WHAT IS DRESSING ROOM SYNDROME?

It is that male patients are uncomfortable with some aesthetic defects as a result of comparing their bodies with other men in gyms, pools and changing rooms of saunas.

Patients with this condition often come to us saying, "I want a fullness in front of my underwear in the locker room at the gym." The main desire of these patients is the massive enlargement of the penis. They want penis thickening rather than lengthening. They want as much fat injection as possible.

As surgeons, I keep this syndrome in the back of my mind and evaluate the patient's wishes accordingly, and plan the surgery accordingly.

Understanding patients is always important, but even more so in penile surgery; because some penile aesthetic patients may not be able to explain their problem clearly due to embarrassment. In this case, it is very important for the surgeon to understand the patient.

WHAT IS THE MAIN FUNCTION OF THE SUSPENSION LIGAMENT?

Unfortunately, what the suspensory ligament actually does is misunderstood by most doctors (and even surgeons). Many doctors think that if this ligament is cut during penile lengthening, the penis will stand low and its stabilization will deteriorate. I think these misunderstandings stem from the name of the ligature "suspended tie". The main task of the suspensory ligament is definitely not to keep the penis erect!.

The main task of the suspensory ligament is to bring the penile tissue coming out from under the pelvis up, in front of the pelvis. In this way, the penile tissue comes in front of the pelvis and protrudes from here. This is why men engage in intercourse with hip movement while having sexual intercourse. When the man pushes his hip forward, he also pushes the penis in front of the pelvis forward. In this way, the penis enters the vagina. That is, the pelvis acts as a piston behind the penis. The structure that holds the penis in front of the pelvis is this suspensory ligament.

In the classical technique, the suspension tie is cut completely. This is the description of the classic penile lengthening surgery, which is in the books. We do not cut the suspension completely for 3 reasons. In our technique, the suspension is cut by 80%.

First, I think it is very important that the suspensory ligament holds the penile tissue in front of the pelvis during sexual intercourse. In this way, the penis, which has a bone support at the back, can easily enter the vagina with the movement of the hip and by taking the support of the pelvis behind it. Therefore, this bone support should not be destroyed (the suspensory ligament should never be cut completely. This is why the classical surgical description in the books is wrong. It is also very wrong.).

The second is the decomposition of the upper part of the suspensory ligament, which ensures elongation in the penis. As the suspensory descends to the lower parts of the ligament, the contribution of cutting the tie to elongation decreases. Cutting the lower 20% of the suspensory ligament does not contribute to elongation at all. That's why I leave the bottom 20% of the suspension tie intact.

Third, if the suspensory ligament is completely cut, there is no place for the penis to attach to the bone. This situation not only makes it difficult to have intercourse, but also causes the penis to slip under the pelvis and shorten while having intercourse. The fact that the penis is completely unsupported both makes it difficult to have intercourse and causes it to shorten.

IF THE SUSPANSORY LIGAMENT IS CUT, WILL THE PENIS' ERECT POSITION BE BROKEN?

The main task of the suspensory ligament is not to keep the penis erect. There are many structures that ensure the erection of the penis. In the first years that I started these surgeries, I was also using the classical technique, that is, I was cutting the suspensory ligament completely. None of my patients at that time had a complaint such as low penile standing. In the books, it is not written that the penis will fall with the cutting of the suspensory ligament. In fact, there are many structures that hold the penis. The suspensory ligament (although its most important task is not to hang the penis..) helps to keep the penis upright, but its most important task is not to keep the penis upright. The suspensory ligament brings the penile tissue in front of the pelvis. Therefore, the cutting of the suspensory ligament does not result in the lowering of the penis, but in the removal of the penile tissue from the pelvis (extension in the penis).

Summary: The function of the suspensory ligament is actually to attach the penis to the front of the pelvis. The name of the suspension tie should actually be "anchor tie". With the cutting of the suspensory ligament, the penis does not fall. It slides out of the pelvis by getting rid of it..

An instructive case: What happens if the suspensory ligament is cut completely?

In February-March 2022, a Turkish patient from abroad called me. This is exactly what they told me on the phone: Doctor, I had this surgery here, but I'm having some problems. I watched a video of yours, I realized where the problem comes from. Can you help?"

First of all, I asked the patient what kind of problems he had. The answer he gave me is as follows: "Sir, when the penis is soft, there is elongation, thickening is good.. It looks both lengthened and thickened when erect. There is no problem in appearance or erection, but when you try to have intercourse, it shortens. I think as you mentioned in your video, the suspensory ligament they cut it right"

I have been saying for years that the suspensory ligament should not be cut completely. This case is a very good example. I told the patient: "Yes, if the suspensory ligament is completely cut, there is no bone structure to which the penis is attached and the penis remains free. During intercourse, it may shorten by entering under the pelvis while trying to enter the vagina; "Because your doctors have applied the technique written in medical books. I think the problem is in the books. It's not a doctor's mistake. Actually, this technical error in classical medical books needs to be corrected. If you come here, we can repair the cut part of the suspensory ligament that shouldn't be cut."

