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Post by sheldon on Apr 26, 2011 17:52:13 GMT -5
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Post by smartman on Apr 28, 2011 16:48:12 GMT -5
There is a paper published in China ( they are well known of penile lengthening they have a famous doctor name Dr. Long Dachau he was the first to do penile lengthening in 1984)
Home » Publications Successive "Z" incision and skin flaps: a better procedure for penile lengthening Lian-Jun Pan, Li-Jie Zhu, Zhong Wang, Zhi-Kang Cai, Jun Da, Guo-Qin Dong, Yu-Feng Huang Department of Andrology, Nanjing University School of Clinical Medicine/Nanjing General Hospital of Nanjing Military Region, Nanjing, Jiangsu 210002, China. Zhonghua nan ke xue = National journal of andrology. 05/2008; 14(4):317-20. Abstract
OBJECTIVE: To recommend the successive "Z" incision and skin flaps as a method for repairing the wound in penile lengthening procedures. METHODS: We performed penile lengthening surgery by successive "Z" incision for 5 patients complaining of short penis, who ranged in age from 16 to 34 years (22.4 +/- 7.2), and 3 of whom had a history of urethroplasty, circumcision and penile reconstruction, respectively. The superficial suspensory ligament and part of the deep suspensory ligament of the penis were exposed and severed to release the penis, and the "Z" skin flaps sutured in a tensionless state. Drainage was necessitated by exudation and the catheter removed in 24-48 hours. The penis was wrapped up by an elastic bandage, and the stitches taken out 8-10 days after the operation. RESULTS: We achieved a mean erectile length of 8.4 cm (range 7.8-9.2 cm) after the operation, as compared with 4. 8 cm (range 4.0-5.8 cm) before the surgery. Two students of the patients obviously became active and confident. No penile contraction was noted during the 12-48 months follow-up, and both the patients and their family members were satisfied with the outcomes. CONCLUSION: Compared with the V-, M- and Z-incision, the successive "Z" incision and skin flaps can yield longer penile length, solve the problem of insufficient skin flap to cover the wound and reduce such complications as skin necrosis and infection. It is well worth recommending for patients complaining of short penis because of penile abnormity, post-operation scar on the penis or circumcision.
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Post by sheldon on Apr 28, 2011 17:42:42 GMT -5
There is a paper published in China ( they are well known of penile lengthening they have a famous doctor name Dr. Long Dachau he was the first to do penile lengthening in 1984) Home » Publications Successive "Z" incision and skin flaps: a better procedure for penile lengthening Lian-Jun Pan, Li-Jie Zhu, Zhong Wang, Zhi-Kang Cai, Jun Da, Guo-Qin Dong, Yu-Feng Huang Department of Andrology, Nanjing University School of Clinical Medicine/Nanjing General Hospital of Nanjing Military Region, Nanjing, Jiangsu 210002, China. Zhonghua nan ke xue = National journal of andrology. 05/2008; 14(4):317-20. Abstract OBJECTIVE: To recommend the successive "Z" incision and skin flaps as a method for repairing the wound in penile lengthening procedures. METHODS: We performed penile lengthening surgery by successive "Z" incision for 5 patients complaining of short penis, who ranged in age from 16 to 34 years (22.4 +/- 7.2), and 3 of whom had a history of urethroplasty, circumcision and penile reconstruction, respectively. The superficial suspensory ligament and part of the deep suspensory ligament of the penis were exposed and severed to release the penis, and the "Z" skin flaps sutured in a tensionless state. Drainage was necessitated by exudation and the catheter removed in 24-48 hours. The penis was wrapped up by an elastic bandage, and the stitches taken out 8-10 days after the operation. RESULTS: We achieved a mean erectile length of 8.4 cm (range 7.8-9.2 cm) after the operation, as compared with 4. 8 cm (range 4.0-5.8 cm) before the surgery. Two students of the patients obviously became active and confident. No penile contraction was noted during the 12-48 months follow-up, and both the patients and their family members were satisfied with the outcomes. CONCLUSION: Compared with the V-, M- and Z-incision, the successive "Z" incision and skin flaps can yield longer penile length, solve the problem of insufficient skin flap to cover the wound and reduce such complications as skin necrosis and infection. It is well worth recommending for patients complaining of short penis because of penile abnormity, post-operation scar on the penis or circumcision. Thanks Smartman for the summary of this article. As I understand it, most PE doctors in the US do a coronal incision. I believe the coronal incision has less complications than the inverted V, and the other types of incisions. I am not sure if any US doctor is doing M-, V-, or Z-incisions. I even think the late Dr. Perovic used the coronal incision for lengthening. Any thoughts on this from our medical members?...
