In the last article, I explained my experience with fat injections and why fat "retents" very well in some patients, while some patients experienced losses in injected fat. You'd better read that article before this article. I'm here to share some case experience with fat injection. Each of these cases has taught me something. As I explain the case examples, I will tell you the lessons I learned. I didn't mention any details to cover up the patients' identities.

1) Patient from a country in Europe: A patient I did penile enlargement with two and a half years ago (I do the penis enlargement by fat injection). This patient came for a second fat injection 2.5 years after surgery. He said: "Doctor, I operated by you 2.5 years ago. You did penile enlargement. You said the fat was bad after the surgery and that the dissolvance would be excessive. I've really lost a lot over time. I came for the second fat injection. " I examined the patient, and there was about 20% of the fat (I say eyeball estimate) that we actually injected. I said okay, let's do the fat injection again. We took the patient into surgery. This time, abdomen fat was excellent. There was no edema in the fat. We are filtering, nothing is filtered. Like mashed potatoes. This fat is very "quality"; it "retains" very well. We did the surgery, we finished it. After the patient came to himself, we went to his room. I said "You're a very interesting patient. You came from .... (a European country) two and a half years ago . Normally, the abdomen fat is very "quality" in patients coming from abroad and it "retents" very well, but your belly fat is bad. I said the dissolvance would be excessive, and it happened. Today, the fat we extracted from the abdomen was very "quality". “It's really strange," I said. The patient said to me, "Doctor, there is a misunderstanding." “What is it?" i said and he answered like: "Doctor, I came from the ..... country about 2.5 years ago, but I had just been there. I went, I enrolled in college, I settled my house, I came back, I operated by you. After that, I started living there. I've been there for two and a half years ". We were shocked. Now the event has become clear. I turned out he wasn't a patient living abroad when we operated 2.5 years ago. He was a patient living in Turkey. No wonder the fat we extracted from the abdomen during your first surgery was edematous and "poor quality". After the surgery, he goes back to Europe and can't come because of school, he lives there for 2.5 years. Meanwhile, he had probably ate lard with what he eats. The abdomen fat structure changes. When he came at the end of two and a half years, the fat we extracted from the abdomen was extremely dry, free of edema and "quality". When the patient made this statement, tit fell into place and everything became clear. This patient's condition supports my thesis. In countries where pork and lard are not consumed, such as Turkey, fat extracted from the abdomen is loose, edematous and "poor quality". When injected, dissolving is too much. In European countries where pork is consumed, abdomen fat is solid, free of edema and "quality" due to pork meat and lard. I consulted with a friend of mine who's an internal medicine specialist in the United States. I asked if the abdomen fat structure could change so much with what we ate. "Of course," he said. "We are what we eat. Eating pork and lard for a long time changes the body fat structure. This is good for your surgery, but bad for the patient. " “Why?" i asked. He said, "If the body fat structure changes and solidifies, it makes the fat you inject "retain"better, but it also shows that the vascular stiffness will be worse in these patients. Arteriosclerosis will be more difficult to treat because the fat occlusing the veins will also be more solid. Ultimately, fatty tissue will be more resistant everywhere ".. Really interesting..

2) My wife has been hurting for a year: I got a call from a patient in Europe a few years ago. Here's what he said. "Doctor, I operated by you 1 years ago. Penile enlargement (we do the thickening by injection of fat). We have been having problems for a year.." I was so surprised, I asked what happened. The answer was: "Doctor, you said there would be some dissolving of fat, there was no dissolving. My wife is hurting". This case was a patient we operated on when we had insufficient experience with fat injection. As far as I can see from the video recording of the surgery, the fat tissue we extracted from the patient's abdomen was dry, edema-free (i.e., quite "quality"). Now we know this kind of fat retends very well. If the fat extracted from the patient's abdomen is this good, it should not be injected more than necessary because it will not dissolve. At least in the short term. In this patient, we injected him a little too much, thinking the fat would dissolve. It's not dissolved. That leads to the problem. If the patient comes from abroad, if there is a possibility of lard in his food and if the fat extracted from the abdomen is dry as mashed potatoes, if no liquid dissolves when filtered through the filter, the fat will not dissolve for a long time. The case will be quite successful. But it is necessary not to inject too much.

3) Sometimes it is problematic that the case is very successful. One of our patients (again from Europe) voluntarily had fat injection into the penis 3 times in 2 years. And every time, the fat "retended" very well. The patient was very satisfied with the result. Then one day, he asked for some of the fat extracted back. He doesn't want to have a penis that big anymore. Probably because he had a new partner and he didn't want an organ this thick. The surgery could be very successful. Think carefully when you're having surgeries like this. The process does not have a remote control so we can press the button and take it back.

4) A plastic surgeon colleague from another city called me one day. He said that they did a joint study with the university and tried to keep the fat injected into the penis alive for longer, and they were conducting a study for this. He said he'd send me documents and data, and he wanted my opinion. I directly said that this study was pointless, that they were trying in vain. What's the reason? Because injected fat tissue should not remain alive in the penis. Normally (as I explained in the first part of this article), fat tissue injected into the penis does not live; it dies and remains fibrous tissue (as it should be). It increases the thickness of the penis in this way. There can be no living fatty tissue in the penis anyway, there shouldn't be. Why? The answer is very simple: there's normally no living fatty tissue in the penis. Think about it, there is adipose tissue under the skin all over the body (arms, back, legs, body and ..). Except for one place: tissue of penis!. There's no fat there!. Because it's not supposed to be. The most correct of everything is in nature. There should be no live fat on the penis or subcutaneous tissue. I have seen fatty tissue that I injected in 2 of the hundreds of patients that I have operated on since 2004 remain alive. That's actually impossible, but in two cases, I've seen all the fatty tissue I injected stay alive. I've seen the results of that, it's not very good. The penis becomes very soft, lipoma (fatty gland) can emerge from living fatty tissue and fatty tissue around the penis can be affected by weight gain and loss. It can get too thick when you put on weight. For these reasons, we do not want fat tissue to remain alive in fat injections made in this region. It works better if it turns into fibrous tissue and provides thickness.

Fat injection is extremely complex, with many different dynamics involved. Therefore, it is not easy to predict the consequences. In this regard, the discoveries of the scientific world continue. I wanted to share my own experiences here in two parts. I hope it helps both the patients and my colleagues.

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
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• Op. Dr. Oytun İdil: +90 533 569 0649
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