I'm struggling with mistakes almost everywhere I go. My friends, acquaintances, colleagues, even my dentist, who know that I perform male genital surgery, ask me a lot of misinformation spread abroad. Even in some congresses I have attended, I am surprised to see how much misinformation specialist physicians have on these issues; I am constantly beginning speeches and make corrections at break time of presentations. I’m tired of repeating but let me write it down here. Misinformation about penile enlargement surgery. Here..

"60% of the injected fat in thickening dissolves...” WRONG! The truth is this: how much of the fat will dissolve can only be estimated. The amount of dissolvance varies from person to person and depending on some factors. It varies so much that you can't give an average rate like 60%. In some patients, 80% dissolvance occurs at the end of 6 months, another fat injection is required. In others, 6-7 years have elapsed since the surgery, there is no dissolvance. I think my colleagues who says 60% dissolves and 40% remains have no experience in this matter. I'll tell you why there are so many different outcomes: the food regime. In our patients who live abroad and (I guess) are not very selective about foods, their abdomen fat tissue is very "dry and solid" because since they consume lard in their meals. When we take this into vacuum injector, this fat fills into the injector like mashed potatoes or crushed bananas, no liquid dissolves when filtered through the filter. This "dry" fat retents very well. It doesn't dissolves even years later. The abdomen fat is very edematous and loose in our domestic patients or in our patients who live abroad who pay great attention to their food, who buy their bread from the halal market because lard is used in bread ovens. This type of fatty tissue tends to dissolve. Some dissolvance occurs within months and another fat injection is required at the 6th month or at the end of the 1st year. Therefore, we cannot give 60-40% average rates for everyone. We can make an estimate based on the patient's nutrition and the structure of the fat we extracted from the abdomen during surgery (dry, i.e. quality / edematous, i.e. very aqueous, poor quality).

- "This surgery does not provide any real elongation" WRONG! There are a few reasons for this misunderstanding. The first is impatient patients. After the surgery, there is a erection where the suspensory ligament is cut at the bottom of the penis. There's a very deep healing tissue forming here. This healing tissue is hard, not flexible. There is also hardness and edema of the injected fat peripheral of the penis. Patients compare the soft, flexible tissue of the penis in the period before the surgery and the erected postoperative state in the first 2 months. Patients who say that elongation is not noticed in erection always complain within the first 2-3 months. These patients see an elongation in the erection as time passes and hardness begins to soften. There are usually no such complaints in the 6th month. Surgeons who claim that there is no actual elongation have either never performed this surgery or are trying to elongate without cutting the suspensory ligament. To achieve elongation, it is essential to cut the suspensory ligament. Some surgeons are afraid to cut the suspensory ligament and perform z-plasty under the penis claiming that "we are elongating under the penis". As the suspended ligament is not cut , there is no elongation. Patients undergoing such surgery also cause the spread of the mistake of "there is no elongation with surgery". To summarize, it is imperative to cut the suspensory ligament for elongation. After the surgery, the patient must be patient. As the hardness softens, you will see elongation.

By the way, let me clarify how long the penis enlarges with surgery. I was surprised to see some surgeons (they are not plastic surgeons, I was one of the 2 plastic surgeons attending that congress, there were no other plastic surgeons..) claiming that there was no penis elongation with surgery at a genital aesthetic congress I attended recently. Visible elongation depends on two things. Let me list item by item so that it is easy to read:

