Phalloplasty FAQ

Dr Elist » Phalloplasty FAQ

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Phalloplasty FAQ

With various penile enhancement procedures performed worldwide, researching the right procedure for you can be challenging for men who seek penile enhancement with safe and permanent results. The Phalloplasty FAQs section of our website provides an extensive collection of questions we receive and which are answered by Dr. Elist based on his vast experience with penile enhancement procedures. We receive numerous calls and e-mails on a daily basis from men who are looking to find answers to their questions about penile enhancement procedures.

NOTES:

  • ALL provided information is solely based on Dr. Elist’s thirty years plus experience in urology, urological surgery, and male enhancement surgery. The information here is not intended to promote Dr. Elist’s procedures or to criticize other procedures that Dr. Elist does not perform. 
  • All questions on Phalloplasty FAQs are posted exactly as received. Any spelling or grammatical errors are based on patients’ wording. In order to maintain authenticity, no correction attempt have been made to the questions’ content.
    

Phalloplasty FAQ Archive:

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R. asked:

Q: “ Dr. Elist—-Are silicone implants safe? Years ago, there was controversy over breast silicone implants; regarding silicone material leaching into the body? Additionally, I use Alprostadil for “ED”. Are Alprostadil injections effective after a Soft Silicone Implant; or will the spongy material of the penis be hidden with the Silicone implant?

Thanks

R.

 

Dr. Elist:

Dear R.,

Thank you very much for submitting these interesting questions.
Silicone leakage from breast implants has been a big controversy since the first silicone implants for breast enlargement were introduced to the world of plastic surgery. In the meanwhile, research and new material development have made breast implants consisting of a silicone pocket and soft silicone gel filling pretty save. Nevertheless, the chance of rupture and material leakage is always given when the implants are exposed to large amount of forces. BUT, while this might be true for breast implants, it is not for our implant!
Our soft silicone penis enlargement implant consists of a soft BUT solid silicone material which when even cut in half does not leak, move, or go anywhere. If would like, you can compare the material or the implant consistency to that of a gummy bear; not as soft or unstable though. Simply said, our silicone implant is a soft but solid structure without any fluid or gel component and without the risk of leakage.
Regarding your second question, the implant covers about 2/3 of the penis surface, which is about 270 degrees. By doing so, the lower part of the penis carrying the urethra is not being covered. We do indeed have some patients who are using injections for erectile issues and have the implant insert. After implant insertion we do teach our patients how and where to inject in order to avoid puncturing the implant.

I hope the above helps to answer your questions. If you should have any additional questions, please feel free to call us at +1-310-652-2600 or e-mail to info@drelist.com.

Best regards,
James Elist, MD

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Kh. asked:

Q: “ Dr. Elist,

If an individual’s penis is 2 inches while flaccid, how much of it do you estimate is hidden within his body. Is over 3 inches of it hidden?  Also, is 2 flaccid inches small enough to be considered abnormal?
Thanks
Kh.”

 

Dr. Elist:

Dear Kh.,

 

In the recent years the expression “average” has gained more popularity then ever. A study published in the September 1996 Journal of Urology concluded that average flaccid penile length was 8.8 cm (3 1/2 inches), and average erect length was 12.8 cm (5 inches); more men are now concerned about their penis size to be “average” or above then before (Read more about average penis size in this post).

Patients seeking solutions for a small penis size frequently have a distorted view of what they actually have.  In these instances, psychological counseling may prove helpful.

I hope the above helps to address your question. If you should have any further questions, please free to email or call us at 310-652- 2600.

 

Regards,

James Elist, MD

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A. asked:

Q: hello Dr Elist ,  
I am interested in doing one of the penile enlargement surgeries , i could see the methods of the ligamentolysis and the one with the implant , and my question is about the silicon implant , doesn’t it change the sensation of the penis ? and the 2nd question  ,  can somebody feel that there is an implant in there for example during sexual intercourse or oral sex ?

best regards

A.

 

Dr. Elist:

Dear A,

Thank you very much for visiting our website and inquiring about our procedures.

