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Male Genital Surgery

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What is the male genital surgery?

The male genital surgery is the surgical treatment aimed to correct and improve the function and the shape of the male genitals. The appearance and activity of the external male genitals are factors of particular relevance in our society and our culture. Through all human history, male genitalia have been associated to virility and reproduction. Most men associate the size of their virile member with their sexual performance.

Although there is no scientific evidence to prove that penis size and sexual performance are directly related, this idea has become a social belief.

What men should consider male genital surgery?

The male genital surgery may improve the external male genitalia condition of those patients who seek results within the normal range. Dr. Nieto is in favor of having a very frank relation with her patients. As a health professional, Dr. Nieto is always willing to listen to you and your concerns. For Dr. Nieto your health and well-being are priority. Therefore, she may decline to perform a procedure if she considers this is not convenient for your health, or if she identifies patient´s expectation are not real. Dr. Nieto´s commitment is to maintain safety and quality.

The candidate must have relatively good health and realistic expectations



What are the basic parts of the external male genital organs?

For your understanding, we refer the basic components of the external male genital organs:

The penis is made up of muscles, nerve vessels, and two parallel cylinders called corpus cavernosum, which are the pair of sponge-like regions of erectile tissue.

Through the center of the corpus spongiosum runs the urethra. The base of the corpus spongiosum is located near the prostate and ends in the glans. The base anchors to the abdominal wall and makes possible the structure to stand firm. Penis size must be considered from the pubic fat to the glans. Penis is basically made up of:

  • Base
  • Trunk
  • Corona
  • Glans

The cylindrical part of the penis is the trunk or “body” of the penis and the conoid part is the glans. The main structure of both is vascular, a network of vessels very communicating between them. The body or trunk of the penis is constituted by two corpus cavernosum and one corpus spongiosum. The corpus cavernosum contains elastic fibrillary tissue which may be enlarging up to four times its basal size during the erection. The corpus cavernosum are wrapped in a membrane that is called tunica albuginea. The corpus spongiosum is located in between the two cylinders of the corpus cavernosum and surrounds the urethra, and it expands itself in the glans. The base of the glans is called the corona. The penis is wrapped by a layer of retractile skin.

What can I expect during the clinical assessment?


In the first consultation with the physician you should clearly express what you want to change or improve. During the consultation you may feel a little anxious, but remember you are with a health professional that is willing to listen to your desires. Through a physical examination, lab analyses and urologic assessment, the physician may determine the problem.


Preoperative indications

Please see our guide of GENERAL RECOMMENDATIONS ON PLASTIC SURGERY

You will find valuable information to prepare for your surgical treatment.

Please observe the following indications:

  • 1 - Stop smoking at least 3 weeks before surgery. Smoking significantly reduces the body´s superficial circulation since diminish blood´s capacity to bring needed oxygen to tissues, and also interferes with proper healing and scarring process.


  • 2 - Inform your surgeon of every medication, vitamin supplements, and dietary or herbal supplement you take.


  • 3 - Your surgeon may recommend shaving the area to be treated. You will be instructed on how to do it.


  • 4 - A physical examination is performed to observe the preoperative conditions. Your surgeon may take measurements and photos.



Male Genital Surgery Preparation



It is considered you are in surgery from the moment you arrive to the surgical area until the moment you have sufficiently recovered from anesthesia. Before surgery, your surgeon, anesthesiologist and the nursing staff will meet you in the pre-operative area to discuss your medical condition and answer any question.

The anesthesia

What kind of anesthesia is used during the male genital surgery?

Male genital surgery is usually performed using local anesthesia and intravenous sedation. You will be informed preoperatively about the anesthesia in your surgery. Our section about Anesthesia provides complete information on this medical practice along with recommendations and instructions.

Hospitalization

Will I require hospitalization?

Usually genital surgery does not require hospitalization. You should resume gradually your normal activities after 3 days and may return to sexual activities within 4-6 weeks. In some cases, the patient may need to stay in the hospital for a short while


Procedures



Penis enlargement

The penis enlargement surgery is the procedure aimed to enlarge the length of the penis. In the last years, the penis enlargement has become a frequent request. Some men associate the size of their virile member with their masculinity, power, relationships, and sexual performance. There is a common social concept about the men penis´ size, and their confidence and social acceptance. There is common concern about the size of the virile member which is often related to self-esteem problems.

The small size condition of the penis seems to be related to a deficiency of the gonadotropic hormone and hypogonadism. The consensus is that the average size of an adult small penis is less than 5.5 cm in the flaccid state, and less than 8 cm during erection. According to statistics, most patients who demand penis enlargement are divorced.

The procedure

In the treatment to enlarge the penis, the surgeon may perform different surgical techniques. One of them involves the administration of a vasodilating agent as the tolazolina to induce the erection. Subsequently, the surgeon makes a crosswise incision in the dorsal face of the penis to expose the suspensory ligament of the penis. Through this method, the penis may be enlarged up to 2 cm. If desired, the surgeon may remove the deep suspensory ligament for more elongation

The autologous fat transfer is a different method to enlarge the penis. Through this treatment, the penis may be enlarged up to 2-3 cm. If the patient requires a higher effect of extension, the surgeon may perform a dissection of the fundiform ligament, both superficial and deeply, which is located below the pubic symphysis. Then the surgeon attaches the tunica albuginea to the periosteum through s retraction of the corpus cavernosum. In order to increase the skin elasticity, the surgeon performs a Z-plasty, V-plasty, or Y-plasty on the back and the base of the penis. Through these two procedures, the penis may increase from 2-3 cm in size.

Another technique for increasing the size of the penis is the lipoinjection. Previously, it is necessary to perform a liposuction in the inner side of the thigh in order to obtain approximately 50-70 cc of fat. Incisions are made on the base of the prepuce. The fat is injected between the superficial fascia and the deep fascia, approximately 15 cc. Once the procedure is done, it is necessary to move and massage the area. Main complications are related to the natural fat reabsorption and the microcalcification formation. Most urologists consider this technique is not functionally effective in all patients.



Preputioplasty

The Preputioplasty is the procedure aimed to correct the phimosis. The phimosis is a condition in men where the prepuce cannot be fully retracted from the head of the penis. It is very frequent pathology in children which was described by Keyes in 1919.

Causes of phimosis

Fat excess in the supra-pubic area

Liposuction may be performed in young men with mild-moderate fat excess who want to improve the appearance of this area. If the patient presents skin laxity, a surgical procedure may be the appropriate treatment. The physician should determine the adequate treatment in each case.

Forcible retraction of the foreskin

Skin laxity

Balanitis

Treatment

Phimosis is usually treated in the childhood when is better tolerated. The surgical treatment is performed by separating and suturing the prepuce skin that hinders the skin retraction to expose the glans. The surgeon makes an incision in the ventral medial line that end in the scrotum, which then sutures through the glans to perform a circumcision incision about 3 mm long, proximal to the crease of the corona. The skin is dissected and the prepuce is relocated. This technique may vary according to the condition of the patient. Preoperatively, your surgeon will inform you about the anesthesia to be used.

Despite taking all precautions, complications may occur. Your physician makes every effort to anticipate to potential complications. Surgery of any kind carries risk of complications. It is important the patient considers the type of surgery, the type of anesthesia and the level of difficulty, since each procedure is completely different.