Penile Enhancement Surgery

Pre-Operative Penile Enhancement Surgery Course

Your initial contact is by telephone (1-800-788-CURE or 773-725-7722) or e-mail at info@msdclinic.com. A trained medical assistant will give you the basic information. Including: costs and answer your questions. You will need to fill out this questionnaire (below on this website) online. After your completed questionnaire is received, our office will contact you and set-up an appointment with Dr. Burman at no cost, by telephone or in person. During the consultation, Dr. Burman will review the questionnaire and discuss all aspects of your surgery, including your options, and answer any remaining questions you might have.

When you arrive at the clinic you will receive a physical examination, laboratory workup and instructions for post-op use of the penis stretchers. We will take pre-operative measurements and photographs.

If you previously have counselled with a psychologist or psychiatrist, a note from your counselor would be appreciated.

Operative Penile Enhancement Surgery Course

OPERATIVE LOCATION AND TIME: Surgery is done at a fully accredited surgery center. The outpatient procedure takes about 75 minutes and you generally leave the surgical facility within 2-3 hours after the operation. If you are from outside Chicago, you will remain in the area overnight. Dr. Burman will see you the following morning, possibly change your dressing. Our office will make hotel reservations for you if needed. Transportation to and from the surgery center is provided.

ANESTHESIA: According to your preference and the circumstances of each case, the operation is performed under general or spinal anesthesia, by a board certified anesthesiologist.

THE PENILE ENHANCEMENT LENGTHENING PROCEDURE:

The penis is much longer than it appears. About half of the length is concealed behind your skin where it can’t be seen. It is anchored or tethered to the underside of the pubic bone by two dispensable, now essential ligaments. When these ligaments are divided your penis will extend forward, usually about 1 1/2 inches. The actual, true length of your penis remains unchanged, but the visible, usable part becomes longer.

The Incision: On the lowest part of the abdominal wall, within the pubic hair-bearing area, a “^” shaped incision is made, with each leg of the upside-down V being about two inches long, and the space between the two legs of the incision about two inches wide. The closed incision looks like an upside down “y” and is usually concealed when your pubic hair grows back. There are no sutures to be removed and no suture marks.

Post-Operative Retraction: Like with any cut or incision made on the body, where the pubic ligaments are divided, your body will heal by forming scar tissue. Scar tissue always shrinks and retracts. As it retracts here, it has a tendency to pull the penis back towards its original position. Before the penis stretcher became available, there was little surgeons could do to prevent this partial loss of new length. Since the development of the penis stretcher, if it is used as directed by the Dr. Burman, our experience suggests that virtually every well-motivated patient will achieve substantial gains in length. The bonus is that if you continue to wear the penis stretcher beyond the obligatory time, you will continue to gain length indefinitely.

PENILE GIRTH ENHANCEMENT

For girth enhancement most surgeons use liposuction fat transfer (LFT). A few use dermal fat grafts(DFG). Neither procedure employs any foreign objects or substances. Some surgeons use alloderm ( cadaver donor tissue ). Each method has its advantages and disadvantages.

Dermal Fat Grafts (DFG):
Dermal fat grafts are done by removing two strips of skin with attached fat, about six inches long and two inches wide, from the crease between the buttocks and the thighs in the rear. These DFG’s are inserted underneath the skin around the penile shaft.

Advantages of DFG include a relatively smooth, symmetrical, finished contour, seldom requiring a second procedure.

Disadvantages include large, sometimes painful, visible scars between the thighs and buttocks, shrinkage of the graft and occasional longitudinal grooves or ridges. DFG takes at least one hour longer to do than LFT. Surgeons who still do DFG usually perform two separate operations,one for lengthening and a later one for girth enhancement. This means two separate trips to the operating room. Additional girth later is not possible. The amount of girth enhancement is limited.

Liposuction Fat Transfer (LFT)(Our Procedure of Choice!):
Liposuction fat transfer (LFT) is done by suctioning fat from the pubic area, abdomen, and “love handles” and injecting this fat beneath the skin around the penile shaft.

LFT Candidates: The six-pack-tummy crowd are probably not ideal candidates for LFT girth enhancement. Such patients will do better if they gain at least 15 pounds before undergoing surgery. This usually means temporarily violating all your healthy habits, so rigorously acquired. The easiest way to gain fat is to stop working out, become a couch potato and gorge on all the rich, fat, delicious, sinful foods you previously shunned. In slender patients, sometimes donor fat can be harvested from the buttocks and thighs.