I think this case is very important. It shows why the suspensory ligament should not be cut completely. This faulty technique in medical books should be corrected as soon as possible. I am currently writing a medical article on this subject that I plan to publish in a year.

My patients are asking.. A doctor or something, wrote on his website, "penis lengthening extends the penis 6 cm".. Why do I say 2-3 cm?

I say that there will be only 2-3 inches of gain in extension, because this is the truth. The friend who says that he has lengthened four to 6 centimeters is lying. This is physically and anatomically impossible.

Look, I am occasionally invited to congresses, symposiums and faculties to talk about this surgery. The first thing I say is "tell patients about the limitations of surgery, don't promise what you can't deliver". From where?

Not being able to extend the penis 6 (six) cm!

There are some tricks that everyone who works in private apply. Every private surgeon knows these, but does not tell them. Sometimes a very difficult case comes. You say you can do it, but you invite a brother you know to the surgery, who has more experience in that case than you. You do the surgery together (as you know, surgery is a master-apprentice job and it is natural to invite a more experienced older brother to the surgery). In the end, there will be a good result, you will send your patient satisfied. Especially new experts call their older brothers for help from time to time until they gain experience. But in penis enlargement, if you throw it from a height and shake it to extend the penis 6 centimeters, no matter who you call for help, no one can make you extend the penis 6 centimeters; because such a thing is not possible. So it's both ignorance and lying to shake it and write it on the website saying "I'll extend my penis 6 inches".

Sometimes a patient calls and gets information about the surgery. When we say that the penis will grow 2-3 inches, he says "we are the richest family here, sir, money is not important, you can grow it as much as you can". This has nothing to do with money. Whether the patient wants to break his heart and give 100 billion, the elongation that can be obtained with surgery is 2-3 cm.

My advice to surgeon friends who are new to these surgeries: "Do not promise things that do not happen. You cannot do it, the patient will not be satisfied, and you will increase the patient's expectation from the very beginning. When the patient returns and complains, there is no revision, because if you said that you will lengthen 6 centimeters at first, this is the case. It's not possible, you can't.

My advice to patients is: be like me, so "REALISTIC"

So why only 2-3 cm elongation?

The answer is simple; because anatomy only allows so much elongation. The elongation thing is to separate the penis from the pelvis where it is attached at the back. Unless a piece is added in between. The tissue of the penis, as a block, is separated from the pelvis and pushed outwards without losing its integrity. This difference is about 2-3 inches.

As we slide the penis out, we also need to lengthen the upper skin. There is no need to lengthen the skin on the underside of the penis, because the skin between the penis and testicles is already very loose and there is no need to lengthen it; but it is necessary to lengthen the skin at the base-back of the penis. The skin at the base of the penis is thick, similar to the skin of the abdomen. It is not flexible and loose like the skin under the penis. Therefore, lengthening should be done at the bottom and back of the penis. That's why Z-plasty or V-Y plasty is done here.

Isn't that 2-3 inches of elongation too little? Are patients satisfied with the result? Why not just an extension?

Elongation of only 2 cm may not satisfy the patient. In addition, if only lengthening is performed, a collapse occurs at the base of the penis, where the body tissue of the penis separates from the pelvis. For these reasons, thickening must also be done. During thickening, we inject fat into the collapsed area at the base of the penis. It should fill the area with the crash. If the lengthening is done together with the thickening, the result will be absolutely satisfactory for the patient. Meanwhile, the collapse at the bottom of the penis is filled with fat injection and the collapse is corrected.

Is the surgery guaranteed?

Let alone the surgeries, nothing in life is guaranteed.

For one thing, there is such a thing as a "complication". What is "complication"? Undesirable results in medicine are called complications. If the stitches are opened after the surgery, if the surgical site is infected, if the result is not as desired for any reason, it is called a complication. The possibility of complications exists in every surgery. While this is the case, it is not realistic for patients to ask for a guarantee and to have a guaranteed surgery by their doctors by completely ignoring the possibility of complications.

The patient who asks for a guarantee wants his doctor to lie by looking him in the eye.

The doctor who gives a guarantee is also lying by looking into the eyes of his patient.

If you're going to have surgery, don't fool yourself by asking your doctor for a warranty.

In surgeries, both the patient and the doctor should share the responsibilities by knowing the possibility of complications. When any complications arise, it is your doctor's responsibility to deal with that complication. During the specialization training, we also receive training on what to do in such undesirable situations and treatment methods.

Being a specialist in a surgical branch is knowing the possibility of complications, taking the necessary precautions in advance to prevent them, informing our patients about these issues and coping with it if a complication develops.

