There are three principal methods of girth enhancement: 1.Liposuction fat transfer (LFT), 2. Alloderm matrix grafts (AMG), and 3. Dermal fat grafts (DFG). Throughout the world, the great majority of girth enhancements are done using LFT. This is the only method we recommend.
LFT: The patient’s own fat is obtained by liposuction of the abdomen, "love handles", thighs and sometimes the buttocks. All fluid, connective tissue and muscle fibers are removed and the pure, dry fat is packed in underneath the skin of the shaft. The fat can be contoured or "sculpted"-- unwanted natural curvatures or asymmetry can be corrected. If the head (glans) of the penis is small the girth can be tapered down to match the size of the head making glanuloplasty unnecessary. Given enough donor fat the girth can be much greater than is possible with any other technique. As the fat is injected, the penis becomes stretched out into its extended position, so even if the patient is not erect, the length will be as long as it can be, even if flaccid. Thus, even with the penis flaccid, his locker room appearance will be greater.
What happens to the fat after injection?
When the fat is harvested, it is removed from its normal blood supply. Every body cell needs a blood supply. The newly injected fat grows a new blood supply (becomes revascularized). A network of new blood vessels grow downward from the skin into the fat and upward from the deeper tissues (tunica) into the fat. These blood vessels meet in about a week and provide a new blood supply and a support framework for the transplanted fat. For the transplanted fat to survive it must be revascularized. For revascularization to occur the recipient site (penis) must remain immobilized. Wrapping the penis securely does this. The reason why fat transplanted into the face does not "take" is that revascularization does not occur because the face cannot be immobilized, and the penis can. If the penis dressings are prematurely removed or disturbed and the penis moves, the fat will not "take". Erections don’t hurt anything because when the penis is wrapped after surgery, it is already stretched out into the extended position. In our experience, "floating" or movable masses of injected fat are due to inappropriate motion of the penis due to curiosity, untimely intercourse or masturbation.
Lumps, Bumps, Clumps
These do not occur if the penis stretcher is worn as instructed. After surgery a photograph is normally taken, which shows a smooth, symmetrical, cylindrical, shapely penis. If the patient later reports lumps, which were not there when the operation was complete, it will be due to the fat piling up--telescoping on itself, as shrinkage is occurring unopposed by a properly used stretcher. When the stretcher is correctly used, lumps do not occur.
Disappearance of Fat, need for "refills"
Fat inserted into the penis does not get reabsorbed. Fluid inserted into the penis does get reabsorbed. After we learned to dry the donor fat before injecting it, no absorption occurred and girth was, and is maintained. No "touch ups" are required unless the patient wants a fatter penis.
The location of choice for harvesting donor fat is the patient’s abdomen. Secondary sources are the "love handles" and the pubic mound. Unless fat deposits are excessive, this provides, at no extra charge, a popular fringe benefit of LFT—abdominal liposuction of that unwanted tummy fat, which is otherwise so hard to get rid of. When you wake up, not only will your penis be large but your tummy will be gone or greatly reduced. If you have lots of excess fat, you could have a "completion" liposuction at a fraction of the usual cost of a standard abdominal liposuction. Oversized breasts can be reduced as well.
Alloderm Matrix Grafts
Why we do not do AMG.
Dermal Fat Grafts
Strips of skin, 2 inches by 6 inches, with underlying fat are removed either from the crease between the buttocks and the thighs or the lower abdomen. This leaves a large, unsightly scar preventing the wearing of a bikini-type bathing suit. The scar is sometimes painful. The graft may pull loose, bunch up or shrink.