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Penile enhancement surgery appears to be an increasingly important treatment for men with aesthetic and functional concerns about their genitals.
With greater awareness of penile anatomy and physiology and advancements in microsurgery techniques, it is now possible to access and enhance almost all aspects of an overtly or partially concealed penile structure. This approach, which we term Iron Man Surgery, has a low morbidity and high success rate. It is a novel operation that could be performed in an outpatient urology department with a minimal period of advice, care, and follow-up.
Penile enhancement surgery has gained increasing interest over the past decade. The penis has three pairs of blood sinuses, which fill with blood when a man becomes sexually aroused. The two sculptured rods become rigid and expand in length, width, and circumference to produce a stiff structure that is used to penetrate and deposit semen within the vagina.
It is clear that a structurally average penis is critical to male sexual activity. However, as the penis is intimately and inevitably involved in male sexual activity, any cosmetic procedure must optimize suture strength without any dead space at the incision site. Without this, it is likely that the procedure will cause functional damage to the penis.
Understanding full penis enlargement and liposculpture is a simple concept to understand, although technically challenging to perform. There are no real secrets here; much of it is just time and experience. A couple of different techniques (one is the “Matrix Technique”) are used to get a more comprehensive enlargement of the shaft, and this requires time and patience.
Full penis enlargement and liposculpture are best performed under general anesthesia, so it is usually better to complete in conjunction with other procedures, such as circumferential abdominoplasty and pectoral or bicep implants, etc.
The penis contains three spongy cylinders made up of sponge-like tissues which can absorb blood and expand – this is what creates the erection. This is the Corpora Cavernosa. The outer coat, known as the tunica albuginea, is what holds everything in place and creates the contracted state. The penis also contains the Urethra and the Corporal Bodies.
Small incisions are made in inconspicuous areas to access the penile shaft for the grafting material, and this is sutured into place. The shaft of the penis is simply covered by a larger (or smaller) layer of skin, and this is the aspect of penis enlargement that matters, neither the size nor shape of the corporal bodies.
The average penis measures 14 cm in an erection, but many men still feel it is too small. This insecurity is amplified in today’s society, where the male image has never been more closely linked to genital size. If you feel you have a small penis, then penis enlargement is something you can consider.
The main techniques for penis surgery and/or enlargement are as follows:
These surgical techniques have their advantages and disadvantages and should be used according to the needs and physical characteristics of each individual patient. The final choice of which technique or even combination of methods to follow must be made in consultation with a specialist in the corrections to be made, taking into account each person’s particularities such as the ability to recover, work in the recovery phase, discomfort, presence of pain, and issues related to personal sensitivity.
Aesthetic surgery has fundamental implications for the patient’s emotional state. The power of sexual matters has profound psychological implications. Before surgery, the surgeon must tell the patient everything that is involved and, if necessary, help him define his actual needs and the real possibilities of change, what you can expect from the surgery and what you can’t expect, and if and when he needs to consult a psychologist to discuss the real problem. Broad-based medical knowledge must always be based on the ethics of medicine, which cannot be disassociated from the goal of psychological well-being.
One of the latest values added to enlargement and regeneration therapy is stem cell introductions. For those not familiar with the concept, either because of poor exposure to the topic or for believing it to be the product of wishful thinking, stem cells are adjustable into the cells of a specific tissue and can transform into the cells of the tissue in which they are injected, stimulating, therefore, its regeneration.
The results in the first cases started to be visible, and they are definitely encouraging indeed, even more striking than immediate. They become permanent. These ultrasound devices with scalpels evoke the Steamroller! The only differences, besides marketing, are the use of soft wave ultrasonic tubes and the whole much higher price.
Regardless of the advertising, there’s no scientific demonstration regarding the chance of formation of adult lymphatic tissues. The bells ring hard towards the inside. The obtaining of realistic and permanent results in penile widening surgery through the introduction of autologous fat cells is surprisingly rare. The phenomenon is, therefore, of essential importance in penile rehabilitation in post-prostatectomy, with losses in penile length often due to stretching subjecting the remaining fibers to a disruptive action with the formation of inelastic, not-stretchy fiber tears with attenuation or disappearance of the force or of the retired growth mechanism.
