Penile Dual Augmentation™ surgery consists of two surgical procedures performed during the same surgery: penile lengthening and penile girth enhancement. Penile Dual Augmentation surgery was developed in order to satisfy customers who want to save time and money when undergoing these two surgeries. Men usually like to have their penises enhanced in several ways, and Penile Dual Augmentation surgery is the most popular choice for making the penis both longer and thicker.

In Penile Dual Augmentation surgery, the patient gains length and girth at the same time. The average length that a patient gains from penile lengthening surgery varies from person to person, and may or may not fall into the normal range of one-half to one-and-one-half additional inches in the flaccid position. Girth enhancement surgery can increase the circumference of the shaft of the penis from a 10% increase to a 30% increase over the existing pre-operative circumference size, depending on the number and size of the grafts used during this surgery. The majority of the Penile Dual Augmentation patients involved in a recent study reported that they felt much sexier after the surgery than before it.

In Penile Dual Augmentation, lengthening surgery is performed first. Increasing penile length requires releasing the suspensory and fundiform ligaments. The surgery begins with a curvilinear incision in the infrapubic region at the base of the penis. Once the surgeon has excised the suspensory and fundiform ligaments that hold the penis, as well as a few collateral ligaments that also need to be disconnected, the internal part of the penis is released. Following lengthening surgery, a physiotherapy stretching technique that involves wearing weights must be used by the patient to ensure the long-term effectiveness of the surgery. The success of the lengthening procedure depends equally on ligament detachment (performed by the surgeon) and physiotherapy (performed by the patient).

Once lengthening surgery is complete, girth enhancement surgery begins with a second incision. This incision is on the neck of the penis, just below the corona, and is approximately one inch long. A graft is then placed in the appropriate area on the shaft of the penis. This area is usually the anterior three-fourths of the penile shaft.

Currently, there are two types of permanent graft available to increase the thickness (girth) of the penis. The first type of graft uses the patient’s own skin (dermal fat graft or DFG). Girth enhancement with dermal fat grafts (DFGs) requires peeling the epidermis from the harvested skin graft before placing it on the shaft of the penis. The second type of graft is AlloDerm (R). (For more information about AlloDerm, see the AlloDerm section on this website.)

Penile Dual Augmentation surgery is performed under general anesthesia. Pain resulting from this surgery is minimal. Most men require one week off work, although it is possible to return to work three to four days after surgery. This varies, depending on the individual and on the demands of the job. Sexual activity must be avoided for at least six weeks after surgery, and there should be no participation in sports for at least four weeks after surgery.

It is important to note that many patients have unrealistic expectations when undergoing this surgery. Despite what is written above, they think that after surgery their penis may increase two to three inches in length and two to three inches in circumference. These expectations are absolutely unrealistic and can create tremendous dissatisfaction for the patient. This dissatisfaction can, in turn, compromise the reputation of the surgeon and his techniques. The patient must have realistic expectations when undergoing this surgery.

Men have anatomical restrictions that prevent such large increases in penis length and girth. One of the anatomical restrictions to penis length is the length of that portion of the penis that exists inside the body and that can be freed up from its ligaments through surgical separation. This hidden portion of the penis varies in length from one-half inch to one inch. Another restriction is that the quantity of cells in every man’s cavernous body is fixed. These cells do not multiply as a result of lengthening surgery. Yet another restriction is the amount of patient compliance with the stretching exercise program following surgery.

The main anatomical restriction to penis girth is the amount of space between the skin and the tunica albuginea that covers the cavernous bodies of the penis. Some men have enough space for three millimeters of graft(s); others have space for ten millimeters of graft(s). The surgeon works with the patient to help him to select a type and size of graft appropriate to his anatomical characteristics.

Penile Dual Augmentation (lengthening and girth enhancement combined) is a safe surgical procedure that provides excellent results when performed by a qualified, trained surgeon. Dr. Alexander Krakovsky is Vice President of the American Academy of Phalloplasty Surgeons. In 2002, the American Academy of Phalloplasty Surgeons issued a position statement regarding phalloplasty surgeries. This statement outlined standards and guidelines for the safety of phalloplasty surgeries that use DFGs or AlloDerm. The statement specifies that phalloplasty surgeries are considered safe and effective under these standards and guidelines only if performed by a qualified surgeon who has completed special phalloplasty surgical training. Many plastic and cosmetic surgeons who have never undergone special phalloplasty training are performing penile enlargement surgeries. As a result, thousands of men are faced with injuries for which reconstruction is very difficult, or even impossible, to perform. Even when performed by a qualified surgeon, it is critically important that the patient learn about the possible complications of this type of surgery before making any decision regarding the surgery and, if the surgery is performed, the patient must precisely follow pre-operative and post-operative instructions.

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AlloDerm (R) is a registered trademark of LifeCell Corporation.
Penile Dual Augmentation^TM is a trademark of Alexander Krakovsky.
 

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