Penis Thickening Implant with Peniflex

Table of Contents

Penile girth enhancement is an attractive niche in the field of genitography. Unlike penile length increasing procedures, penile thickening trauma of action is desired to give rise to an immediate penis enlargement. Following a 6-week interval, pectoral fat grafting and unilateral PGS with pectoral fat injection were administered to all.

Follow-up was performed through change in length and change in circumference measurements, 3D-modeling derived circumference measurement, forearm readings, themselves, and patient satisfaction. The clinical significance was determined using odds ratios and positive and negative predictive values. Triplicate circumference measurements weeks post-op A were positively correlated with orthonic girth < and > 9 cm.

Chronologically, forearm, follow-up, and 3D-modeling readings were also correlated with one another up to week-2 and then decoupled subsequently. The forearm’s difference in readings between opposing follow-up week intermediately with one from the same week constitutes another statistically significant correlation subset.

Background and Rationale

Thickening of the penis is one of the procedures in genital aesthetic surgery and, like penis lengthening surgery, it has been a procedure of the past few years. The demand for penis thickening has increased due to the positive results of existing and new implant materials. Peniflex D-Ring Width & Volume implant, made of “Peniflex”, is a medical device. The first clinical PeniX-comfort study on penile thickening with Peniflex implant was published in 2020. Our penetration for penile thickening is the widest and most detailed study in the literature.

In medicine, the development of new techniques is often driven by the search for solutions to those patient concerns that are merely an aesthetic problem. The absence of scientifically verifiable and treatment-requiring data in the longer and the least diameter of the penis, which is in a wide rinolojik angle, confirms the presence of aesthetic, not functional, concern.

Peniflex D-Ring Width & Volume implant, made of “Peniglass D-Ring”; It is a medical device and in reliable use as an artificial ligament, tendon, and cartilage since 2010. It was used as an implant for penis thickening at low temperatures (-5 Co) for penile reshaping. The penile thickening operation with the Peniflex implant does not affect the penile sensitivity or erection requirement negatively, without disturbing the glans structure, which is about 50% of the penile aesthetics, as in the penile lengthening surgery.

The PeniX-comfort Study Group was initially formed with full-time physicians, residents interested in this to Bing hospital and priy hospitals. 10,000x Cosmecu carpeniflex thin cylinder (d=9 mm x h=6 mm) was used. Beauty perception in human beings is often subjective. The same is true for genital aesthetics. The question that came to mind was “what would be the other answer if we did this job on the patient 100 times? The results of the PeniX-comfort study were shared with the scientific world. Then, PeniX-comfort moved on to working in a principle form. Long-term imaging, three-dimensional measurements, girth measurements, sexual function assessments, and sexual quality of life expectations were applied.

Scope and Purpose

The aim of this study was to show the results, application technique, and device features of Penis Thickening Implant with Peniflex in penile filler implantation. It is aimed to contribute to the literature with the results of the short-term outcomes of penile thickening filling application statistics in the surgical community. With the advantage of penile extension, clear data on penile thickening effect were obtained through current work, which provides statistically significant advantages in the specific area.

The placement of penile implants plays an effective role in preserving penile length after penile retraction surgery for the treatment of Peyronie’s disease and in improvement in sexual function. Penile thickening implants were created by placing semi-rigid or inflatable devices in the fibrous connective tissue compartment specifically for penile thickening to achieve a penile thickening effect.

Subcutaneous placement of elongated penile prosthesis, generally used to increase penile length and girth during sexual intercourse of men with micropenis or poor erectile capacity, may also provide a penile enlargement effect. Despite its occasional use, there is no research on in vivo results, complications, and satisfaction of the device. The present study clarifies the results of penis thickening via subcutaneous penile thickening with Peniflex.

Historical Overview of Penis Enlargement Techniques

Historically, techniques for penis enlargement have been numerous and sometimes unusable for serious researchers independent of conflicting areas. The first approach, which was applied to deformity-stricken penises rather than precious enlargements, was a STAT-P procedure, miggino techniques, use of catgut suturing, and some seeking aid outside these techniques. Seay studied patients admitted with penile neoplasms and reported the information obtained after circumcision operation in these patients.