A precious source of cells is our fat tissues. When fat is subjected to specific treatment, it is broken down into its component highest stem cells. These stem cells are trapped in fat cells, which are finally lost. What we have witnessed, then, is the aspiration of unwanted fat from the belly or inner thighs of patients attracted by this surgery, cell processing, and reinjections, often made in those body areas that are not easy to correct otherwise.
The principles of anaplasty are the same as those used in hypospadia repair. Two different techniques (direct and inlay) have been reported for the glansplasties. In Caucasian patients, the direct technique is associated with unsatisfactory long-term aesthetic and functional outcomes.
Any procedure that transplants a well-vascularized tissue shows a better result but is prone to retraction. As an alternative, the inlay technique uses collagen scaffold materials and dermal and bladder matrices. These procedures suggest the use of grafting materials that facilitate re-epithelialization, overcome the time delay for the penile hair epilation before the galvanoplasty, reduce the risk of graft retraction, increase the number of epithelial cells that contribute to successful seeding, and reduce the resulting hair folliculitis/epithelization. These new alternatives are attractive but have not been widely evaluated for MID and its complications.
Dorsal anaplasty is a widely used surgical technique. In this patient, the dorsal side of the phallus was going to remain stable after rotation, and the incision line where dorsal glansplasty sutures were to be applied was relatively perpendicular to the intended coronal groove.
Therefore, we thought that the dorsal glansplasty technique would provide an additional suture surface. Although skin grafting, a urethral separation procedure, or a combination of these procedures can be additional factors, the type of graft is also essential. In patients with posterior hypospadias, the intermediate dorsal glansplasty technique (IDGT) or OMS, which forms the glans with a vascularized pedicle, represents a thriving option.
These techniques, which can be combined with gland precision on critical areas and counter incisions, have fewer complications, lift the glans towards the abdominal wall and prevent cone-shaped glans formations, rotate the meatus in a healthy location and prevent it from developing from the before to after-EPS stage, and create a pleasing aesthetic appearance; on the other hand, they cannot avoid penis tubularization, with resulting lower flap quality.
Scrotoplasty is a surgical procedure aimed at either repairing or treating an existing scrotum or creating a new one. This surgery may be performed on infants with birth defects that affect the scrotum’s structure or function, and it can also be done on adults for gender affirmation purposes.
In general, annuloplasty and scrotoplasty are new reconstructive surgeries that create a hypertrophic, sensitive glans penis and pronounced scrotum from the preexisting nongender-confirming structures in FtM gender reassignment patients. If necessary, both surgeries can be performed independently, or one can be performed before the other, either in preparation for the phalloplasty/metoidioplasty or after these surgeries.
Follow-up surgeries may be necessary to ensure the best possible aesthetic appearance in all patients. These new eponymous surgeries significantly enhance the cosmetic and functional outcomes of transgender genital gender reassignment surgeries, significantly increasing sexual satisfaction and confirming the satisfaction of FtM transsexuals.
Premature or rapid ejaculation can occur at any phase of the sexual response cycle. Absent, decreased, or lost ejaculatory control has been reported by men in the postorgasmic state or during physical sexual relations. Premature ejaculation can then lead to disappointment, anxiety, and dissatisfaction within the relationship. This can occur at any stage in the man’s life. It may be divided into two sorts of premature ejaculation. If it has happened since the person’s first sexual encounter, it is called ‘primary.’ If it is already happening after prolonged regular sexual intercourse without sexual trouble, it is called ‘secondary.’
Currently, ‘early ejaculation’ is the most general term used to refer to the condition. The term’ rapid ejaculation’ is often used to emphasize that the velocity of the man’s execution is rapid or swift. Although this is a mistake, some authors use the term’ premature orgasm’ while orgasms have nothing to do with the idea of ejaculation. In rare instances, the condition exists in young adolescents, although many of these young guys do not identify the issue as they tend to delay ejaculation. Some subjects subscribe to the idea that premature ejaculation is erectile dysfunction.
From this viewpoint, because the male organ begins to lose erection within seconds of ejaculation, premature ejaculation occurs. If the man continues to have a sexual interest but fails to maintain an erection, the rapid loss should not be confused with the second sort, a circulus vitiosis of hemodynamic insufficiency, causing the man to ejaculate early.
The Full Penis Enlargement aims to remedy the issue of penis size discrepancy and offer something better than the already existing surgical options. In this patent-pending technique, two elements are introduced: lengthening the part of the penis that is hidden in the body and growing more penis. These are two separate procedures conducted under the same anesthetic.
