Why can’t I smoke cigarettes and get a fat tissue transplant?

To stay viable, transplanted fat tissue needs lots of blood flow. For 72 hours after surgery, the body doesn’t even recognize the transplant and thus it gets zero blood flow (which is why we employ our Affirmall technology before your procedure).

The fat tissue is transplanted to the subcutaneous tissue layers that surround the penis organ. The subcutaneous tissue area has almost no veins or arteries – only tiny capillaries to supply blood. Thus, the success window regarding blood flow is especially narrow.

Smoking cigarettes inhibits blood flow. It will cause a fat tissue transplant to fail. We don’t perform any procedure we think might fail. You cannot “cut down” to smoking one or two cigarettes per day and achieve a successful fat tissue transplant. It will fail. If you can’t completely quit smoking cigarettes for a minimum of six months (three months before your procedure and three months after), you don’t want to waste any money on this pathway to a thicker penis. It will all be gone within six months after the procedure making a SemiPerm hyaluronic acid or Bellafill non-surgical girth enhancement a much better value.

How Much Thickness Can Be Added to Your Penis?

When most patients decide to finally pull the trigger on an enhancement, they often feel compelled to become as big as possible as fast as possible.

That’s a nightmare begging to become reality. Some men don’t like the change in outer penile texture with select girth bulking agents. If you start more slowly you can easily adjust your best pathway.

Penile thickness is increased by adding a bulking agent to the subcutaneous tissue layers that surround the penile organ. Note the small size of the subcutaneous layers in the illustration. You can only add but so much at the start to ensure a good outcome.

The good news is that human skin and tissue are very stretchable. Variations in the size of women’s buttocks over time is a classic example of the pliability of fat tissue and skin. Alas, it requires adequate time to safely expand.

You can eventually add nearly unlimited amounts of penile thickness given adequate time for the skin to stretch between procedures. The limitation with penile width is in how much you can add at one time. You can safely add about one inch of girth at a time. Alas, we usually don’t recommend that you keep adding width beyond a certain point since it can make the penis appear distinctive as the width proportion in comparison to the glans (head of the penis) get out of alignment. In extreme cases, it transforms the appearance of a circumcised penis to that of an uncircumcised manifestation. Some men are fine with this change because of the heightening response from intimate partners. Others don’t feel it looks appealing.

You can get a glans enlargement to offset the changes in proportion, but they don’t last long. The glans is home to your “orgasmic” nerve endings, and thus you must be very careful what goes in that space. Enhancing a penis that can no longer achieve orgasm kind of defeats the purpose for the whole project, no? At present, there are no permanent bulking agents considered safe for the glans.

I didn’t find options using dermal grafts for increased thickness. Is there a reason you don’t offer that pathway?

Dermal grafts are a form of surgical penile thickness enhancement where girth is increased by adding a new additional layer of outer dermal tissue. We presently don’t offer dermal grafts for penile enlargement. We don’t believe the outcomes, cost and long-term results make for an appealing combination.

We’ve performed dermal grafts in the past. There are aspects about dermal grafts that are appealing like the more natural rigidity of the shaft skin when erect.

Why We Don’t Offer Dermal Grafts for Penile Augmentation

There are two primary reasons we don’t offer dermal grafts for penile augmentation currently.

1. The Value Proposition Isn’t Very Appealing: The most added thickness a patient can gain from such a dermal transplant is about a half an inch. You can’t add more later if you want an even thicker penis. You can’t add a fat tissue transplant on top of it. We found most men prefer adding more than a half inch in penile thickness. Likewise, we find some patients aren’t sure what thickness will be best for them, early on. Do you recall our #1 insight under “Keys to a Successful Penile Girth Enlargement” list? Keep your options option.

We believe these procedures don’t give a notable girth increase and limit future options.

2. Long Term Sustainability Issues with Biologic and Synthetic Dermal Tissue: Over time, transplanted dermal tissue tends to age and contract at a different rate than our own tissue. It makes sense when you consider it. When you look in a mirror: does your facial skin look the same way it did seven years ago? Did your best friends facial skin change exactly as your own? We’ve even had a number of patients who received cadaver skin transplants arrive at our clinic for repair of shaft unevenness. Based upon clinical studies for burn victims, even the highest quality synthetic dermal grafts will begin to show changes inside of a decade, some in as little as five years.

Surgery is required to repair morphed dermal grafts. We don’t feel that comprehensive combination of circumstances is appealing.

Do you offer silicone implants for enlargement?

No, we do not.

However, we are one of the leading clinics to repair men who incurred damage from a silicone penile implant for enlargement.

In our opinion, the absolute worst product in terms of anything regarding penile enhancement is silicone, whether through black market injections or the FDA-cleared versions. The injectable liquid versions tempt some because the low cost and longevity.

