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Penis Widening Surgery

Believe it or not, for many years girth enhancement was the less reputable sibling of penile lengthening. While lengthening may have had its problems, it did generally what it was supposed to do. It was a net positive. Penis widening, on the other hand, was generally a net negative. But times have changed and so have the procedures. There are a plethora of girth enhancement techniques. Some have become standardized, others are still experimental. Unfortunately, effectiveness is strongly correlated to cost and invasiveness. The methods are as follows:

  • Fat Injection
  • Dermal Fat Grafts
  • Alloderm Grafts
  • Saphenous Vein Grafts

What Is Fat Injection?

This was the first method devised for penis widening. It's also the least invasive, least costly and least effective. It's basically the same procedure used to pump-up lips and fill in wrinkles. Without it, Cher would look her age. Essentially, fat cells are removed from a different part of the body - usually the stomach or buttocks - and injected under the penile skin. Because the transferred cells are from the recipient's own body there is no possibility of rejection. For fat injection to work, you need excess fat somewhere in your body. For most people in the developed world, this isn't a problem. But if your desire to enhance your dick is part of an over-all plan to have the perfect sculpted body, fat injection isn't for you for no other reason than as you lose weight, your dick will shrink.

What Is The Downside Of Fat Injection?

Well for one, fat cells are very delicate. Only 30 percent survive the liposuction and transfer process. This means that the procedure has to be repeated several times. The transplanted fat tissue then needs to re-vascularize itself. This can work well in some areas but not at all in others, leading to bumpy fat nodules all over your dick. And if that's not bad enough, the fat cells can shift in the penis - usually towards the base - resulting in a big fatty bulge at the root of your dick, giving it the appearance of a partially deflated balloon.

Another drawback is the texture of the fat itself. Even when your dick is hard - it's soft. This is especially the case in the first few months after injection before much of the fat has been reabsorbed. During this period the shaft of your dick will appear puffy and bloated. Because no fat will have been injected into the glans, the head of your dick will remain the same size as before, giving your dick the appearance of a pig in a blanket (a sausage wrapped in a pancake) or a hot dog sticking out the end of a bun - both tasty treats no doubt, but perhaps not kind of thing your girlfriend will want to feast on when the lights go down.

How Much Does Fat Injection Cost?

Fat injection is cheap, at least relative to the other surgical interventions. But it's not that cheap. You're still looking at US$1,000 minimum and usually double that. And that may not include subsequent visits when the fat has been reabsorbed. By the time all is said and done you may end up paying more. The only reason to consider fat injection is that it is considerably less invasive than any other form of surgical girth enhancement.

What Are Dermal Fat Grafts?

Dermal fat grafts were a girth enhancement technique developed in the mid-nineties as an improvement on the obvious problems with fat injection. Basically strips of flesh are hived off from your own body and wrapped around your skinless dick. "Wow," you might say. "Doesn't that hurt?" Answer: Yes. It hurts a lot. But as they say... No pain, no gain. And gains are definitely to be had. The operation varies from surgeon to surgeon but the essentials are this:

  1. You're put under general anesthesia. This is major surgery we're talking about.
  2. Strips of flesh roughly five inches long, 2 inches wide and a quarter-of-an-inch deep are excised from a donor site, usually the gluteal folds (where the butt cheek meets the top of the thigh) to minimize evident scarring. These gaping wounds are sewn together and your unconscious body is flipped over.
  3. A circumferential incision (a "circum-cision" as a matter of fact) is then made just behind the glans of the penis and the skin of the penis is peeled back to the base - pray the anesthesiologist knows his stuff because you really don't want to be waking up at this point.
  4. The strips of skin and underlying fat (ergo, dermal fat grafts) are placed atop the exposed tunica albuginea and the penis skin is pulled up and sewn back in place.
  5. After you wake-up you're given a jar of pain killers with a couple of refills and a bill that will stop your heart. Post surgery, you'll also have to wear a penis traction device for several months to keep the penis stable while the grafts grow into place.

Do Dermal Grafts Work?

You bet. Depending on the thickness of the graft, dermal fat grafts can add up to an inch in flaccid girth and a 0.5 inch to 0.75 inch in erect girth (the grafts get stretched out). This may not seem like much but in dick terms it can be the difference between skinny and fat. It's the same difference proportionally as between a 32 and a 38 inch waist size. Your girlfriend will notice a difference, something she may not do with a three-quarter inch improvement in length. Dermal grafts are far more stable than liquid fat injections. While up to 80 percent of injected fat is reabsorbed, only 20 percent of dermal fat suffers this fate. That's because the grafts themselves are intact pieces of flesh complete with blood vessels and skin. Dermal grafts suffer none of the lumpy unevenness of fat injections. They're also firmer to touch.