1) The first is that the penis to be big enough!. Surgeons who do not have any experience with this surgery unfortunately, because of the name of the surgery, they have the following idea in plain logic: This surgery is a small penis enlargement surgery. NO! WRONG! Guys, this surgery is actually an operation to "enlarge normal size or bigger penis even bigger! it is not surgery to enlarge small penises! " We're not adding a piece between in this surgery. We slide the inner part of the penis out. So we're actually "we use the material at hand". In other words, the bigger the penis is, the more elongation will be or the smaller the penis is, the less elongation will be. According to my experience, there is no benefit in erection in patients whose penis length is less than 9 cm; there will be no elongation. At a convention, one of my master asked me after my presentation like this: "What should patients with micropenises do? I accept these patients for surgery.." I think it's a very wrong attitude. It is wrong to admit a patient to the surgery with the promise of elongation that you cannot achieve with surgery. These patients are already psychologically disturbed. There are a lot of patients with micropenises like this who are on the verge of suicide. It's wrong to give these patients false hope. Other solutions need to be developed for these patients (I mentioned in my previous article about penis size, finding a bride from the Far East is a remedy..) In contrast to cases with micropenises, in patients with very good penis size, you can see very clearly the elongation at the end of the surgery. For example, in my first black patient that I operated on (his penis size was 20 centimeters in erection), when I looked away from the operating table and looked at the penis at the end of the surgery, I thought of two things: “The penis is out of the penis, it's a snake!... How is this going to get an erection? " The answer to that question immediately occurred to me: "He'll get an erection the way he used to. There's no difference in erection, because what we do is we slide out the invisible part of the penis. We have not inserted a piece between. " I mean, the bigger the penis is, the better the elongation. There is no need to measure with a ruler, it is visible. It is certain that there is elongation, the problem is that the penis is be big enough (at least it should be 9-10 cm in erection) so that the elongation we performed we can seen. If the penis is too small, the elongation will be in millimeters and it will not be noticible.

2) The second factor is that sufficient time to elapse after the surgery. We see the elongation at the end of the surgery and photograph it, but the healing begins in that area. Healing means stiffness in the tissues. Hardness means lack of flexibility. Unfortunately, in the first months after the surgery, patients always compare the flexible and soft state before the surgery and the state in which the tissues become hard after the surgery. Some even complain that "I didn't see enough elongation" before the sutures came out. Whoa, wait a minute! The healing needs to be over, the tissues need to soften. This process is at least 6 months. You must be patient.. No patient comes with such complaints in the 6th month.

As a result, if it performed on appropriate patient (we already select patients, we do not perform this operation for patients whose erection penis size is under 9 cm) when it is performed, if patient be patient and wait for hardness to soften, there is no reason not to see elongation at the end of 6th month.

- "There may be numbness or erection problem in penis enlargement surgery" WRONG! Can this surgery be performed if there are such possibilities? Ask yourself that. Only a very thin vein passes through the suspensory ligament. It passes through the lower levels of the suspensory ligament. When the suspensory ligament is cut, when we get to the lower 20%, we see that it is cut and there will be a small bleeding. That tells us we're close to the end of the suspensory ligament. There is no harm in cutting this vein. While the skin is being cut, veins thicker than this are already cut. There is no harm in them. There is no important structure that passes through the suspensory ligament except vein. In order to have numbness or erection problem in penis, an important nerve, an important vein must be cut or injured. However, this surgery is the safest surgery among plastic surgeries. First of all, surgery is "penis enlargement surgery," but literally, "penis tissue is never touched!" The surgery is obviously performed peripheral of the penis. In this respect, it is a unique aesthetic surgery. For elongation, the suspensory ligament connecting the penis to the pelvis is cut up to 80%. For thickening, fat is injected into the subcutaneous part of the penis. No procedure is performed on the vein, nerves, erectile tissue, seminal duct, urinary tract of the penis. Therefore, it is a very safe surgery.

By the way, I told you there's a vein running through the lower part of the suspension ligament of the penis. In fact, when this vein is cut, there is a small bleeding, and we understand that we have reached the lower 20% of the ligament. I don't think this tiny vein has a specific name. I will call this vein "Idil vein" with this article. I think because it's a very small vessel, no name has ever been defined for this vein...

I wish you all success, health and prosperous year.

Dr. Oytun İdil (Plastic and recontructive surgeon)
www.idilpenissurgery.com
oytunmd@gmail.com
+90 533 5690649
+90 505 2965569

Op. Dr. Oytun İdil

(Plastic aesthetic and reconstructive surgeon)

• Whatsapp: +90 533 569 0649
• E-mail: oytunmd@gmail.com
• Op. Dr. Oytun İdil: +90 533 569 0649
           +90 505 296 5569
• Asistant: +90 553 985 8087
• Office: +90 212 296 3656
           +90 505 137 1393
• Address: Halaskargazi mah. Rumeli cad. No:3 D:1
  Nişantaşı, şişli - Istanbul / Türkiye