However, unlike injected PMMA, which can be chemically or surgically removed if you’re unhappy with the outcome, injected silicone stays inside you for the rest of your life. Likewise, you can’t change course toward another type of penile girth enhancement if you start with silicone – you’re stuck. Finally, a urologist will never be able to examine your inner penile health if that need arises as silicone blocks the view of ultrasonic sonography. Remember, life-lasting can also relate to your longevity of dealing with a lifetime of problems.

We believe a silicone implant to enlarge a penis is likewise a bad idea. The manufacturers of penile prosthetic implants for severe erectile dysfunction tried this decades ago to maintain all the original penile length like before the prosthetic was installed. They discovered that triggered an unacceptable number of cases with infection and many men who ended up with a fibrotic build up at the base of their organ (a byproduct of intensive sexual intimacy) and in some cases, severe Peyronie’s disease.

Female silicone implants for breast enlargement have a relaxed existence atop a rib cage. The journey of a penis is far more violent between intercourse and masturbation. The risks and complications far outweigh the rewards in our opinion.

We strongly advise all new patients to begin with procedures where you have the maximum number of future options if you change your mind about your direction later.

For this reason, we don’t recommend using the only FDA-approved PMMA product (Bellafill) to a beginner. Once PMMA is injected into the subcutaneous tissue surrounding the penis organ, several other potential future girth enhancing options like a Fat Tissue Transplant or Dermal Graft Transplant can no longer be employed since PMMA permanently restrict the necessary blood in the outer shaft tissue to support any form of transplant. Also, as mentioned earlier, it blocks the ability for a urologist to see inside your penis with duplex Doppler ultrasound technology in the event you face a penile health event in the future or have a need for PGE injections to enhance function as you age.

I’ve seen some of your before and after images where the penis shaft is noticeably larger than the head of the penis. Is that how your procedure works? I don’t like that look.

When a penis is thickened beyond its natural proportion, it appears a bit unnatural to first glance. 

Some of those pictures are just after a procedure, so there’s some swelling present that will go away after a few months.

What men are not a good candidate for a penile girth enlargement?

We provide girth procedures for men of every size, shape and health paradigms, including both surgical and non-surgical solutions.

However, there’s two types of men we found that won’t get a good outcome if that start with a penile thickening procedure.

A patient with an engorged suprapubic fat pad that’s covering a visible portion of the flaccid penis shaft is not a good candidate for a penile thickening as his first procedure. It will cause the wider penis to visually shorten, sometimes substantially. It’s simply a matter of displacement. In a finite amount of One of our LifeSize procedures is the best place to start with such cases.

A patient with a Micropenis diagnosis is likewise usually not well suited to start with a girth enlargement. While it doesn’t measurably shorten the penile like with overweight patients, it usually gives the appearance that its shorter.

We find a penile lengthening procedure to be best suited for such cases. A micro penis patient can add girth after first fully optimizing their length.

A couple of other doctors say that fat grafts fail, and I’ll lose all my increased girth if I do that. How can you ensure that won’t happen?

Our breakthrough Affirmall technology provides the most viable fat tissue transplant available anywhere. Additionally, there’s important pre- and post-surgery care required of patients. Those who fail to follow their care regimen don’t get as good of results as those who do.

Our average loss for transplanted fat is 37%. That’s why we harvest and implant 50% more than required to offset this loss.

Some patients feel they “lost it entirely” after the post-surgical swelling subsides, which can take up to four months after a surgical girth procedure. An examination usually reveals they still retained one inch of thickness; they just got used to seeing 1 ½ to 2 inches of added thickness and assumed that would be their outcome. We’ve learned if we attempted to transplant enough to cause a girth increase that large, it all fails. Additional thickness can be achieved through another procedure six months to one year after the first one.

We succeed with our fat tissue transplants. It’s all natural, lasting and allows you to change to any other procedure in the future.

Despite what you may have heard or read about Free Fat Transfer (FFT) or Fat Tissue Transplant (FTT) – that it doesn’t work, that it disappears, that it results in “lumpy-looking,” distorted penises – this is simply no longer true if FFT is performed correctly.

To understand what has led to this misinformation, we must look back at the beginning or early years of Penis Enlargement. Our experience with transferring or grafting free fat from liposuction to other areas of the body (such as the face) taught us that some of the fat graft would disappear for a variety of reasons. A little extra “over fill” was done to compensate for this loss. This worked well in areas with a small amount of fat, such as the cheek, lips, or deep facial wrinkles. We discovered that repeating this method every few months yielded the best results.

