For Patients / Girth Enhancement




Penoplasty: Girth Enhancement (Enlargement of the Penis).

Type

Day Hospital

Procedure

45 Minutes

Anesthesia

Local with Sedation

Discharge

After 3 Hours

1st Follow-up

After 1 Week

Work

After 1 Day

Sexual Activity

After 30 Days
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Premise (due)

(The considerations shown hereunder derive from almost 20 years of activity in the field of dimension modification surgery of the penis, by a specialist surgeon who has over time utilized most of the techniques listed below).

In past years, the necessity to perform less invasive and especially less risky methods to obtain an enlargement of the penis has stimulated research in materials which can be implanted below the skin with the purpose of obtaining an aesthetic result that does not influence the functionality of the organ. As a result various solutions, all coarsely translating to the use of synthetic materials or heterologous (taken from another organism, human or animal) or autologous (taken from the same organism), have been used.

Synthetic materials are made up of fillers, resorbable and not. The use of non-resorbable fillers (polyacrylamide - Formacryl - Bioalcamide) has since been abandoned because of various problems regarding rejection-engraftment-aesthetic results. Among resorbable materials, hyaluronic acid (macrolane) is used, which however being unable to engraft, tends to form unavoidable and unaesthetic accumulations and for this reason was quickly abandoned by us.

In the field of heterologous materials (foreign to the body), for a certain period porcine dermis (Intexen LP), a layer of material taken from pigs, was used in our country. After a brief period of initial enthusiasm, problems of compatibility of the material and aesthetic results (among which shortening of the penis during erection), were soon identified which drastically reduced its use. In confirmation of this, the US manufacturer of Intexen LP announced that as from April 2011 the product would be removed from the market. Other materials of a prosthetic nature are in our opinion absolutely not recommendable, both because of possible complications and the unnaturalness of the result.

Autologous materials, made up in most part of adipose tissue, have the advantage of not causing allergic reactions or rejection (fat is harvested from different areas of the same body), and developing a more natural visual and tactile effect. The transplant of autologous fat, harvested from the patient himself, is a widely consolidated and widespread surgical procedure both in aesthetic medicine and in the volumetric application to various regions of the body which goes from the face to the buttocks and in andrological surgery for the volumetric enlargement of the penis (lipopenosculpture).

Compared to normal volume fillers of animal or synthetic origin, the use of autologous fat presents a series of advantages which range from the impossibility of rejection and incompatibility to the absence of the risk of transmitting infections and diseases and to the complete integration with the receiving anatomical area.

The disadvantages are made up of the possibility of asymmetry, nodularity and particularly the partial resorption of the fat itself. This occurs because adipose tissue requires a lot of nourishment (read blood) in order to survive and when it is harvested for transplant in other areas it loses it vascular connections and those formed anew can be insufficient for adequate nourishment. Moreover, the harvested adipose material contains, besides the pure fat cells, a high percentage of diverse materials (water, oil, degradation products, etc...) responsible for the alteration of form and consistency of the penis.

The result is that a part, which varies from person to person depending on the personal characteristics of each body, is reabsorbed, thereby losing a large part of the filler effect which had been achieved.

Parallel to the appearance of problems caused by synthetic materials (particularly those caused by the polyacrylamide gel) there was an increase in research to render the graft of autologous fat more durable and effective.

Puregraft has proved to be very useful in this sense and has marked great progress but till today it has not been possible to achieve a permanent stabilization of the fat transplanted, which to an extent varying from patient to patient tends to be partially reabsorbed in any case.

"Lipopenostructure"

For the enlargement of the penis "lipopenostructure" is a simple and quick (and decidedly the least invasive and the safest) surgical procedure. Let us see in detail what the method involves:

Lipopenosculpture with Puregraft Fat Purification

This procedure is performed in a sterile environment, and consists of two phases: first the harvest of adipose tissue using lipoaspiration, second the purification process of the fat through centrifugation.

Following local anesthetic using the tumescent technique (or other anesthetic depending on other procedures associated), a given quantity of fat (previously agreed upon by the surgeon and the patient) is taken from the sides or the abdominal region. The procedure is performed with the help of small cannulas which are introduced through minute incisions. The harvested fat then undergoes a washing and centrifugation process to separate the globules from the oily film and hematic and infiltration material therein contained (Puregraft). The whole procedure has duration of about 30-40 minutes and at the end there will be no visible scar. The above described procedure presently represents the best technique and is decidedly the most used worldwide because of its harmlessness, the aesthetic results and the durability of the results. A modicum quantity of the fat, variable from person to person (from 20 to 30%), could be reabsorbed in the following months. To annul such a possibility, we implant a slightly higher quantity of fat than is necessary. This method is to be considered permanent and without the need for future "touch ups"; nevertheless, given its simplicity and safety, it can be repeated using simple local anesthetic for as many times as deemed necessary. The results are very often highly satisfactory.

The "Lipopenostructure" procedure

The combined lipopenostructure operation (for penis enlargement) is a simple and quick (and decidedly less invasive) surgical method which is made up of 3 distinct phases:

  1. harvesting of adipose tissue from the supra-pubic region or alternatively from the abdomen and/or the sides using thin cannulas. This procedure, besides obtaining the necessary fat, enables the reduction of the supra-pubic adipose panniculus (frequent fat accumulation zone in men) rendering the insertion point of the penis deeper this way determining a lengthening of the visible part of the penis.
  2. purification of the fat using the Puregraft Technique: Click here to read more...
  3. uniform implantation of the fat obtained into the space between the skin and the corpus cavernosum penis through two minute incisions at the base of the penis.

The harvest and implantation of the fat are performed through two miniscule skin incisions (about 2 mm), and therefore without surgical wounds, all under local anesthetic. The quantity of fat to be implanted depends on the basic anatomical condition, the desire of the patient and in the final analysis on the quantity of fat available.