Growing more penis is nothing new, as a penis pump has been doing it for decades. What is new and unique is that a penile prosthesis is used in conjunction with this to add to the volume of the penis. The result is that the penis grows longer and thicker after this procedure. The Full Penis Enlargement procedure is a significant advancement in the field of penis surgery. The beauty of it is that this is a non-destructive technique; it doesn’t preclude future procedures like the traditional methods do.
To be eligible for Iron Man Surgery, the candidate should:
Penis enlargement surgery enhances the length and girth of a man’s penis. The underlying penile tissues are rejuvenated with fat collected from the patient’s body. Here, all the essential information is given to those desiring to have such surgeries.
Called phalloplasty, penis enlargement surgery is made with fat collected from the patient’s own body, which is injected into the penile body after determining the required size. The main idea behind this method is the same for fat transfer to any region: it gives long-lasting and natural results. At the present time, the best results are achieved with this method. There is no incision on the penis or scrotum.
This is also a minimally invasive surgery in terms of being able to return to work 48 hours after surgery. The additional thickness that an erect penis gains with fat transfer enhances the pleasure of the partner. In addition to the methods above, a subcutaneous silicone implant may be placed in the penis for penile aesthetics, where an aesthetic appearance is primarily requested instead of enlargement. In the surgery where the desired length is placed in the penis, the seromuscular tissue connecting the penis to the torso is also loosened.
The size of the penis that is inside the body is carefully taken out. The operation, which lasts for only 30 minutes, is usually performed under local anesthesia. When dissected and sutured carefully, there is still a slight change in the angle when the penis stands. Therefore, it creates the appearance of a larger penis.
However, the limit of the penis potential depends upon the patient’s initial form and length, as well as his sexual desires and the role model (usually faked by the press and the menagerie of male images and others). The maximum possible thickening using the correction of the corresponding possibilities (though not proportional to the initial size) is achieved with a successful surgery of the severed ligaments.
The penis thickening in the territory below the pubic hair in the minimum vessel of the dermo-cutaneous graft is 4-6 cm, application of the micro-cuffs or MEGAFORM – the high porosity vascular enlargement aspect and the glans volume bulking.
Under normal conditions, in erect conditions, penetration is preceded by penis engorgement. When the vaginal walls make pressure, and the penis swells as much as possible, ejaculation follows, while the man imagines himself expanding inside the vagina. This way, the couple’s full satisfaction follows on both sides. In thickened cases, the sensors put pressure on the nerves, stimulating them in the corresponding way.
It is important to understand that thickening surgery will serve, first of all, healthy men who want to make their penis thicker to the limit of their potential. Every patient, before surgery, must ask himself what penis thickness will really satisfy him and will correspond to his sexual desires.
Glanuloplasty is an important step in the creation of the distal portion of the phallus, which is more involved and detailed compared to neophallus creation in sex reassignment surgeries. This is primarily because we aim to create a phallus that looks more like a natural penis in some respects.
The neophallus created in a typical sex reassignment surgery does not really need to look like a natural penis since a skin unfurling is used and only the distal sensate part is depicted, then lengthened with the neurovascular pedicle from the flap. The neophallus does not have all of the eversible prepuce, penile raphe, or visible vascular channel required for annuloplasty without further surgeries. However, in our case, using the anterolateral thigh flap, the blood supply comes in a predictable pedicle from the lateral femoral circumflex artery and its branches.
Making a neophallus with an appropriate size in the first surgery would be disturbing to the patient with an inability to urinate standing and restrict mobility, regardless of its appearance during the period of osteotomy fixation. Moreover, if the flap is too large, the blood supply of the flap might be inadequate.
This is why we designed a flap to create a small phallus with a proper length in the first surgery, which can be further elongated in the future according to the primary urologist’s decision. The external urethral meatus is the most troublesome part for surgeons and patients; its location and patency are so important. Usually, the external urethral meatus will become terminal after several fat-skimming operations, and its location is also important for voiding.
Scrotoplasty is a surgical procedure aimed at either repairing or treating an existing scrotum or creating a new one. This surgery may be performed on infants with birth defects that affect the scrotum’s structure or function, and it can also be done on adults for gender affirmation purposes.
Iron Man surgery time can vary considerably, based on which aspects of the process are carried out. In general, the surgery takes 2.5 – 3 hours.
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