Given the location of the placement of the subcutaneous soft silicone implant under the penile shaft skin, sensation is not affected, and nerves are not damaged.

To your 2nd question, our patients generally describe the feel and looks of the penis after surgery as “natural” or “normal”, but “big”or “huge”, etc. If asked, the majority of patients refer to their penis after surgery as being big and naturally looking and report never being addressed about having had any procedure done to the penis. This is especially the case with men who attend gyms or public showers.

I hope the above helps to address your questions. If there should be any further questions, please do not hesitate to e-mail or call us at 310-652-2600 in order to schedule for a personal consultation.

 

Regards,

James Elist, MD

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H. asked:

Q: “I had two prior surgeries, dermal graft and fat injection. The dermal graft became bunched and twisted which ended up shortening my penis. I had the dermal graft removed. The fat injections worked for about 1 year; the majority of the fat dissolved. Since, I have tried the other two methods with poor results, I am thinking about trying your implant. My question is would I be a good candidate since I had prior surgeries?”

 

Dr. Elist:

Dear H.,

Thank you very much for contacting us with your question.

I wish you had contacted me before all the prior procedures to avoid all the disappointment that comes with fat and dermal graft penis enlargement surgeries.

Dermal graft and fat injection procedures are non-permanent and give unreliable results. Dermal grafts and fat injections do disappear or become dislocated after a certain amount of time, disfiguring the whole penile appearance. In some cases we even observe severe calcification of the injected fat which our patients describe as “having a piece of rock/bone under the penile skin”. These procedures are also associated with a high risk of infection, necrosis, scarring, and skin damage. Almost on regular basis, we see patients with the aforementioned complications which require immediate removal of the dermal grafts/fat and skin grafting to salvage the remaining penile skin.

In general, we do not accept patients for our implant surgery if prior procedures (except for circumcision) have been done to the penis. In particular, dermal grafts and fat injections do cause tremendous amount of internal damage to the skin in so far that the skin is not suitable for the implant surgery. Simply said, those procedures damage the skin from inside in so far that the skin is not able to accommodate and hold on to the implant.

While we can perform a removal of dermal grafts or fat, subsequent implant surgery can not be guaranteed at this time. The internal skin condition must be assessed during removal surgery and IF shown to be healthy enough, implant surgery MAY BE considered after several months of skin recovery. If the skin condition is determined to be not suitable for implant surgery, the implant surgery will not be scheduled.

If there should be any further questions, please do not hesitate to e-mail or call us at 310-652-2600.

Best regards,

James Elist, MD

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D. asked:

Q: “Can you point me to studies conducted by dispassionate third parties – preferably a research institution – on the efficacy value of your unique elist implant procedure?

 

Dr. Elist:

Dear D.,

Thanks for all your question.

As noted on our websites, the ELIST implant penile enhancement surgery is a patented procedure currently performed at our facility only. If you visit our research section you will find the announcement of our most recently prepared paper about the use of the ELIST implant, submitted for publication.

I hope the above information sufficiently answers all your questions. Should you have any further questions, please do not hesitate to submit and e-mail your questions, or give us a call at 310-652-2600 for a complimentary consultation appointment.

Best regards,

JAMES J ELIST. ,M.D., F.A.C.S

Diplomate of Urology, National Board of Physicians and Surgeons

Dr. Elist Health Portal: www.drelist.com

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D. asked:

Q: “You advertise the implant can lengthen the penis in addition to adding immediate girth. Do you cut the suspension ligament when you do the implant? If not, and biologically speaking, how exactly are length gains achieved? Is it a sort of traction device? 

 

Dr. Elist:

Dear D.,

The suspensory ligament is not cut during the ELIST implant surgery.

Cutting the suspensory ligament will leave it with two severed ends which will have the tendency to build scar tissue and possibly be a cause of retraction. Also, cutting the suspensory ligament is likely to change the angle of the erection (as it will detach the penis from the pubic bone) and the additional weight of the implant will further drop the penis towards the bottom.