Asking for a guarantee is a lie. Do not deceive yourself.

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Finally, answer a few questions for yourself:

Can you guarantee yourself that when you leave the house in the morning, you will return home safely in the evening?

Do the people you vote for in elections (president, deputies, local governments, etc.) give guarantees about their administration? Which party that comes to power guarantees that it will fix the economy and reduce unemployment?

Is there a place that gives a guarantee other than white goods or electronic devices? which they also give a warranty of 2 years or so..

Click here to read an article I wrote on the warranty issue..

CAN THE SUSPENSORY LIGAMENT BE SEWED AFTER IT IS CUT IF DESIRED?

This is a question frequently asked by patients who are afraid of cutting the suspensory ligament.

First of all, let me reiterate: I don't think cutting the suspensory ligament has any bad side effects, as long as it's not cut completely. You won't be harmed. Since I think that cutting the suspensory ligament completely removes the bone support necessary for sexual intercourse, I do not cut the suspensory ligament completely. In this way, there is no harm in cutting the suspension ligament.

Now let's come to whether the hanging tie can be sewn back into place. The suspension tie can be sewn back into place. Although such a thing has not been requested by anyone until now, the suspensory ligament can be sewn back in after it is cut, we know this, because in patients with "congenital penis shaft rotation", the suspensory ligament is cut and re-stitched.

"Congenital penile shaft rotation" is an interesting congenital anomaly. The penis is congenitally sideways. The books say this is a very rare deformity, and many surgeons may not experience a single "congenital penile shaft rotation" in their lifetime. I have seen 4 cases so far, I have operated on two of them. So, why is the suspensory ligament cut and then stitched again in this deformity?

In this deformity, the penis attaches incorrectly to the pelvis from birth and stands sideways. The procedure to fix it is to cut the suspensory ligament completely, rotate the penis, and sew the suspensory ligament back to the penis while it is in the normal position. Special threads (braided, non-melting surgical threads) that have no loosening share are used for this surgery. Thus, it is ensured that the penis adheres to the pelvis in the correct position. The posture of the penis is corrected.

So it is of course possible to re-sew the suspension tie; but to date, not even one of the penis enlargement cases has made such a request...

Click here to go to the page about congenital penis shaft rotation: Total penis shaft rotation...

SHOULD WE APPROACH PENIS ENLARGEMENT SURGERY WITH A "VISUAL" PERSPECTIVE OR A "TACTIC" PERSPECTIVE?

In all books and articles, this surgery has been approached from a purely visual point of view. It has always been ignored how the patient's partner will feel when he touches the surgical site.

We have to change this perspective!

This surgery is performed completely and directly for sexuality. No one should have sexual intercourse with the opposite sex. Sex is a tactile event rather than a visual one. That's why I think we should consider "touch" and approach these surgeries in a different way.

We are still developing this surgery by listening to our patients and evaluating their feedback. Finally, we have added some innovations to the surgical procedure.

For example, we inject fat around the part of the penis that is not visible from the outside and continues under the pelvis (inner part). The reason for this is this: in the technique normally written in books, only the visible part of the penis is taken into account and thickening the visible part is considered sufficient. If the patient's partner holds the bottom of the penis, this part may feel thin; because fat is not injected into this bottom part, which normally continues inwards and is not visible from the outside. After listening to such feedbacks, we decided to inject fat around the part that is not normally seen from the outside, but will be felt when you hold the penis from the bottom part.

We see that the modifications we made, thinking that the patient's partner would touch the genitals, contributed positively to the outcome of the surgery. Patient satisfaction is high thanks to these minor modifications.

Two factors determine whether the injected fat "holds or not" in thickening...

Of course, fat injection has a lot of technical details, but the following 2 factors determine the adhesion of the injected fat tissue for thickening in penis enlargement surgery:

1: Having intercourse, masturbation or massage in the first 3 weeks after the surgery... Since the injected adipose tissue has not yet taken the form of connective tissue in the first 3 weeks, it mixes with the blood and melts with actions such as having intercourse or massaging. It is possible. That's why you shouldn't have intercourse for the first 3 weeks, you shouldn't masturbate, you shouldn't massage. I hear that some clinics recommend massage to their patients. I think it's completely wrong advice. Massaging in the first 3 weeks will melt the injected fat.

2: The quality of the fat taken from the navel and the sides of the waist... If the quality of the fat taken from the navel is good, that is, if it is dry, like mashed potatoes, it holds well and remains without melting for many years. If the fat taken from the belly is very edematous, if the adipose tissue floats in the serum in the injector, it means that there will be a lot of loss. No matter how much you strain and condense this fat, it tends to melt. In this case, we also consider the melt rate and inject a little more fat. We call the patient for control after 6 months. In these patients, it is usually necessary to inject fat once more within 1 year.