Note the marked deletion, skin defects, and rarely available procedures for reporting other deformities from the used records. With penile amputations, some surgeons have worked in this area to reconstruct the amputation site. Penile enlargement is not seen among these old microsurgeons. Finally, Bennett and Lewis, who still care about penile deformity, have reached the latest stage in penile prosthesis surgery.

There was only an interest in pathologies such as cosmetic penis surgery within urology, and no responsibility for very special authors in the literature related to penis lengthening surgery was encountered. This study is probably the first example of a penis thickening procedure without sacrificing the glans penis and shows the results as a single case in the current literature. In summary, medical data of all penile growth operations, other authors, were reported between 1973 and 2010.
In some communities, men have sought to enlarge their penises, and there have been many techniques in this regard.

A varied literature contains various apparatuses to lengthen and widen the penis by mechanical or vacuum expansion. However, some people still resort to surgery as both lengthening and thickening operations, concerned about the damage that can be caused by the above-mentioned devices. For centuries, when we look back to see these surgeries performed, we saw only one branch of that surgery developed, namely the elongation of the penis.

Also, very special researchers have reported on this subject. The other option is to restore the penis dysfunction to the original status by doing our surgery directly, even if congenital or secondary formations are constructed of the penis. In reports in the literature, Red Boswell mentions a simple method of elongation when a congenitally short penis was reported as urologist treatment in children.

Understanding the Mechanics of Peniflex Implant

One requirement for the insertion after search approval of a new penis external prosthesis and augmentation device is a detailed breakdown of the mechanics of its action. In this section, the objective is to highlight the mechanics of action. The study of both the mechanical characteristics of the device and those of the tissues of habitual contact will allow a better understanding of the general pressing mechanisms.

The German company Simmetria, founded in 1998, has designed a penis-thickening procedure termed Peniflex Implant PFI. It is placed via a transverse approach. PFI acts as a buttock implant. It was created to be placed below or above Buck’s deep investing structures using a plain pocket: a submuscular layer, a muscular one (in cases of limited muscle size, one separate split coat of muscle is enough), or between the muscular volume. The main purpose of PFI is to mimic the gluteal fat expansion, resulting in a round penis with a greater circumference.

Peniflex Implant consists of two pads made of different textures. The anatomic “aleatory non-woven, three-dimensional cell-structure” polyurethane foam (Alea-MEDImesh, Aleamed, Germany) acts to autoclothe the implant and perfect the adherence avoiding any minimal shifting, rolling, and rotation of the prosthesis. The same mesh is in use by the same supplier for male and female breast microsurgical supermicro-fatgrafting when extracellular fatty extrinsic matrix to us is useful.

Both pads are made of self-sterilized high-density, neutral-tissue, oval, form-stable, pulsion-, resorption-, solutions-, and additions-proof, totally removable, and pathological lock liquid gel silicon. Peniflex Implant is distinguished for its chemistry with the firm tissues at room temperature of 10–40 degrees C. During normal traction, the pads do not yield but leave a specific pattern of different indurations if the pushing strengths exceed 600 deca-Newtons per centimeter. Peniflex Implant is 100% filled with gel silicon to reduce the valleys of the push stresses between the tissues and the device.

Surgical Procedure and Techniques

The most commonly used technique for augmentation of the penile girth is autologous fat injection. Nowadays, a progressively increased number of articles are being published regarding many other injectables. To our knowledge, a wide volume of outcomes of filler injections are available and reviewed in the literature but there is no comprehensive surgical study assessing the implantation technique and long-term results of a penis thickening implant.

Surgical procedure and techniques: Surgical procedures were carried out by a single surgeon for all techniques. Continued with sagittal sectioning until the base of the glans penis is reached. Then, an appropriate slit was created in the penile skin with placement of an appropriate tubular dilator in the penis to ensure size uniformity during implantation.

