Phalloplasty FAQ

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. Meanwhile, research and new material development have made breast implants consisting of a silicone pocket and soft silicone gel filling relatively safe. Nevertheless, the chance of rupture and material leakage is always possible when the implants are exposed to large amount of forces. However, 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. If you would like, you can compare the material or the implant consistency to that of a gummy bear. 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 teach our patients how and where to inject in order to avoid puncturing the implant.

In recent years the expression “average” has gained more popularity than 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 below than before.

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.

Given the location of the placement of the subcutaneous soft silicone implant under the penile shaft skin, sensation is typically 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 “bigger” 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.

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 a 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 with prior penile procedures (except for circumcision). In particular, dermal grafts and fat injections cause tremendous internal damage to the skin in-so-far as the skin is not suitable for the implant surgery. Simply said, those procedures damage the skin from inside, and 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 cannot 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.

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, including an IRB-approved, 400 patient, 5 year retrospective review that was published in the peer-reviewed Journal of Sexual Medicine.

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.