DO YOU P-SHOT? WOULD YOU RECOMMEND?

I've been hearing about this P-shot application for about 5-6 years. This application, after all, is nothing but mixing the fat with the PRP prepared from the patient's own blood. The substances and cells in PRP are all about wound healing and tissue regeneration. Therefore, if we want tissue healing and regeneration, PRP will of course be useful. Due to these properties, PRP is very effective in injuries and in cases where tissue regeneration is desired. For example, its effect on knee cartilage regeneration, facial aesthetics, firearm injuries in the elderly is indisputable; but this is not the case with penis enlargement.

The amount of fat we inject for the purpose of thickening the penis is more than the fat can hold as living tissue. If we say as classical knowledge, in order for the fat to be kept as living tissue and to survive, the fat tissue must be injected into the living tissue with healthy blood, in the form of a column with a maximum diameter of 1 centimeter. In this way, the adipose tissue nourishes and lives from the surrounding tissue. However, the amount of fat injected in penis enlargement is much higher than this and therefore does not hold as living tissue. Fat tissue dies and becomes connective tissue. For many reasons, we do not want the fat to retain as living adipose tissue (watch the "thickening" video for a detailed explanation on this subject).

To summarize, the adipose tissue injected for thickening does not remain alive, but turns into connective tissue. This is more true in terms of the outcome of the surgery. It is not right to try to keep the fat alive. Even if we want this amount of adipose tissue, it will not survive, it will turn into connective tissue. Therefore, adding PRP into it to try to keep the fat alive -in my opinion- is useless..

That's why I don't use p-shots in penis enlargement surgery. I don't believe it helps either. I think it is an app made up to earn extra money..

On the other hand, injecting PRP into the erectile tissue of the penis may be beneficial for patients with erectile dysfunction. This is another matter entirely. Erectile dysfunction has nothing to do with penis enlargement. Even if there is an erection problem, performing penile enlargement surgery may make the erection problem worse. Here, PRP can be injected to treat the erection problem. For this purpose, PRP injection is made into the hardened erectile tissue, not under the skin.

How is penis size classified for Türkiye?

We can roughly make a classification for our country (lengths are measurements from the base of the penis to the tip in erection):

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Micropenis: shorter than 5 cm (penis enlargement surgery does not give very good results)

Short penis: Between 6 and 9 inches (although not very good results can be obtained from penis enlargement)

Normal limits: Between 10-18 cm (good results are obtained without penis enlargement)

Large penis: Larger than 18 cm (penis enlargement works best.)

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I can easily say that 99% of the patients who applied to the surgeon for penile enlargement surgery in our country are patients within the normal limits. As many surgeons think, this surgery is not done to enlarge penises that are small in size. The larger the penis, the more successful it is, as the surgical procedure is to slide the penile tissue out without damaging its integrity. If the length of the penis is less than 10 cm in erection, it is not possible to extend it by surgery. Therefore, this surgery does not work in patients with short or micro-penis.

This surgery is actually not a penis enlargement of the small penis's surgery.

This surgery is actually "the surgery to enlarge normal or large penises"; And the larger the penis, the better the result. Contrary to popular belief, it does not work in cases with micropenis.

You are considering penis enlargement surgery, but you have not told your partner yet.. What should you do?

I have been performing these surgeries since 2004 and I have incredible experience in this regard.

My advice to you (you have two options):

1) Either tell your spouse that you are considering this surgery, convince him. Come to the doctor with his consent..

2) ..or don't say it at all; be a surprise after surgery.

DON'T TELL YOUR WIFE AT THE LAST MINUTE AFTER YOU TAKE THE SURGERY DAY...

Why?

The surgeries of our patients, who came for the day for penis enlargement and told their husbands the night before the surgery that they would have this surgery, were always canceled at the last minute (the morning of the surgery). If your wife finds out about this surgery at the last minute, she will probably be very angry and mess up. We have witnessed this event many times.

Either talk to your spouse from the beginning and get their approval, or don't say it at all, it will be a surprise. In both of these cases, the event does not happen. Both the patient and his wife are satisfied.

WITHOUT THICKENING, THERE IS NOT ONLY PENIS EXTENSION, WHY?

Sometimes our patients just want an extension. Unfortunately, extension alone is not possible, because the result will not be good.

I show the photo you see below to my patients who only want extensions from me. This photo was taken in the middle of a penis enlargement surgery. Penis lengthening has been done but thickening (fat injection) has not been done yet. If only stretching is done, the image will look like this. Notice that there is a collapse at the base of the penis (the place marked with the red X in the photo on the left). This is where the suspension tie, indicated by the green X in the drawing to the right, is cut. When the suspensory ligament is cut and the penis is pushed out, a gap is created between the penis and the pelvis. Here the skin collapses slightly. This depression must be filled with fat injection. If it is not filled, it will be a bad image. Therefore, fat injection must be done.