Fate of Injected Fat: Within six weeks after surgery about 10{b3b011aadac538a55a5f3a1f3843dacae511a7fa031f7693495761f9c3e0ebc4} of your new girth is normally absorbed and disappears. We therefore intentionally over-correct for this. This is not fat but water. Uneven fat distribution occurs infrequently. With improvement in techniques of fat preparation, “lumps, bumps, and clumps” are largely a thing of the past.

The Advantages of LFT are: No penile incisions or visible thigh-buttock scars are created. Greater girth gains are possible with Allograft.The operation takes at least 2 hour less than DFT and costs much less. At the same time fat is harvested for girth gain, completion liposuction of the tummy, “love handles” and pubic area can be done, if desired. Another advantage of LFT is that if you want a still fatter penis, more fat can always be added later. Length and girth are done at the same time. Separate procedures are not necessary.

The Chief Disadvantages of LFT: The infrequent (estimated at around 5{b3b011aadac538a55a5f3a1f3843dacae511a7fa031f7693495761f9c3e0ebc4}) occurrence of persistent lumps, asymmetry, or both. Since, even before enlargement, few penises are perfectly symmetrical, and since most lumps, if they occur at all, are small, the great majority of our patients are content. Patients who are happy with their operation usually do not contact us and our efforts to reach them are not always successful. Therefore, our best guess is that about 8-10{b3b011aadac538a55a5f3a1f3843dacae511a7fa031f7693495761f9c3e0ebc4} of our patients may be candidates for a “touch up” to improve symmetry, smooth out the contours or both.

Allografts:
Advantages includes a relatively smooth, symmetrical finshed contour.

Disadvantages: (1)The idea of having cadaver tissue put into their penis is not attractive to many patients. (2) The cost of such tissue by itself is $3000 or more, thereby greatly increasing the cost of the operation. Also allograft takes 2-3 hours longer than DFT.(3) Here again, two operations are required since lengthening may be done separately. (4) The use of processed cadaver tissue for penile use is not recommended by the company that sells the tissue. (5) Although no transmission of viruses from donor tissue to a recipient has yet been reported, the possibility exists. (6) The amount of girth that can be achieved is limited.

COMPLICATIONS:

Complications include, but are not limited to, disappointment with “low-end” results; infection, scrotal/penile swelling; bleeding; wound disruption; temporary hardness beneath the skin flap; temporary, patchy, loss of sensation; temporary burning or split stream on urination; discomfort lasting more than 3-4 days; temporary pain with erections; discoloration of the penis/scrotum, and wide or hypertrophic scar.

As of this writing (about 2040 cases), we have not seen: permanent loss of sensation; infection that did not clear up with antibiotics; change in angle of erection; problems with ejaculation or erections due to the procedure; “pivoting” or “swiveling” or instability of the penis following ligament division. Of course, any and all of these complications are possible.


CIRCUMCISION

Ideally, uncircumcised patients should be circumcised at least six weeks before girth enhancement is undertaken. Length and girth enhancement and circumcision can be done at the same time, but discomfort is greater and healing may be slower. If lengthening only is desired, circumcision is not necessary.

Post-Operative Penile Enhancement Surgery Course

For six weeks after surgery we ask that you refrain from manual stimulation and intercourse of any type. The dressing on your penis is a part of the operation and is not removed for 10 days. No showers or baths for 10 days (sponge baths only). For the first few nights put 2 ice bags wrapped in a bath towel beside your bed. If you awaken with an uncomfortable erection, apply the icebags and the erection will subside.

Most men resume their fitness programs and return to work within a few days. A few have felt the need to stay out for several weeks. To protect the incision we advise no abdominal stretching, sit-ups or bench presses for 6 weeks.

Most patients take only a few pain pills; some don’t take even one aspirin; a few will take a pain pill every four hours for weeks. What is mild discomfort for one patient may be significant pain for another.

If you are from the Chicago metropolitan area you will leave the surgical center and return home about 2 hours after the operation. Bring a pair of sweatpants with you to wear home. If you are from out of town, plan to arrive at Dr. Burman’s Clinic the day before surgery. Plan to spend that night in an inexpensive hotel. Our staff will help you make a reservation, if you request it. On the day of the surgery you will remain in the area overnight. Dr. Burman will see you the following morning and possibly change your dressing. You can then leave for home. Free transportation to and from your motel or home on the day of surgery is provided. You will receive Dr. Burman’s home telephone number and the clinic numbers. You are encouraged to keep in touch and report on your progress. If you don’t call us, we’ll call you.