Each technique has specific steps and approaches: For the penile implantation, we used local anesthesia during the hospital admittance to control the penile protrusion at the time of general anesthesia. This former ambulatory local anesthesia has been shown to contribute to the aesthetic satisfaction of the patient. The distribution and intensity of end-implantation injections consist of the final stage of the local anesthesia step that was used for all surgical approaches described in this study. Balloon attachment of the dilator aspirated to reach the normal level of the maximum dilatation and this removed immediately after aspiration.

In order to minimize the risk of neurovascular trauma and to improve surgical implantation comfort, a medially based incision is recommended. For the ultimate satisfaction of the patient and surgical comfort of the clinician, a single incision under the abdomen could be used for the implantation of a combination of the three main techniques. Significant advancements and new instruments have contributed to the enhancement of the many procedures that have already been described in the literature, offering the possibility to operate with a single incision in future applications.

Post-operative Care and Complications

For the first 48 post-operative hours, patients should keep the penis in a horizontal position, lying down. They are not allowed to walk, and parents should put their index finger under the male glans to keep it raised when they need to urinate. A corvette drainage is used in all patients. It is removed after 24 hours if the bleeding is lower than 100 cc. On post-operative day 2, the outflow drain starts, and the patient is allowed to return home.

Complications: In our experience, we have had no cases of post-operative infections, erosions, dislocations, or corporeal thrombosis. All patients reported penile pain lasting approximately 24 h, with a visual analogue scale (VAS) of less than 3. In 7 of 100 cases, there was a minimal hematoma near the glans that was self-limiting. The new external shape of the penis was very well accepted by patients and their partners.

Only three cases of pendular penis (without any effect on the self-erectile penile pump) were solved with the repositioning of the prosthesis inside the corpus cavernosum at the third reopening. In two of these cases, the pendular penis had a psychological origin during the psychological evaluation performed following an alleged mechanical failure of the prosthesis. Moreover, the penis of patients with Peyronie’s disease is more upright and pendulous than patients without, even without implantation. All patients had pleasure in penetrating sexual intercourse after 45 days, without pain and without notable curvature.

How to Prepare for Penile Implant Surgery?

Communication with the patient to reduce his anxiety, assure him about the results and possible complications, and inform him about the process to follow. In some patients, surgical procedures such as circumcision or penile prosthesis placement may be performed simultaneously; if this can be determined during the preparation phase, the patient should be informed in advance. In obese patients, scrotal skin resection may be important for fixation of the pump after penile prosthesis placement; if there is a need for such a procedure, the patient’s weight and body mass index should be taken into account in the surgical plan.

Patients with cardiovascular and other systemic diseases should be consulted and examined by a cardiology department doctor before the procedure is inserted. Patients should not be taking aspirin, coumadin, or flammables; if they have to do so, the patient should be informed about stopping these medications at least two weeks before the surgery. In uncontrolled comorbidities such as hypertension, diabetes, chronic obstructive pulmonary disease, etc., a referral should be taken from the corresponding department, and advice should be taken on control. In a patient with a urinary system infection, antibiotic treatment should be given at least one week before surgery until the preoperative infection is removed. In case a clogged catheter occurs, the clogged catheter should be removed, and a new catheter should be reinserted before surgery. The urethral catheter change is necessary in many patients; it is more comfortable to change the catheter at least one day before the surgery.

Any skin diseases, such as herpes, etc., in the genital area should be treated before surgery. At least 5 days before surgery, especially hair in the operation area should be removed. In electrolyte and zinc deficiencies, it will shorten the time required for the dressing to be made suturing. These are our general recommendations that will speed up the discharge after penile prosthesis implantation.

There may be some additional recommendations according to the preference of the doctor performing the procedure. In short, a smooth surgery can be performed in a patient who has undergone the necessary preoperative preparations.

Surgical Procedure

Placing a Penile Prosthesis

There are a variety of different types of prostheses. The key issue is the size of the prosthesis so that it fits the length and size of the penis. Although it is common for some surgeons to insert a slightly larger portion than the actual penis of the patient, I object to this practice. The most commonly applied type of prosthesis is the flexible rod prosthesis. Urologists usually prefer this type since it causes less shrinkage in the penis.