There is one more thing I want you to see in the photo.

In the photo on the left, the stem part of the Y-shaped suture line connected to the V-Y plasty at the base of the penis (distance indicated by red A), the length of the collapse at the base of the penis due to the cutting of the suspensory ligament and pulling the penis out (red B) The distance indicated by >) is almost the same and is about 2 cm. This distance indicates the elongation achieved by surgery.

The elongation obtained by cutting the suspensory ligament is exactly as much as the stem of the Y-shaped suture at the base of the penis. This distance is equal to the length of the collapse at the base of the penis (depending on the cutting of the suspensory ligament).

This photograph is proof that the penis enlargement obtained by cutting the suspensory ligament is not an illusion, but a real elongation.

Why not a stand-alone extension?

URINE INCONTINENCE CAN OCCUR AFTER PENIS ENLARGEMENT SURGERY.. WHY? WHAT TO DO, HOW TO TREAT IF URINE INCONTINENCE?

We have experienced short-term urinary incontinence in 8-10 patients after penile enlargement surgery. This event usually lasts for a short time and resolves spontaneously after 1 week.

To date, this complaint has continued for about 2 months in only 1 patient. We asked the patient for all necessary consultations and had all the necessary examinations and films done. We finally found out the cause of urinary incontinence. This question has nothing to do with the surgical technique. It's all about stress. Watch the video below.

Urinary incontinence after penis enlargement surgery. An annoying but temporary problem..

What causes urinary incontinence after penis enlargement surgery? How is it treated?

"WHILE GOING TO DİMYAT TO RICE, LET'S NOT BE FROM THE BULGUR AT HOME" - A Turkish proverb

This is the most frequently asked question by our patients. Have no such worries.

This surgery is perhaps the safest and most interesting surgery in plastic surgery; because the procedure is penis enlargement, but we do it without touching the penis. During the extension, we cut the suspensory ligament behind the penis; We do not touch the tissue of the penis itself. While thickening, we inject fat under the skin of the penis. In other words, all the surgery is done completely around the penis, the penile tissue is not touched.

Do not forget that, in penile enlargement surgery, the penile tissue as a whole is shifted outwards without losing its integrity. No vein or nerve of the penis is damaged during the operation. Therefore, it is not possible to damage the penis during the operation.

On the other hand, we clinically record all our surgeries on video. If you wish, you can watch your surgery later. All actions are documented.

Sir, what is this! You sewed the seam like a quilt!!!

My patients sometimes text me when I remove the dressing on the 3rd day.. "You did a good job, my teacher..", "I was promoted from the local league to the super league thanks to you.." like.. One day, a patient of mine sent a message like this: How did you sew, teacher! You sewed like a quilt, it's so bad..." Yes, I sew like a quilt, but ask me why am I sewing like this?

The reason why my patient calls the stitch "quilt stitch" is because I stitched the wound lips together. This is a suture technique and is known as "everte suture" or "continious horizontal matress" in medicine. In some areas, we especially sew the wound lips outward, because the wound will collapse as it heals in that area. If you sew the suture in relief, after the wound heals, that swelling will decrease and the suture scar will be level with its surroundings. Thus, it becomes as obscure as possible. If we had sutured the seam without embossing (at the same level as its circumference) at first, the wound would collapse as it healed and a hollow scar would remain. That's why in this surgery, we especially sew "like a quilt" when sewing the surgical site. You can see this sewing technique in the video below. Since the video is for teaching purposes, the stitching is a bit rough.

Continious horizontal matress surgical suture...

There are two penis enlargement surgeries: 1) Classic suspensory ligament cutting technique and 2) Perovic technique. What are the differences between these two techniques?

1) Classic suspensory ligament cutting technique (this is the technique we apply):

1) Classic suspensory ligament cutting technique: The essence of this technique is to slide the inside part of the penis out. For this, the suspensory ligament holding the penis in front of the pelvis is cut. The cut suspension tie is indicated by the green X in the drawing below. The penile tissue is slid out as a block. As it can be understood, the success of this surgery is completely proportional to the length of the penis, since no part is added in between. The larger the penis, the better the elongation. On the other hand, this technique does not work in micropenis cases, since no part is added and the success of the surgery is proportional to the size of the penis. In my experience, if the penis is shorter than 10 cm in erection, this surgery does not work well. One good thing about the classical technique is that it is extremely safe. The integrity of the penile tissue is not disturbed and the penile tissue is slid out as a single block. Therefore, it is an extremely safe method.

To summarize, the classical technique is extremely safe, it provides elongation by sliding out one piece without disturbing the integrity of the penile tissue, but the bigger the penis, the better the result, the smaller the penis It doesn't work in cases of micropenis..