What's The Downside To Dermal Grafts?

In a word, pain. Excruciating, unending, "Oh my God it's been two months and I still can't sit down!" pain. Seriously, if you have a job that requires you to sit, think very carefully before submitting to this procedure. There is pain on the other side too. To keep the grafts stable while they fuse you have to wear a traction device that will exert a tugging pressure at the exact place where the de-gloving incision was made. For at least a couple of weeks you're going to deeply regret doing this to yourself.

A second major drawback is scarring. Even with the most skillful surgeon, a scar line will be evident, but it's also very possible you could end up looking like your ass was sewn onto your dick. For the most part, the scars will be hidden, but scarring is a real issue.

A third concern is infection. Because the incisions are made in a place where the flesh folds onto itself and is rarely exposed to air and light they're a veritable breeding ground for microbes.

As well, in the first few days after surgery, the grafts are still free-floating and can buckle and/or shift out of place. And if the traction device is not worn sufficiently, the grafts can fuse on the shortened penis and your erect dick will be shorter or bent, possibly sideways. There's also the possibility of rejection. If the grafts are too thick or the penis skin too tight, the grafts might not receive enough blood and portions may become necrotic. If that happens the grafts may have to be removed and you'll be left with your old skinny dick, two unsightly scars and huge hole where your bank balance used to be.

These problems are not common but they have happened and they could happen to you. Just letting you know.

How Much Does Dermal Graft Surgery Cost?

Anywhere from US$4,000 to US$8,000. It's a lot for sure, but if you're gonna do it, best not to cheap out.

What Are Alloderm Grafts

Alloderm grafts are the same thing as dermal grafts, only they're made from AlloDerm.

What The Heck Is Alloderm?

Well, etymologically speaking it's a union of the Greek words allos, meaning "other" and dermos meaning "skin." But you don't care about that. AlloDerm is a trademark name for a patented process and product developed by biotech firm LifeCell. Technically, AlloDerm is Acellular human cadaveric dermis. In plain language, it's processed skin from the body of a dead guy (or gal).

Now, I know what you're thinking. Yuck! You're probably also wondering how it is that you can sew another guy's dead skin into your dick and not have it be rejected. The answer to this is that all living components of the tissue (cells, viruses, bacteria) are removed in a specially patented process. What exactly that process is I can't tell you because LifeCell is stingy on details.

But isn't tissue made up of cells? Well, yes, but it's also made of a bunch of other stuff including collagen fibers, elastin filaments and other protein derived structures that support the cells. Without them we'd just be blobs of icky stuff. Think of AlloDerm tissue as a city with all the people removed.

When AlloDerm tissue is placed within a living body, stem cells migrate into this de-populated city and attach to these protein structures. Interaction with the surrounding cellular tissue allows the usurping stem cells to differentiate appropriately and repopulate the structure. It all sounds a bit like magic but then so do most of life's processes.

AlloDerm was originally developed as replacement for traditional skin grafts in situations where there was insufficient skin to cover the necessary area. It was especially useful in treating burn victims but it quickly found applications in cosmetic surgery including penis girth enhancement.

Is Alloderm Safe?

Yes, apparently. AlloDerm tissue is screened for a number of viruses. In over 30,000 recorded applications, there hasn't been a single case of disease transmission linked to the grafts.

Do Alloderm Grafts Work?

According to the surgeons that use them, yes. They're implanted in exactly the same manner as dermal grafts. A circumferential incision is made just behind the glans, the penile skin is peeled back and the grafts are laid over the corpus cavernosa. The only difference is that they're much thinner (no epidermis, no fat layer) and therefore multiple layers have to be applied to achieve the same kind of bulk. This is problematic in two ways. First, AlloDerm grafts are expensive and so multiple applications are multiply so; secondly, there is a thought that stacked layers cannot be re-colonized by new cells quickly enough before the protein scaffolding breaks down and is re-absorbed. By this reasoning, re-absorption would likely be uneven and lead to the same kind of lumpy dick as fat injection. Surgeons who use AlloDerm grafts for girth enhancement say this isn't the case, but no long term follow-up studies have been done, so no one really knows. The BIG upside to AlloDerm grafts is that you are spared having the grafts sliced from your own body.

What Is The Downside Of Alloderm Grafts?

It's still very new. The first AlloDerm girth enhancement procedure was performed in 1998. Only in the last few years have clinics begun to specialize in girth enhancement using AlloDerm Grafts.