During the ELIST implant surgery, the suspensory ligament is not cut, but it is rather stretched while putting in the implant using the suspensory ligament as a proximal resistor. While immediately extending the flaccid penis length, the implant continues to stretch the suspensory ligament and the penile skin with its length (ca. 2 inches of additional implant length remains inside the pubic area for later gains), as well as its weight, and allows for further extension of the penis for additional and progressive length gain.

Best,

James Elist, MD

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D. asked:

Q: “When Alloderm is used for widening the patient must stay off his feet for about 2-3 weeks. This makes it difficult for people who have the funds to pay for the procedure but are unable to take that much vacation time at once. What is the typical recovery time for your procedure? 

 

Dr. Elist:

Dear D.,

The ELIST implant surgery is performed on an outpatient basis, takes about 45 to 60 minutes, and patients are then picked up and brought back to their accommodation of stay. The subsequent 3 (three) days, you will be coming to the office for your usual follow-up visits, and you will be able to go back home in the afternoon of the third day after surgery (that is, if you are not local).

If your job does not require any excessive amount of heavy lifting or strenuous physical activities, you can go back to work the next day when at home; many patients choose to take of a whole week just for themselves to recover better from the surgery. The recovery period is usually 4-6 weeks; light upper body exercises are allowed 2 weeks after surgery, light lower body exercises after 4 weeks, and sexual activity can be resumed 4-6 weeks after surgery and upon our approval.

Best,

James Elist, MD

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D. asked:

Q: “You advertise the implant as a “soft silicone.” When I think of silicone I think of a women’s breast implant – pleasantly soft and pliable. How does the implant feel when the penis is erect and supposed to be hard? 

 

Dr. Elist:

Dear D.,

The ELIST implant consists of medical grade soft silicone; it is a solid structure (as you can see here) which is soft to the touch (comparable to a gummy-bear; though not as soft). However, it does not have the same consistency as a women’s breast implant, which consists of a shell and a saline / silicone GEL filling. When the penis is erect, the strength and stiffness of the erection will be bigger in dimension, and the erection feels natural.

Best,

James Elist, MD

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C. asked:

Q: “I’m interested in increasing the length and girth of my penis by 3 inches. In October 2012, I had surgery to release of the suspensory ligament along with the ventral phalloplasty procedure. Also, I used the pro Extender System for 4 months. The results were unsatisfactory to me. After reviewing your video, I’m convinced that the procedure will give me the results that I desire. The best way to reach me is via email. Please advise further details. Thanks, C.”

 

Dr. Elist:

Dear C.,

Thank you very much for contacting us regarding the desired penile enhancement procedure.

As you have noted and personally have experienced, the suspensory ligament release procedure has some limitations to it. As you have experienced, and despite the use of the extender, the gains are not always present, and some patients may even experience some retraction and penile shortening due to suspensory ligament healing and scar tissue formation.

The penile enhancement procedure using the patented subcutaneous soft silicone implant (ELIST implant) on the other hand provides increases in penis length AND width at the same time (an average of 2 inches). The results of the procedure are permanent.

 

I hope the above is sufficient to answer your question. I know that there might be many further questions, and you are more than welcome to submit them via e-mail or call us at 310-652-2600 for a personal phone consultation to discuss further details in person.

Best,

James Elist, MD

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M. from Canada asked:

Q: “Dear Dr. Elist,

I had PMMA injected and now have open wounds on my penis. The largest is 1×2 inches. I am keeping them clean, and have been using hydrocolloid dressings, but they seem to be slowly getting worse rather than better. I know this is not your problem or procedure, but I’d greatly appreciate any advice you can give me on how to take care of this complication? Is there any chance my skin will heal over these wounds?

Your expertise is greatly appreciated.

Regards,

M.”

 

Dr. Elist: 

Dear M,

Thank you very much for contacting us with this rather serious problem.

Unfortunately, most men are not aware in how far a wrong decision regarding the choice of procedure might affect the outcome and severely damage the penis.

