The field of penoplasty comprises two separate procedures, one of which enlarges the length of the penis, Extension penoplasty (or phalloplasty), while the other, Enlargement, increases the girth or circumference of the penis.

Both of these procedures can be undertaken at the same time, and, in both cases, can either be performed under general anaesthetic or with local anaesthetic with sedation. The procedure takes between one to two hours to complete, depending upon whether one or both are performed. Enlargement penoplasty aims to increase the girth and volume of the penis, both at rest and erect.

This is undertaken by injecting fat which has been harvested from the body via liposuction (a process known as Lipostructure or lipofiling) through a small incision in the penis.

The fat, which is usually taken from the lower part of the abdomen, preferably the pubis, is then shaped into the shaft of the penis. The liposuction itself can create an improved impression of the penis as men tend to accumulate fat in this region.

The gains are immediate and, in many cases, impressive. A small stitch may be needed to close the incision. A support garment will be applied after the procedure. This garment may be required to be worn for up to one week post-operatively.

If the foreskin is long Mr Marcellino may also advise you to have a circumcision. Normally, around 30% of the fat injected into the penis is re-absorbed into the body in a few months. The remainder is usually permanent. In a number of patients top-up procedures (3-4 stages surgery) may be necessary in order to maintain the results.

There is a limit to the thickness of the fat grafts that can be applied in the first instance as it is necessary to ensure adequate blood flow to the grafts. Sometimes it is therefore necessary to perform top ups of fat in 3-4 subsequent treatments.

In some cases (around 10%) the penis may appear asymmetrical due to the position of the fat, or lumps may occur due to fibrosis or hyper reaction to the grafted fat cells. These problems are normally resolved with massage or cortisone injections.

In rare cases corrective surgery may be required. Swelling to the head of the penis can sometimes occur and some pain or discomfort is possible for the first 12-24 hours or more. Instead of fat it is now possible to use a hyaluronic acid called Macrolane. This procedure has the benefit of being quicker and far easier to perform. Please read the relevant page to find out more.