IS IT AN ACCEPTED PROCEDURE?
Enhancement phalloplasty is a cosmetic
procedure. It does
not fall within the standard domain of the urologist. It
rarely corrects pathology or anatomic defects (most phalloplasty
patients have normal-sized penises.) By training and experience
urologists are not equipped to deal with problems of “self-image,” “self-esteem,” and
appearance. Yet urologists have felt that since the penis
is involved, this is their turf. Early results with phalloplasty
were often unfortunate and the unhappy recipients of these procedures
went to see urologists who then formed what, for them, was their
definitive and abiding unfavorable (and understandable) opinion
of the procedure. Despite the impressive advances in pre-operative,
operative and post-operative care and the thousands of satisfied
patients, these unfavorable opinions have not been altered. Both
the American Urological Association and the American Academy
of Cosmetic Surgeons have repeatedly issued position papers indicating
that they have not seen long-term results showing phalloplasty
to be either safe or effective over the long term. In fairness,
close to none of these physicians has ever performed a phalloplasty
himself and it is probably safe to say that very few of these
physicians has ever seen a phalloplasty patient himself. Consequently,
since only the unhappy patients have gone to their urologists
for another opinion, these urologists haven’t seen any
happy patients.
In 1994 the American Academy of Phalloplasty Surgeons
was formed imposing stringent requirements for membership and
comprised exclusively of surgeons with extensive hands-on experience
in performing phalloplasties. These surgeons, having performed
phalloplasties probably numbering in the tens of thousands, have
declared these procedures to be both safe and effective. The
effectiveness of these procedures may be attested to by the increasing
numbers of patients seeking this operation.
Body Builders, Weight Lifters, Actors, Models, Dancers:
The six-pack tummy crowd are probably not ideal candidates for
LFT girth enhancement. Such patients will do best if they
gain at least fifteen 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, gorge on all the
rich, fat, delicious, sinful foods you previously shunned, and
eat a heavy meal before you go to sleep.
Experimental?
Unproven?
Some surgeons regard enhancement phalloplasty as experimental
and questioned its safety and efficacy over the long term. The
Society for the Study of Impotence and the American Academy of
Cosmetic Surgeons have expressed these views. On the other
hand, the American Academy of Phalloplasty Surgeons, comprised
exclusively of surgeons with personal experience with this procedure,
believe it to be both safe and effective and not experimental. We,
ourselves, have performed over 2500 phalloplasties in the past
twenty years and we believe the procedures are safe and, within
the constraints set forth above, effective. Enhancement
phalloplasty should be undertaken with realistic expectations. Your
penis will not be three inches longer (except possibly with prolonged
use of the penis stretcher). Nor will you double your penis girth
(unless you repeat the girth enhancement). The operation
may not salvage a troubled relationship, nor ensure that a patient
will emerge from deep depression. Deep-seated feelings
of inadequacy or poor self-image may not be assuaged. But
if you are realistic, stable, and well motivated, we believe
you will be pleased with the results.