One of the reasons why we do not perform PMMA, besides not being approved and thus only available across the borders, is the severe internal and skin damages PMMA does to the penile skin.

We have had many patients who were treated for fat removal, AlloDerm removal, and PMMA removal, which had left them with more or less severe conditions.

Usually, and based on our experience, the only way to close the skin wounds is a complete removal of any remaining PMMA, and trial of primary closure IF sufficient skin remains available. Sine a partial removal of the necrotic edges of damaged skin is needed for wound closure, the remaining skin might not be sufficient for a primary wound closure and require skin graft transplantation.

If you would like to receive a more thorough consultation, please answer to the above questions and submit your pictures. We can continue our e-mail correspondence, or you are more than welcome to contact us at the office number: 310-652-2600. Furthermore, you are also more than welcome to come and see us in Beverly Hills / Los Angeles for a complimentary and free of charge personal consultation which would make a definite assessment possible.

Regardless of your decision, it is highly recommended that you proceed with appropriate medical and surgical care in order to prevent further damages to the penis.

Best,

James Elist, MD

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MM asked:

Q: “Just a Question, to have enlargement done do I have to be circumcised?”

 

Dr. Elist: 

Dear MM,

Circumcision is a must if you are considering the penile enhancement surgery with the subcutaneous soft silicone implant.

If you are considering the penile enhancement surgery, we can perform the circumcision. The implant surgery can then be performed after 6 weeks of recovery when the skin has healed properly.

 

Best,

James Elist, MD

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Javier Asked:

Q: “hello, and thank you for your response i had a 3 pcs penile implant done by dr Elist back in 2008 and i’m pleased with the results but i want to know can i have the length and girth procedure done ?? and finally why it was not done when the implant was done? do you now offer the 3 in 1 procedure??”

 

Dr. Elist:

Dear Javier,

It is always a pleasure to hear back from our patients. And it is wonderful to hear that you are pleased with the results, as expected.

Furthermore, yes, you can come to us for the penis lengthening and widening procedure using the patented subcutaneous soft silicone implant. Our patients have not only regained any lost size as a result of the prosthesis, but were able to achieve additional length and girth after the implantation of the ELIST implant. Please note that these two procedures (penile prosthesis for erectile dysfunction and ELIST implant for penile enhancement) cannot be performed during the same setting. The penile prosthesis for erectile dysfunction need to be placed in first, and after a recovery period of 6 (six) weeks, the ELIST implant can be placed in for increased length and girth.

If you should be interested in undergoing the ELIST implant procedure, please do not hesitate to e-mail me back, or call us at 310-652- 2600 to discuss further.

Thank you,

Best,

James Elist, MD

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S. O. from UK asked:

Q: “The second complaint and main reason for removal was the feel and appearance. I would like to see the implant in an erect penis so that I can see how it looks. I’m also interested in what gains I can get, I would ideally like 2 inches in length and 1 inch in girth when erect.”

 

Dr. Elist:

On average, based on our past experience, our patients have seen an increase of 1.5 to 2.5 inches in length and girth. Nevertheless, as with all available options for penis enlargement, we cannot guarantee end results. With the ELIST implant it is possible to achieve two types of gains:

  1. Immediate gain in flaccid length and girth, as well as erect girth, and
  2. Progressive gains in erect length over the next 6-12 months.

While the implant adds instant thickness and length to the flaccid penis, the increased length of the erection likely occurs over time when the skin stretches, allowing the penis to move further out of the body.

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S. O. from UK asked:

“I have deliberated over this procedure for some time now and feel that it is the option that is right for me. I have done some research on various forums and have seen mixed feedback, I appreciate that this should be expected with regards to anything, some people will be happy and some will not.” 

 

Dr Elist: (Mixed Comments)

We are proud that the vast majority of our patients are highly satisfied with the outcomes of their procedure. Unfortunately, there can sometimes be a very small, but vocal, minority online often propagated by other practices who offer other enhancement procedures. It is important that all patients follow all post-operative instructions closely. Our office is always here to help answer questions and for any follow-up visits.

Best Regards,

James J. Elist, MD.