AlloDerm grafts also suffer the same implantation problems as dermal grafts. In the first few weeks they are prone to shifting. A penis traction device must be worn for the first few months. If the grafts fuse when the penis is in a shortened state, your erections will be shorter. Not the kind of thing most guys have in mind when they're trying to make their dicks bigger.

How Much Does Alloderm Graft Surgery Cost?

A lot. Anywhere from US$5,000 to US$10,000. About a third of this amount is for the AlloDerm grafts themselves. Expect this amount to decline in the years to come with improvements in technology, economies of scale and competition. Already there are several other players in the processed tissue market. If you can afford the time more than the money, this might be something worth waiting for. Not only should the price of the procedure drop over the coming years but other surgical techniques are being developed, including saphenous vein graft surgery that may prove superior.

What Is Saphenous Vein Graft Surgery?

Saphenous vein graft surgery involves removing a section of your saphenous vein and grafting it onto the tunica albuginea to enlarge its capacity. The saphenous vein, which runs down the inside of the thigh, is easy to access and sections of this vein have been used as the conduit of choice for heart bypass surgery for decades.

The tunica albuginea is the thin but very tough elastic tissue that encases the corpus cavernosa. If the penis were a blood vessel, the tunica albuginea would be its wall. More than any other component, it is the capacity of the tunica albuginea that determines your dick's size. The skin will stretch larger and the corpus cavernosa will grow to fill the space. Expand the tunica and you expand the dick. At least that's the theory.

The saphenous vein makes an ideal donor material for tunica grafts because the tissues are very similar in structure and thickness. Because it's so thin, the graft quickly establishes a blood supply from the underlying lumen of the corpus cavernosa. And because it's a vein, its endothilium lining releases anticoagulants that prevent the formation of hematomas which could cause contracture and bending.

It's a two stage procedure. Like dermal grafts, the first step is to harvest the donor material. Two small incisions, about one foot apart, are made in the upper thigh. The vein is cut one at one incision and pulled out through the other. It is then cut in half and each piece is dissected along its length. The resulting pieces flattened out are about half-an-inch by 6 inches.

Then, as in graft augmentation, a circumferential incision is made behind the glans and the penile skin is pulled back to the pubis. An incision is then made along the length of each corpus cavernosum from head to base. The grafts are then stitched into each side of these incisions. The overlying skin is then pulled back up the shaft and sewn into place.

Does Vein Graft Sugery Work?

According to one Egyptian doctor, a patient went from a girth of 11.5 cm (4.5") to 19.5 cm (7.7"). Just so you know, that's about the width of a beer can. Hmm. I emailed the doctor to ask for clarification on this figure but failed to get a response. I was prepared to write off the result until I stumbled across a follow-up study of 37 men who had undergone the operation. Measurements were taken 9 months after surgery and while there were no meaningful increases in flaccid diameter, the increases in erect diameter ranged from 1.1 cm (0.4") to 2.1 cm (0.84"). That's diameter, folks; presumably measured at the point of greatest width. In terms of circumference, that translates to a gain of 2 - 2.5 inches. If somebody's not fudging the results, saphenous graft surgery is by far the most effective means of girth enhancement currently available.

Another advantage vein grafts have over dermal or AlloDerm grafts is that you're not required to wear a dick stretcher for six months after the surgery. The penis also looks proportional when flaccid. No little wiener head sticking out of a bun.

What Is The Downside Of Vein Grafts?

It depends on what you want from the surgery. If you're looking to show off in the locker room, this isn't going to help you. This is also very invasive surgery. You're not just laying tissue over a de-gloved penis. You're actually slicing open the most important part of your dick. You're looking at a longer healing period for the penis itself and you'll have to contend with scarring at the incision sites, although these should be much less pronounced than with dermal grafts.

There is also the possibility, given the volume increase in the erectile chambers, that your erections will not be as hard as before. This has not been mentioned in the literature for girth enhancement, but it has been discussed as a side effect in other vein graft surgeries on the tunica albuginea.

How Much Does It Cost?

Hard to say. As yet there are no clinics (in North America, at least) that were offering this surgery. It's very new and still controversial. In fact, at the time of writing there was only one doctor in the world with extensive experience in this procedure. His name is Prof. Eduardo Austoni. He teaches urology at the University of Milan. If you're in town, look him up. At some point, barring unforeseen problems with the procedure, it will be performed around the world. Given the complexity of the work required you'll probably be looking at cost anywhere from US$6000 - US$12,000.

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