary to secondary surgery. Thus, it seems that psychological and psychosocial aspects play a significant role, or possibly the main part, in people’s desires for such surgery. Identifying individual patients’ objectives, models, and their abilities should firmly guide is penis thickening surgery safe and efficacious healthcare.
Penile surgery in the aesthetic and reconstructive setting aims at increasing genital size and thus enhancing sexual pleasure and self-esteem. Cosmetic penile surgery considerations take into account the patient’s individual wishes, and many men desire an increased penile girth. This cosmetic indication appears to prevail in Western countries and thus triggers a number of inquiries from prospective patients towards plastic surgeons. For all penile girth enhancement procedures, immediate complications and long-term aesthetically and functionally relevant results have been published.
After all permanent and non-permanent fillers, implantations of fat, dermo-fat, dermis, or skin have the potential to provoke long-term side effects such as aesthetically degrading resorption, displacement, induration, foreign-body granuloma, calcification, local pain, erectile dysfunction, acute ischemia, necrosis, and amputation. No standardized method for penile thickening exists, and results can vary from satisfying to disastrous, not only between physicians but definitely also between patients regarding scar formation and tissue reaction. It is logical that the patient should be counseled pre- and post-operatively about all possible problems, complications, and risks including pain exceeding 7 to 10 days, postoperative hematoma, edema, inflammatory reaction, thrombosis, and necrosis including glandular amputation rate after both penis elongation and thickening. Results of a questionnaire after penis elongation revealed sexually active patients with transient pain and those with painful palpable plaque. Some patients had prolonged painful glans and were dissatisfied with the results. All patients but one reported a decrease in libido.
Safety of penis thickening surgery and Considerations: Pre-operative assessment can help identify and manage surgical risks of penile girth enhancement to maximize patient safety of penis thickening surgery during and after the procedure. Postoperatively, patients need to be monitored in order to recognize possible complications. The safest techniques produce the best results, limiting the patient’s desire for reoperations. Ability to treat complications: surgeons must be able to manage both surgical and secondary complications. This generally involves the ability to perform phallic reconstructive techniques. Level of anesthetic risks of penile girth enhancement: can the patient tolerate the necessary amount of general or local anesthesia required for the operation? Ideal indicators for any surgical practice: experience determination. Facility: certified hospitals and surgical care facilities maintain optimal safety requirements and have undergone rigorous review processes. Qualified hospital care is essential in minimizing complications. Safety of penis thickening surgery precautions in very safe surgical facilities are generally considered. Beyond the surgical technique, many of these concepts apply to a variety of elective and reconstructive surgical patients. However, these safety measures won’t prevent all problems.
Pre-operative assessments are therefore recommended to ensure is penis thickening surgery safe, not to prevent all problems and adverse events, and are not based on any technique. Patients must therefore be ready to experience stress and anxiety after the operation, especially due to the remaining harness or palpable implants even in the flaccid state. Surgeons must be thoroughly trained and qualified. Only after you have identified experienced and qualified surgeons can you move on to the next decision block. Penile surgery considerations are not generally offered by plastic surgeons or other physicians with non-urological specialties. Pre-surgical counseling and education: patients seeking surgical penile hypertrophy must first undergo a psychological evaluation. Ethical issues must be addressed, including the ability of patients to give their informed consent. The patient must be aware of all the risks of penile girth enhancement and benefits associated with any peno-scrotal surgery, including religion, sexual activity, and social prejudices. Postoperative care includes routine monitoring, assessments, and medical photography. These measures guarantee early identification of potential complications, including sores, infections, swelling, allergies, and/or hematomas. Early complications can be reversed and treatment options.
Patient Satisfaction Patient satisfaction is an important factor in qualitative assessments of penile thickening surgery. Patients have very high expectations of the result of the surgery and thus, in general, the rates of satisfied patients are also high. Factors influencing dissatisfaction are, for example, a deviation in actual results compared with the preoperatively provided circumferential gains, or an underestimation of the importance of penile length for sexual functionality. Also, some patients expect that the increase in penile circumference will change their life completely, with respect to their self-confidence, the attitude of women, or social recognition, and the operation cannot meet any of these incorrect expectations. Quite a few patients have had previous penile surgery considerations that did not satisfy them, and their dissatisfaction with their appearance is not an aspect of the phalloplasty itself but a deeper psychological problem. As with any surgery, dissatisfaction scores generally increase as the incidence and recognition of complications increase.
Five years after surgery, dissatisfaction significantly decreased in the study with the most extended follow-up in phalloplasty patients. As well, a high percentage of patients declared they were satisfied with penoscrotal prostheses 2 years postoperatively and a significant portion found their sex life improved in the report of 6-year follow-up results. Hence, a satisfying result, as assessed by a patient, years after penile surgery considerations is not only the direct postoperative result, but has to be related to other aspects such as long-term side effects, social aspects, ongoing medical treatment, patient support from the health providers, the condition of the patient in general, and often psychological aspects as well. A long follow-up time is required to assess patient satisfaction—and the limits of patient satisfaction—following penile surgery. The most important points of dissatisfaction in our results concern appearance-related discontents visible in the quality of life, while erectile discontents obtained the lowest rates throughout the period of time up to two years postoperatively. Patients warned that phalloplasty was a palliative procedure reported the lowest rates of satisfaction. This rollercoaster of satisfaction seems to be the consequence of heterogeneous demand, coming from a deeply heterogeneous, largely psycho-trauma-experience-related background of feelings, senses, and all kinds of expectations of and regarding a ‘man’s body.’ Long-term outcomes were very poorly predictable based on short-term results. Good cosmetic results of penile enlargement might be significantly less important to the patient and his romantic partner than presumed by the surgeon, but especially the index patient solicits very handsome genitalia.
