(P5) penile enlargement by Ligamentolysis and fat injection

Background Penile size dissatisfaction is a problem that is more prevalent than what is perceived; it is not taken seriously by healthcare professionals. It is reported that 45% of men are unhappy with their penile size. Most men are too ashamed to seek professional help, so they go to online sites that promote fake pills, creams, lotions, or try to solve the problem themselves (DIY Penile enlargement), which causes significant complications or undergo high-risk procedures without proper counselling. To evaluate the outcome of penile augmentation surgery by division of the suspensory ligament of the penis with insertion of silicon buffer for flaccid length enhancement, plus liposuction and autologous fat injection for penile girth enhancement. Methods A retrospective audit of patient outcomes after surgical Penile Augmentation (PA) at one centre, over a 6-year period. 584 patients had division of the suspensory ligament of the penis with insertion of silicon buffer with liposuction and autologous fat injection. The following data were collected: - Pre and post-operative flaccid penile length and girth. - Patient reported satisfaction rates. - Complications. Results 584 patients were included in this study; the mean patient age was 38 (22–72). The Mean follow-up duration was 6 (3-12) months. The mean increase in flaccid length was 3.8 (1.5-6) cm. The mean increase in girth was 4.2 (2.5-5.5) cm. The patient reported satisfaction rates were 85%. No serious adverse events were encountered; the following complications were recorded: partial fat absorption occurred in 125 patients (21.4%) and was managed by fat top-up. Phimosis occurred in 25 patients (4.2%) and was managed conservatively in all but 3 patients who required a circumcision. Hard fat lumps occurred 34 patients (5.8%) and were managed by in-office needling. Migration of fat in the scrotum occurred in 40 patients (6.8%) and was managed conservatively in all but 7 patients who required surgical removal of the fat lumps, infection of the silicon buffer occurred in 6 patients (1.02%) and was managed by removal of the silicon buffer, discomfort from the silicon buffer occurred in 5 patients (0.86%) and was managed by removal of the silicon buffer. Conclusion Penile enlargement by division of the penile suspensory ligament and injection of autologous fat is a safe and effective procedure that is associated with high patient-satisfaction rates.