2) Perovic technique (we do not do this surgery because it is too risky):

2) Perovic technique: In the Perovic method, the penile tissue is divided into two (veins and nerves are preserved on the back side and the urinary tract is preserved on the lower side) and a cartilage piece taken from the ribs is placed in between. This piece of cartilage is usually placed between the glans penis and the body of the penis. The thing that provides the elongation is this piece of cartilage put in between. This technique works even in cases of micropenis, since the piece is inserted. In an erection, whether the length of the penis is 5 cm, 2-3 cm elongation can be achieved. There are many modifications of this surgery. Various variations have been tried, in which the penis is cut not straight but in steps. It is a fact that this technique is a very dangerous operation since the penile tissue is cut in two. The blood circulation of the glans penis may be impaired and the glans may be lost. Even in the articles of the surgeon (Dr. Perovic) who described the method, cases of loss of the glans penis are mentioned. Dr. You can see photos of such cases in Provic's articles. Although it works even in cases of micropenis, it is such a risky surgery that it has not become widespread in the world. Due to this high risk, we do not perform this surgery.

To summarize, the Perovic technique is a very risky technique, the tissue of the penis is cut in half and a piece of cartilage is put in between. When trying to lengthen the penis, the glans of the penis (even half of the penis) may be lost. On the other hand, the success of the surgery does not depend on the size of the penis itself, since it provides lengthening by putting a piece in between, lengthening can be achieved even in cases with micropenis..

If a surgeon does not cut the suspensory ligament (classical method) or cuts the penis in one area and does not add a cartilage piece (perovic technique), it does not mean that he is not doing lengthening. Therefore, do not believe those who say that we do not cut the suspensory ligament, we extend the penis from the lower side. No such technique.

The matter of clumping of the injected fat tissue.

A frequent complaint of patients (in the past) was lumps of fat in the areas where fat was injected after surgery. If these lumps formed a few months after the surgery, they felt like chickpeas. To avoid this problem, it is necessary to pay attention to some points.

First, look at the photo below. Here you see the preparation of the oil for injection. These two injectors are connected to each other by means of a spacer attached between the two injectors. The adipose tissue is thinned by passing from one injector to the other; that is, the adipose tissue is crushed.

According to our experience over the years, the better this thinning process is, the less clumping is seen. So it is important to crush the oil thoroughly. At this point, it is very important that the hole in the middle of the spacer placed between the two injectors is thin. If the hole is thinned with a thin spacer, no clumping is seen.

See the photo below. The spacer on the left, with a large hole in the middle, is the spacer we used in the past. At that time, our patients had lumps. We now use the right-hand spacer with a very thin hole. We haven't seen clumping in our cases for a long time.

If the injected fat is thinned well and well distributed to the subcutaneous tissue while being injected, there is no clumping.

We have recently been working on an oil injection technique that will increase the retention rate of injected oil and at the same time completely prevent clumping (2023). If the results are successful, I will announce it on this site..

"Invisible ring" deformity in the penis..

This is a rare, interesting deformity..

Let me tell you what the problem is: In penis enlargement surgery, sometimes when injecting fat for thickening, the skin does not stretch in one area of the penis and a region remains narrow in the form of a ring, as if there was an invisible ring. On the body of the penis, that annular region remains narrow, while other areas thicken; as if an invisible ring prevents the ratio from thickening during thickening. This is a very rare issue. From 2004 to 2023, we encountered this problem in only 10-12 patients. Except for one patient, there was no clue of this problem in the preoperative examination in the others. In other words, it is not possible to understand that this problem will occur in the examination performed before the surgery. During my examination in only one patient, I noticed a slight thinness in one part of the body of the penis and told the patient that we could encounter such a problem during the surgery. As I predicted in the surgery, an area on the body of the penis remained narrow all around, as if there was an invisible ring.

I think this problem is completely caused by the skin of the penis. There is a developmental problem in that area of the skin and the skin does not stretch in a ring-shaped area. This may even be a congenital mild form of amniotic band in the penis. The amniotic band is a congenital knuckle found in the fingers, arms, and legs. The patient's fingers, arms or legs as if an invisible rope is tightening, regional stenosis occurs. In fact, if these amniotic bands are too tight while the baby is developing in the womb, there may even be ruptures in the fingers, arms or legs. There is even the possibility that the narrow (non-flexible) areas of the skin we encounter on the penis may be a mild form of amniotic band. You can see examples of amniotic bands in the picture below.

If we have encountered this problem during penile enlargement surgery and there has been a narrowing all around as if there is an invisible ring, the remedy for this is to make a second oil injection after at least 6 months, forcing the skin in that area to stretch. Usually the appearance improves...

PRECISE AND CLEAR! There is so much false and false information circulating on the internet that, by telling the truth, my tongue is gone.. I am writing here again, item by item...