One disadvantage is the semirigid prosthesis. When it is in its asleep form, it has a chance to stay with the penis in the meatus because it does not shrink during the day. However, those who are rigid and who want to use a bulbous are forced to choose the nonflexible prosthesis option.

The following paragraphs will walk you through the surgical procedure, including the various options when placing a penile implant. The article discusses the type of penile prostheses currently available, how the surgical procedure is performed, and what one can expect in the postoperative period.

Overview of Penile Implant Surgery

Penile implant surgery has a very high satisfaction rate. This means that when men and their partners want to use a prosthesis, prosthetics are not only effective but also very reliable in providing patient and partner satisfaction. One report published in the Journal of Sexual Medicine reported “93% of men would recommend a prosthesis to their friends.”

As the prosthesis is “inside” the body, once deflated, it provides a natural flaccid appearance and is semi-rigid when manipulated. For many men, the most satisfying feature of a prosthesis is the confidence it provides. The feeling that a natural erection is not required and “can’t let me down”.

There are two different types of penile implants – malleable and inflatable. Non-inflatable Prosthesis (Malleable Prosthesis). These are rigid, semi-rigid or non-hydraulic. They are flexible but the penis is declined all the time. Inflatable Prosthesis. Those exist in 2 or 3 parts. Three years after a prostatectomy or less, a 2-part inflatable prosthesis is the treatment of choice. More than 3 years after a prostatectomy, a 3-part inflatable prosthesis is the best device.

Post-Operative Care

Penile prosthesis surgery is done through a scrotal incision. This incision is not accessible to the patients. It is behind the scrotum and is 5 mm in length. Post-surgery, patients usually stay in the hospital for 1 day because the patient doesn’t get any pain, he can easily be discharged the next day. After discharge, sexual activity is not recommended for about 6 weeks, and a follow-up appointment is made. Patients start having sex 4-6 weeks later.

After discharge, the patient should wear foreskins for 30 days. Foreskin wearing time may also vary depending on the surgeon or the patient’s characteristics. After discharge from the hospital, how to and how to use the staples, how to wear foreskins, and appropriate wound care procedures are also briefly given with the help of a nurse. 

After that, it is also possible that the patient will not go to the hospital for a long time if there is no pain or related problems. The cause, unsolvable pain, and local swelling during this period of care, which seems to be mechanical in terms of local conditions provided by the patient, does not cause the patient to come to the hospital apart from the control that is sufficient, but in case of any other situation, the hospital should be urgently contacted.

Penis Thickening Implant with Peniflex FAQs

What is “penile enlargement surgery”?

As a growing number of men are interested in undergoing penile enlargement surgery today, there is also an increasing amount of information about the operations considered for this purpose. For the most part, people who undergo penile enlargement surgery want to achieve lengthening of the erect penis and enlargement of the penis in its flaccid or erect state in order to feel more comfortable about desired results from sexual intercourse.

With the developments in aesthetic and plastic surgery, new possibilities have been introduced for the enlargement of the penis, and nearly all individuals who have penile enlargement surgery with new techniques are satisfied with the outcomes. New penis enlargement surgical procedures are generally performed by specialists in aesthetic, plastic, and reconstructive surgery.

One of the newest curiosities in the area of penile enlargement is the implant peniflex-released 1.5 years ago, called penis thickening implant surgery. However, there is very little data regarding penile thickening implant (peniflex release) in the literature. In this comprehensive guide, all steps of the penile thickening implant surgery, including the preoperative, intraoperative, and postoperative period, along with its indications, results, and frequency, are discussed in detail.

Penile enlargement surgery consists of thickening the penis by penile prosthesis impaction between the erectile body structure and biological albuginea, so that the transmitted pushing force can be evenly carried by the abundant fibrous soft tissue around, thereby fundamentally solving the problem of cover thickness.

As it is known now, 16,114 cases of penile enlargement surgery have been accomplished by peniflex in 2021 without any implant-related complications. Truly speaking, after thorough perusal of the plethora of literature related to CCPs, we believe that most of the ills associated with CCP are just caused by the use of inappropriate prostheses, not the endothelialization they announced.

