Autologous fat injection is a simple and time honored tool in increment of penile girth……Male genital surgery includes penile lengthening and increment of penile girth. Diameter of penis may be increased by fat injection or placement of dermis. Fat infiltration to increase the girth of penis is a common and time tested technique with almost nil side effect. Fat is usually harvested from non-fibrous areas like pubic region , trochanteric area or inner aspect of thigh. Best donor site is trochanteric region due to pure fat but pubic area liposuction has got two folds advantage. It not only increases length of penis but also reduces abdominal obesity. Collected fat is sedimented for one hour or centrifuged and middle portion of fat is collected for injection purpose. Upper portion contains mostly triglyceride ,breakdown product from adipocyte and lower most portion contains blood ,tumescent fluid are discarded. Fat which is middle portion is injected into penis under skin in different planes with radial and retrograde fashion to avoid nodularity and cyst formation.
Complications are infection, absorption, fat embolism, cyst formation and nodularity. Small incisions are made at 6 and 12 o’clock position with the help of no.11 scalpel and pure fat is injected slowly by 2ml syringe with 14 gauge needle. Small incision is repaired by 6-0 atraumatic catgut. Penis is covered with fluffy dressing and ice pack is applied for initial two days.Penis is kept in upright position to prevent congestion. Small dose steroid may be used to reduce inflammation. Reabsorption of fat in penis is rare unlike other parts of body. Maximum quantity of fat infiltration is 60 ml but it is always safer to be on lower side to avoid penile distortion and cyst formation.
Sometimes length and girth increment of penis are performed in one sitting . Fat is injected into penis and supensory & fundiform ligaments are divided. Penoscrotal webbing is corrected by single or multiple z-plasty. All these three operations can be done together or any two operations simultaneously. Overall it is seen that all combined operations has got much complications and failure rates than simple fat injection or penile length increment operation.
So I prefer to perform two Penile Enhancement Surgeries separately in my Cosmetic therapy clinic after an interval of 3 months with least complication and nil fat absorption.