At the Center for Reconstructive Urology, we do not perform penile enlargement surgery, also called phalloplasty. However, Dr. Gelman specializes in the treatment of complications including massive penile swelling and a damaged urethra as a result of surgery.
Penile enlargement surgery uses procedures to increase the length and girth. The techniques to increase length include the cutting of a structure called the suspensory ligament of the penis, often followed by the use of penile weights and other stretching devices. The cutting of the suspensory ligament does not change the length of the penis, but rather releases an attachment of the penis that provides support at the base. A portion of the penis extends into the body and the objective is to “bring out” that portion. Unfortunately, this can change the position of the penis so that it exits a bit lower than the normal anatomical position. When the ligament is cut in, this alters penile support and causes a low hanging penis, and scarring forms. When phalloplasty complications occur, scarring tends to be dense and tether. This often leads to dissatisfaction with penile enlargement surgery.
Penile Girth enhancement procedures involve the placement of a bulking substance under the skin of the shaft of the penis. This can include commercially available tissues such as Allograft Dermal Matrix Grafts, silicone implants, fat, and dermis (tissue between skin and fat) harvested from another part of the body. Unfortunately, the placement of these substances in the penis can lead to an abnormal reaction leading to dense scarring, nodularity, and massive disabling lumps.
We perform surgery to remove these masses and to revise scars. However, there are certain risks to this surgery, and patients are very thoroughly counseled prior to surgery so their expectations will be realistic. When the mass of abnormal tissue is removed, this can cause a damaged urethra and other deep penile issues. We have never had the complication of urethral or penile injury.
Dr. Gelman’s major concern is the skin. The penile surgery is performed with great care under optical magnification. The objective is to remove the abnormal tissue while preserving the blood supply to the skin. The problem is that if you are too close to the skin, there can be ischemic damage to the skin with subsequent skin loss, and if the dissection is far away from the skin, a significant amount of abnormal tissue remains. In addition to blood supply issues, the surgery can be associated with swelling of the skin after surgery due to a compromise of lymphatic drainage. The Center for Reconstructive Urology employs excellent surgical techniques to decrease the chance of complications during and after penile surgery.
Men who undergo penile enlargement surgery often pay thousands of dollars cash for the procedure as this is a cosmetic surgery generally not covered by insurance. However, the treatment of penile enlargement complications is often covered by insurance. Patient cost is based on benefits, but coverage can be up to 100% of the charges, depending on benefits. At the Center for Reconstructive Urology, we bill all insurance carriers on behalf of our patients. In addition, all surgeries are performed at the University of California, Irvine Medical Center, located in Orange County, and UC, Irvine is contracted with most major carriers for the facility and anesthesia fees.