Do not be afraid of cutting the suspensory ligament! Cutting the suspensory ligament does not cause low penis, resentment, curvature, numbness, infertility, or high exchange rates!!!...

Penis enlargement surgery is a surgery with no possibility of complications if it is done properly. We do not touch the penile tissue in penile enlargement surgery! The suspensory ligament behind is cut to lengthen it, and subcutaneous fat is injected to thicken it. We do not touch the erectile tissue, vein, nerve, hair, head of the penis. When you go to Dimyata with rice, you can't have bulgur at home.

There is no penis enlargement surgery performed under the penis where the suspensory ligament is not cut. When I say enlargement, I am talking about the physical growth that you can measure with a ruler. Penoscrotal web correction under the penis is not a lengthening method, it does not extend the penile tissue even a measurable millimeter from the outside, only the penis appears to be extended. With the lengthening surgery, in which the suspensory ligament is cut, real elongation is achieved as the penile tissue is shifted out. Real penis lengthening surgery is not an illusion surgery. So, if you want to grow like a man, that suspensory ligament at the bottom of the penis and at the back will be cut, my brother!.. Although we do not cut 100% as in the classical technique, we cut 80% of the suspensory ligament. Cutting the lowest part of the suspensory ligament will not contribute to elongation. Therefore, it is sufficient to cut the suspension tie by 80% for the lengthening process.

The most annoying complication that may be related to lengthening and thickening in the surgery may be difficulty in erection due to excess fat. If the patient does not have a very good erection before the operation; If the patient has an erection problem, when excessive oil is given around the penis, the blood that fills the penis and ensures an erection cannot circulate to the vessels in the penis. The erection difficulty that existed before the operation in the patient becomes obvious. This is due to the fact that the pressure of the blood, which is completely filled into the penis, cannot break the resistance of the oil injected around the penis. For this reason, I do not recommend injecting excess oil around the penis. We usually drink 60-70 cc in a session. We do not pass. This amount is an extremely safe amount. Also, if the patient has erection difficulties, I recommend that this erection difficulty be treated before enlarging the penis.

In the last 1 year, news of 2 deaths related to this surgery was reported in the press. In the first case, the fat injected to thicken the patient was injected with a needle and given intravenously. It was really an ignorant move. We make this injection with cannulas with a round and closed tip (like a bullet tip) and the hole close to the tip, on the side. It is impossible for these cannulas to enter the vein and deliver the fat into the vein. In this respect, these surgeries are extremely safe when performed with the right technique. In the second case, the patient died as a result of a severe drug allergy (anaphylactic shock) during narcosis before the operation was started. Since the patient is a wealthy person and the operation to be performed is penis enlargement, the incident was reflected in the press in this way; otherwise the patient died before starting the operation. In this second case, the death has nothing to do with penis enlargement surgery. Completely a complication of anesthesia and allergy... I am sharing the links of these two news below:

1) First case of death Cause of death of the patient, intravenous administration of fat with wrong technique

2) Second death case The cause of death of the patient was an extreme allergic reaction to the anesthetic drug. It has nothing to do with penis enlargement surgery. The patient died while injecting the anesthetic before starting the operation.

"40% of the oil injected in thickening melts... They say so, my teacher..." Who says that! Are all the patients twins? People are not uniform. There is such a thing as a body. Yes, there will be some melting in the injected oil, but this varies between 0% and 100%. It varies so much from person to person that you cannot give a rate like 40%. I talked about this at length in the "Penis thickening video". I can roughly say that the retention and melting of the fat are determined by 2 factors: The quality of the fat taken from the belly and the sides of the waist and whether to have intercourse within the first 3 weeks after the surgery (there should be no movement on the penis in the first 3 weeks, so we recommend a 3-week sexual abstinence to the patients). Watch the video I mentioned.

When some patients say that you should not have intercourse for 3 weeks after the surgery, they say, "Sir, if it will be better, I will not enter for 6 weeks". Do not do this! So wrong!. If the penis does not get an erection for a long time, it becomes smaller. The penis shrinks. For example, patients who are seriously injured or have suffered a cerebral hemorrhage sometimes cannot leave the intensive care unit for months. Sometimes these patients need to be put to sleep for a long time. In these patients, the penis becomes smaller because it does not get an erection for a long time. So do not prolong sexual abstinence for more than 3 weeks just because it gets better. The three-week period is sufficient for the injected oil to hold, do not extend that period. Do not forget that the working iron (penis) shines!..