The issue arose when a few high-profile doctors used this “overfill” theory to place excessive fat in the penis, and the body was unable to develop a good blood supply to the grafted fat quickly enough. Some fat died and was absorbed by the body. Unfortunately, the fat was not absorbed evenly, resulting in lumpy, distorted penises.

These issues were caused by improperly performed procedures by doctors who were typically not well trained or experienced in Fat Tissue Transplant. Of course, they blamed the procedure rather than themselves. They abandoned FFG while disparaging it and promoting alternative methods. These have proven to be far more prone to failure and long-term complications. What they don’t tell you is that these FTT issues are uncommon and easily resolved.

We abandoned these early techniques years ago at Rejuvall and quickly discovered that the best results in FFT could no longer include the practice of overfilling the penis. We fabricated surgical instruments to take the appropriate size pieces of fat and developed techniques for properly placing them in the penis. This, along with a combination of special nutrients to prevent fat absorption and promote increased blood supply to the graft, we found to be the simplest and safest solution to the problem. We are pleased to report that results are excellent and improving. The occurrence of cysts, nodules, or other complications with this procedure is now extremely low and easily corrected.

You say I must first be circumcised before getting a girth enhancement, but I found other doctors who will enhancement my girth even though I’m circumcised. What gives?

Our surgeon is recognized as one of the leading penile reconstructive surgeons on the planet. According to him, there’s over 30 different results that can go very wrong with a girth enhanced uncircumcised penis. Several of those outcomes can cause devastating outcomes.

It’s not safe. We won’t do it. We strongly advise against patients following this path.

Potential healing delays from circumcisions performed just after birth

Most circumcisions are performed just after birth by the delivering physician. For the sake of speed, infancy circumcisions are performed by pulling the foreskin back away from the glans and cutting away the excess skin along the penile shaft.

Looking down at your penis when flaccid or erect you will notice a “lighter” toned skin coloring in the area closest to the glans (head) of your penis if your circ was performed just after birth. This is called the “inner prepuce”, it’s a less dense and less durable dermis than typical penile shaft skin since it was previously situated beneath the outer foreskin before that was trimmed away.

The Issue: A Hidden Scar Line

Anytime an incision is made into the epidermis, a scar forms during healing. With deep incisions, the scar often remains visible upon the outer skin. With minor incisions like those performed during an infant circumcision, the scar becomes invisible, but it remains beneath the skin.

None of this mattered until the advent of penile girth enlargements. The prepuce skin in the distal portion of the penile shaft has no impact on sexual performance or sensitivity.

We discovered that infancy circumcision scar lines slow the healing process in about 20% of patients getting a penile girth enhancement. The degree of recovery delay is based upon how deeply the delivering physician cut into the tissue surrounding the penis organ when performing the circumcision.

Unfortunately, an infant circumcision cannot be reversed and there’s no way for us to appraise the depth of the original incision prior to an enlargement.

Thus, it’s something we’ve learned to navigate during girth enhancement procedures, but it sometimes requires patience and dedication on the part of the patient with following prescribed aftercare techniques or follow up visits at our clinic.

Circumcision Scar Line: Three potential sources for delayed healing

1.  Blocked lymphatic drainage

The most common impediment to healing from an infancy circumcision is when the residual circumcision scar line is substantial enough to create a barrier that inhibits post-surgical swelling fluids from readily exiting the area behind the circ scar line. Basically, the scar line blocks the lymphatic drainage necessary for healthy healing.

This condition will usually manifest with what looks like a “pinched” narrow line around the penile shaft between the circumcision line and the glans. Residual trapped fluid from swelling that can’t effectively get reabsorbed into the body, will often resemble a thick neck area around the glans.

Complications with non-surgical enhancements from a heavier circ scar line are usually easier to resolve than surgical thickening procedures due to the simple fact there’s less swelling involved in non-surgical procedures. It’s also why we remain emphatic about starting with 10ML of the chosen dermal filler, so we can first condition the inner prepuce during the first treatment. This is particularly true with Ellansé since the polycaprolactone (which triggers an inflammatory response that creates long lasting level III collagen) can trigger significant swelling when used in larger amounts.

2.  Circumcision Scar Line: Fat necrosis trapped behind scar line

A Fat Tissue Transplant is performed exactly as it sounds.  Healthy, living adipose fat cells are harvested from a select location and transplanted to the outer layers of the penis to make it naturally thicker.

We harvest “extra” fat cells in anticipation of the fact some of the transplanted fat cells won’t survive the relocation process (We typically lose between 30%-35%).

Dead fat cells located beneath the circ scar line are usually easily reabsorbed into the body. However, fat cells that expire in the area above the circ scar line sometimes get trapped and can’t easily reabsorb and turn into palpable nodules known as fat necrosis (dead fat cells).