Penile lengthening and thickening, or penile thickening and fullness of the penis through corporal circumference implants (CCPs), are surgeries in great demand and may be performed consecutively or at different times if there are no results.

The main motivation of the patients who undergo only the prosthesis fistula surgery, according to their own statements, is the feeling of an insufficient penis. There is no disorder of sex development or other testicular or gonadotropin disorder in those without accompanying penile deviation and corpus spongiosum cyst, and those with inguinal hernias and body hair along with the tissue appearance.

Patients without congenital adrenal hyperplasia and corpus spongiosum cyst were included, and if the inguinal hernia is not supported, CCP is placed in an appropriate serous layer, cyst excision and cyst outflow were relieved. People living in Istanbul and its surroundings who have completed at least 6 months of regular follow-up after fistula surgery and have not yet had poron implant placement can be counted.

What is the Peniflex?

The Peniflex is likely a critical piece of equipment or tool in penile enlargement surgery. It’s something people would use for penis thickening, for instance, in surgery. It’s a non-inflatable prosthesis, so it’s not a fluid-filled device, and unlike many of the prostheses used for penile implants, it is designed to go under the tunica albuginea, or the actual meat of the penis, rather than go inside of the anatomical parts of the penis. There are two springs inside of the Peniflex which are biocompatible.

The technology behind the Peniflex is composed of Nitinol, which is a biocompatible spring inserted behind the pubic symphysis. Nitinol is an alloy of nickel and titanium that is heat-activated to a set shape. It is shape memory due to its transformational thermoelastic properties. Super elastic at body temperature.

Stented with regular desmitis techniques it goes across body temperature, and becomes extremely elastic, developing a spring-power which can protrude outside of the shaft, but then when left alone becomes soft again. When Nitinol is left to regain its original shape, it searches for its set shape which has been incorporated into the Peniflex. Thus the Nitinol will essentially push the distal edge of the prosthesis into the irregularities of the distal corpora, which in turn will make the corpora more flexible with improved hardness, straightness and bi-corporal stimulation.

The PeniFlex is a device designed to be inserted into the subcutaneous area of the penis as a thickening prosthesis during plastic surgery of the penis. The prosthesis consists of a tubular shell and one or more flexible ribs arranged helically along it, which allows the prosthesis to bend in and out. When bent, several such prostheses attached to one another form an increased longitudinal section circular shape, providing a thickening effect to the penis.

The PeniFlex has a crescent cross-section; however, the outer and inner surfaces have any other shape. Besides thickening, it has hardening, hemostatic, and tunical modeling (straightening) capabilities.

How to do Peniflex “penile enlargement surgery”?

The incision mark around the corona and graphic demonstration to both the patient and surgeon are presented before the patient is given spinal anesthesia in the dorsal decubitus, low frog position. Special attention is paid to monitor the patient’s blood pressure, heart rate, and oxygen saturation levels throughout the operation.

After urethral catheterization, betadine sprays are applied with the help of a positive pressure blocker for sterile wound preparation. The patient’s penis is carefully isolated by hanging it up after sterile drapes are placed in the operation field. The cavernosal arteries are visualized and the Peyronie’s patients are separated with the help of a 5x loupe binocular surgical microscope from a ventral incision using a “no touch technique”.

A Blair circular rim incision is implemented to separate Buck’s fascia just around the corona with a zero-degree scalpel to avoid epithelium injury either in the penile skin or the outer layer of tunica albuginea. Also, Buck’s ligament is cleaned up while dissociating Buck’s fascia from the tunica albuginea. The outer and inner dermis layers are sutured without any pressure, stress, or effect to the thrust using a 2/0 invertible rapidly absorbable suture.

The pre-op length and thickness of the penis from both the acapella point and the corona level using a millimetric measuring tape are matched with the post-op penis straight skin closing length and thickness. When concentrated saline is administered, the patient is taken to the recovery room. The patient can comfortably return to his social life and natural sexual activity after the one-month free-of-charge clinic and long-term care. The patients are followed up every 6 months during the 2-year over-the-phone follow-up.