There are still doctor friends who ask me if this nerve is injured while the suspensory ligament is cut, if there is no possibility of injury to this nerve.. Now if this is asked again, I will scream! Friends, the suspensory ligament is just at the bottom of the penis and is IN THE MIDDLE! WE ARE WORKING ON THE MIDLINE OF THE PENIS, ON THE BACK, BOTTOM OF THE PENILE, WHAT IS THE VESSEL, WHAT NERVE IS THERE.. Please, if you still have questions, look at an anatomy book!.. They ask me "brother, how do you protect the pudental nerve?" he.. Where is the pudendal nerve tee! The dorsal penile nerve, which is the extension of that nerve, does not cause any problems as long as you do not cut the penis itself. Remember, in this surgery, the penis itself is not actually stabbed with a knife. The penis is shifted out with its erectile tissue, vessels and nerves as a complete block (without spoiling its integrity). Therefore, there is no risk of injury to any tissue. What should we do? We should take a look at the anatomy books and refresh our anatomy knowledge.. ;-)

We do not have control at 3 points in penis enlargement..

The first is the structure of the patient's belly fat. As I mentioned above, belly fat is of higher quality in people who eat animal origin. This oil will provide thickness in the penis for many years without losing volume. On the other hand, in people who eat plant-based sources, belly fat is of poor quality and some volume loss occurs in the months after the surgery. I recommend that people with bad belly fat have another fat injection within a year. In these patients, we perform the second fat injection for half the cost of the first operation.

The second point that we have no control over is the prohibition of intercourse within 3 weeks after surgery. During this period, the patient should not have intercourse. Some clinics impose a relationship ban during this process and on the other hand, recommend that the patient massage the patient. This is completely illogical. The prohibition of intercourse is already given so that there is no movement on the penis. If there are movements such as massage on the penis within 3 weeks after the surgery, there will be a lot of loss in the injected oil. That's why massage, intercourse, masturbation, even oral sex are prohibited.

The third point beyond our control is the way the patient keeps his penis in the laundry. If the penis is kept too tilted to the right or left after the surgery, the distribution of the injected fat may be impaired. That's why I recommend keeping the penis straight, in the midline as much as possible.

Two of my patients kept a diary after surgery. I am sharing a few parts of these two diaries by taking their permission. I shortened the diaries because the articles were too long.

first diary (unfortunately only in turkish):

From the diary of another patient. This patient of mine had a penis enlargement surgery before and he came to me for a second fat injection due to some melting in the fat tissue. If our former patients need a second fat injection, we do it for a small fee.

Day 0 (Surgery day): There is no pain at all, since the bands are very strong, there is not much tilting to the right or left. The only problem is that the seams sting like an insect bite and go away after 2-3 seconds.

Day 1: No pain, no need to get support while getting up from the bed. The size of the seams has decreased. Antibiotics were taken.

Day 2: It can be worn over loose underwear + basketball shorts. Antibiotics were taken. I even went to the wedding wearing sweatpants, the abundance on the front can be hidden in the photos. No alcohol was taken.

Day 3: The 2.5-hour flight was uneventful, buying an emergency exit gate ticket might be helpful to stretch your legs. Since the bands in the bandage have started to loosen slightly, they are now pulling the hairs and this can hurt a little. Since the bands on the coke side started to loosen, the shaft began to lie more to the right and left. It is necessary to pay attention to this.
Note: In the first operation, I shaved 0 hairs in the area and this situation is not good at all, the growing hairs touch the sensitive areas like thorns and it hurts, when you remove the tapes on it, it hurts more because they are close to the root.
In this 2nd operation, instead of cutting the hairs in the operation area completely, I left it short (I cut it 2 days ago, it will be the number 3), this both reduced the stinging like thorns in the operated area, and you can easily remove the bandage by cutting the hair from the loosened places with the help of scissors when removing the bandage.
I took the bandage off when I got off the plane in the evening of the 3rd day. There is no problem, there is a very slight pinkness/bruise due to the cocktail beer lying around. Thin seams are better and less noticeable than thick ones. All seams are closed and traces of blood have dried. I did not knit anything over the seams.
If the first opening shaft was seen too thick, do your object, then the shaft relaxes and stretches slightly and reaches its main image. Wiping with a wet but alcohol-free cloth can temporarily replace the dream. It's normal to have an odor. Don't stick to the leg, just wipe it off and use shabby boxers.

Day 4: I went while. I still can't wear pants, tight shorts are not possible either. I wore the black synthetic tracksuit that I went to the wedding the other day. Everything looks alright. At this point, you have to decide whether the shaft will hang towards the right leg or the left leg while wearing the tracksuit. I chose the right leg, a slight bruise started to form on the right side of the shaft (all over). It happened to me in this first operation as well, there is nothing to panic about. After 4-5 hours, I took the shaft to the left leg to balance the situation.
I took a shower at night and there was no problem or burning. At night after the shower, the shaft was yellow and livid in places, but the pain did not bother you. I lay on my back with the air conditioner on for 14 hours.

Day 5: I feel flat in the morning, I tried a tight fit, but it seems like it gets tired during the day so I didn't risk it. Continue with the basketball sort. It looks like the fog is starting to come down a little.