With this combined method the results are very often extremely satisfactory and in almost all cases, it will not be necessary to perform ulterior fat implantation in the future, even though it is technically possible and simple.

In most cases the increase in circumference obtained (measured in a flaccid state) is of about 30%.

This procedure can be performed under local anesthetic (with or without sedation), following the concept of "painless surgery"

Since there are no surgical incisions, discharge is done within a few hours after the operation and immediately from the day after all activities including sports can be resumed with the exception of sexual activity, which can be resumed no less than 30 days after the operation to avoid an uneven engraftment of the fat.



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Professor

Alessandro Littara


About

Prof. Alessandro Littara was born in Pisa on 15 April 1964. He is an authority in male genital aesthetic surgery thanks to his pioneering work in penoplasty, a technique he has performed since the 90’s and which he has continuously modified, improved and perfected during his personal experience with thousands of cases from all around the world.

Education

  • Degree in Medicine and Surgery with top marks from the University of Pisa
  • Specialization in "General Surgery" at the Università degli Studi di Pisa (Institute of general and experimental Surgery, Cisanello Hospital, Pisa), with a thesis entitled: "Surgical therapy of varicoceles: modern orientation".
  • Specialization in "Ultrasound diagnostics in Surgery" at the University of Pisa
  • Specialization in "Andrology module operator" at the University of Pisa
  • Specialization in "Sexology" at the University of Pisa
  • Winner of the concourse to attend the "European School of Andrology and Andrological Surgery" (organised in European centres of excellence by the Italian Andrological Society)
  • Certification for LVR (Laser Vaginal Rejuvenation) and DLV (Designer Laser Vaginoplasty) procedures, at the Laser Vaginal Rejuvenation Centre of Los Angeles, directed by Dr David Matlock.
  • Contract Professor of Reconstructive Uro-genital Surgery, University Of Pisa

Training

Training (1991) at the Centre for Andrology of the University of Pisa (directed by Professor G.F. Menchini Fabris), where he currently works as an external collaborator. He also specialized as an Andrology module operator and in Medical Sexology, at the same centre.

Long collaboration with the Istituto di Chirurgia Generale II - Unità Operativa di Endocrinochirurgia (directed by Prof. P. Miccoli), of the Università degli Studi di Pisa, with respect to surgical practice.

Student of Uro-andrological surgery as taught by Prof. E. Belgrano (director of the Urology clinic of the University of Trieste) and Prof. F. Carmignani (director of the Urology clinic of the University of Genoa) for more than five years, staying up-to-date with Avant-guard Uro-andrological and gynaecological urology surgical techniques.

Adjournment at the Istituto San Raffaele of Milan in the Urology department directed by Prof. Rigatti.

Head of the medical and surgical Andrology-sexology branch at the Casa di Cura "Mercurio-Quisisana" of Montecatini Terme (PT), where he participated in about 1000 andrological surgery, Uro-gyneacological and general surgery operations in the capacity of first operator and also as assistant.

Activity

Participation as a student at the "European School of Andrology and Andrological Surgery ", organised by the Italian Andrological Society in European centres of renowned excellence.

Practices as a freelance professional in the field inherent to the medical and surgical diagnosis and therapy of pathologies of Uro-andrological, uro-gyneacological and sexological nature.

Numerous appearances as a speaker at many congresses of Uro-andrological and plastic-cosmetic nature. Strong supporter of computerization, and author of the first Italian website dedicated to andrology (website of the Andrology Centre of Pisa) and since 1996 has been furnishing an information service for the public through his own website (www.androweb.it).

Radio 24 collaborator with regards to medical and surgical andrology and sexology. He collaborates with national newspapers, weeklys and monthlies with wide distribution and also with national and regional television programmes. He conceived and conducted a radio transmission dealing with sexology (SessoOS) at a local Tuscan radio station for two years. He participates as a subject matter expert in the transmission "Istruzioni per l'uso" presented by Emanuela Falcetti on Radio 1 and Radio 3.

Founder and head of the "Centro di Medicina Sessuale" of Milan, where all pathologies of the sexual and reproductive sphere for both males and females are treated. He manages a multi-disciplinary team made up of andrologists, gynaecologists, assisted reproduction specialists, psycho-sexologists, psychiatrists, plastic-cosmetic surgeons and lawyers.

Training and certification to perform procedures of female genital laser surgery at the Laser Vaginal Rejuvenation Centre of Beverly Hills, directed by Dr. David Matlock. Surgeon affiliated with and certified to perform DLV (Designer Laser Vaginoplasty), LVR (Laser Vaginal Rejuvenation) and G-Spot Amplification procedures, by the said centre.

He currently works as a freelance professional and consults in Milan, the main seat, and periodically in Rome. He collaborates with centres specialising in Infertility therapy for couples, and is a contract Professor of Uro-genital Reconstructive surgery at the University of Pisa.

Membership in Scientific Societies

  • Member of the Italian Society of Andrology (S.I.A.)
  • Member of the Italian Society of Andrology and Sexuality Medicine (S.I.A.M.S.)
  • Advisor of the Italian Society of Sexology and Sex Education (S.I.S.E.S)
  • Member of the Italian Society of Male Genital Surgery (S.I.C.G.E.M.)
  • Member of the European Society of Sexual Medicine (E.S.S.M.)
  • Member of the International Society for Sexual and Impotence Research (I.S.S.I.R.)
  • Member of the American Academy of Cosmetic Surgery (A.A.C.S.)
  • Member of the American Academy of Penoplasty Surgeons (A.A.P.S.)
  • Advisor of the European Association of Genital Plastic and Cosmetic Surgery and Rejuvenation (A.R.P.L.E.G.)

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