Step-by-step Penile Enlargement by Peniflex

Step One: Incision Making

In either form of our Peniflex implantation, first, we will mark the starting and finishing points. The second step is to make an incision over the shaft of the penis ranging in length from the point to roughly two inches above the base of the penis. This is a small incision that goes only part of the way through the skin; the rest of the penile shaft is left intact. This procedure can be laser incisional or midline surgery.

Step Two: Dissection Making

The third stage of surgery is to dissect and make a space through the soft tissue (fat and blood vessels) and the suspensory ligament inside the penis. The soft tissues are gently separated from the tunica, organ’s shell. The suspensory ligament is cut out from under the symphysis pubis. The suspensory and fundiform ligament are only partially sectioned (mid-portion); this is required to lengthen the flaccid penis slightly in addition to its lengthening when erect. Finally, with an elevator and a pair of forceps, a space (a tunnel of 8-10 inches) is made.

Step Three: Positioning and Fixation of the Peniflex

The Peniflex is placed in the space created in the tunica albuginea first by pushing the distal ends away (proximal-released implantation). The second PEFI group desires the Peniflex to be pushed in the way of implantation-first distal and lastly proximal. It passes all the way down to where the fake insertion point created by the marking is. (In the Pur visits, the real Peniflex is then placed under the implant, making the illusion complete!) The Peniflex must be at the fold of the tunica albuginea at this point in time.

What are the advantages of Peniflex “penile enlargement surgery”?

Peniflex penile enlargement surgery, or penis stiffening, is by no means the only method of penile thickening or elongation. Many other procedures, such as injections, fat grafts, and even silicone-based extensions, have been used for penile elongation. In comparison, the following advantages come to the fore with Peniflex:

Peniflex penile lengthening, in the first place, ensures the elongation of the entire penis. Since the suspension ligaments are dissected and elongated, the penis gets longer. Others, such as injection treatments, silicone filler, and fat graft treatment, do not contribute anything to the elongation of the penis. Their only effect is on the expansion magnification on the penis by the steroid, silicone, or fat. The result of a study conducted in the U.S.A. with silicone filler application is an increase in circumference of about 3.1 mm. Effects with silicone fillers last up to 6 months. Due to the body’s immunological system, the silicone filler is cleared from the body.

Although the body does not reject and expel it like other biodegradable foreign materials such as silicone and fat, PMMA will join the Peniflex operation and behave towards it. PMMA will make the penis firm at the site of the injection. Peniflex is a painless and successful technique.

It also has a high rate of satisfaction. Nature provides this in every region of the body untouched by the body and authorized by the FDA. We have achieved a high rate of satisfaction in our clinical applications as well as in long-term applications in scientific studies. It does not harm manhood and ability to have intercourse. PMMA does not impair libido in terms of sexual function. Unlike surgical applications, the problem can be solved with treatment.

Because the tissues heal properly, it does not cause deformation. Its shaping power should not be overlooked. It even fills the defects left by other fillings. Preferred for penile thickening studies recommended by European doctors specializing in the field. At the same time, it applies to homosexuals who increase the penis size and provide the thickening process and also enlarges the circumference of the penis. In European countries, cosmetic urologists, sexually transmitted diseases, and erectile dysfunction specialists recommend penis stiffening surgery using PMMA in one session. There is no urinary physical blockage in urination.

Surgery for penile gland thickening and penile elongation is usually performed simultaneously. A Peniflex Penile Thickening Implant can be used for penile thickening using the Becker PMMA technique. After penile gland thickening, if the patient has a positive reaction, penile elongation surgery can also be performed using the technique of dermal flap through the suprapubic incision area in the same session. However, it is not recommended to continue with penile elongation surgery for a few months after penile gland thickening, as the penile diameter may decrease over time.

One of the most important questions is whether the new range of thickening is temporary or permanent. At the end of 18 months of follow-up, the results were stable and further examination revealed an increase. The attachment of the implants filled with silicone demonstrates an acceptable thickness with a natural appearance, satisfying the patients. It is important to inform the patients undergoing this process that they will be under the doctor’s control for a long follow-up regarding the prognosis and future expectations of the increase. It is also important to include in the information about this process that the patient can undergo another surgical operation if the thickness is not at the desired level


      

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