Penis enlargement and thickening surgeries are complementary surgeries since performing them together allows us to look for a penis with greater size and naturalness. The level of thickening that we perform depends on the length of the penis and its anatomy, so it depends on the level of length that we achieve.
In penile thickening we are looking for an increase in the circumference of the penis size. The application of this technique focuses on the shaft of the penis from the base to the glans.
Thus, there are four techniques for its increase, such as:
- Use of hyaluronic acid.
- Fat infiltration.
- Stem and adipose cell infiltration.
- Use of dermal matrices.
As for the use of stem and adipose cells, their high cost is the main limiting factor, although it is the technique of choice in most cases. Its extraction must be performed with a small diameter liposuction cannula through which we extract the cells from the abdomen, treat them and infiltrate them in very small deposits in the penis. This allows the cells to begin to live in new tissue and therefore behave as a graft. The plane of placement of the cells in the penis is of paramount importance. They should never infiltrate under the skin, instead, they should be placed between the deep layers of the penile shaft to prevent them from being palpable or producing nodules in the penis.
The increase in penile width will always be conditioned by the patient’s anatomy. This is mainly due to the fact that the infiltrated cells are required to survive in the penis. Therefore, if we apply a volume of ten cells their survival is assured, but, as the infiltrated volume increases, the surviving volume decreases exponentially. To maximize thickening, we look for the point of maximum cell survival that ensures maximum penile thickening.
The use of hyaluronic acid does not allow significant increases in volume given its high price and the fact that the volume created is conditioned by the projection of the same rather than by its own volume. Also, as the penis is a very vascularized area, its absorption can be erratic and variable. In general, the duration of the result hardly exceeds six to eight months, requiring a new treatment.
The main problem with fat infiltration is the high rate of resorption and the presence of nodules and cysts secondary to the fibrosis produced by the organism when resorbing the infiltrated tissue.
Acellular dermal matrices are thick layers of similar tissue that exist deep within the skin. These are located between the penile shaft and the skin. For this, it is necessary to perform a deglobing or separation of the penile skin. Subsequently, the matrix is placed around the penile shaft and finally the penile skin is replaced. The main disadvantage is that they cause a scar at the junction between the skin and the penile shaft, which can cause fibrous retractions. Also, since they are external structures, the risk of infection or rejection is much higher than the other options.
In short, the use of stem cell and adipose infiltration is presented as the current option of choice for penile thickening, without forgetting that this technique depends on the patient’s anatomy and should ideally be performed together with penile enlargement.