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Post by smartman on Apr 28, 2011 18:11:50 GMT -5
Sheldon,
I think what you mean by coronal incision (is the incision near to the glans as you mentioned Dr.Perovic is using but he used it for degloving the penis ).
But these Chinese surgeons use SUCCESSIVE Z-PLAST incisions in the PUBIC area( ZZ ) to push the skin flap and the penis more forward .
They have excellent result in the erect length gain from 3.4-3.8 cm (so around 1.5 inches).
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Post by sheldon on Apr 28, 2011 21:24:47 GMT -5
Smartman, Perhaps it is not called a coronal incision, but perhaps just a 'linear incision' or 'straight incision' near the pubic base of the penis. Dr. Giunta calls it a curvilinear incision. I believe most US doctors use this type of incision for cutting the suspensory ligament now, such as Reed, Rosenthal, Giunta, and Krakovsky. I found this information from Dr. Giunta's site: drgiunta.com/phallo_lengthen.html"We have developed and pioneered the use of the LASER to detach the ligaments. The advantages are: a smaller 1" incision therefore less pain, swelling and bruising and also quicker healing. There is less scar tissue produced to possibly obstruct the lengthening and therefore a better overall result is more likely. The ligaments are then reconstructed to prevent any change in the angle of erection and prevent scar retraction compromising the results. The use of the operating microscope also makes this a more precise operation." "Improperly performed lengthening procedures which did not apply good Plastic Surgery principles (such as Z plasties, Y-V plasties, U plasties, etc.) left unsightly visible scars and created unacceptable results, thus causing Phalloplasty to be legitimately criticized by many unhappy patients. Unfortunately, this "bad press" has still persisted." "A simple 1" curvilinear incision in the pubic area is all that is required to gain access to the ligaments." drgiunta.com/phalloplasty_gallery.htmlFrom Dr. Giunta's gallery, it seems as though all photos have a small incision above the penis on the pubic area. It seems like Dr. Giunta is against z-plasties and other plasties. I am not sure if doctors such as Morganstern, Singh, and Barron, are using z-plasties. It seems like the Chinese surgeons are getting good results using z-plasties, while the American surgeons are using a curvilinear incision.
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Post by poiuytrewq24uk on Apr 29, 2011 11:17:27 GMT -5
Im intruiged, so does this lazer or z incision work?
1.5 inch gain on such a small penis? that sounds huge.
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Post by smartman on Apr 30, 2011 10:24:51 GMT -5
There is another plastic surgeon Dr.Panfilov (in Germany) who published a paper about phalloplasty and he could give you an increase in length about 1.5 to 4.8 cm, to get that increase in lengthening he does : A subtotal dissection of the ligament fundiforme penis below the symphysis could be done, pull the corpus cavernosus out, and fix the tunica albuginea at the periost. At the root of the phallus, the skin can be elongated by V-Y-plasty, and the scrotal skin can be released by 1 or 2 Z-plasties. This is his publication from Pub-Med : Aesthetic Plast Surg. 2006 Mar-Apr;30(2):183-97. Epub 2006 Mar 17. Augmentative phalloplasty. Panfilov DE. Source info@nofrete-privatklinik.de Abstract Until 20 years ago, penis size (either nonerected or erected) was not mentioned, discussed, or defined even in serious books of human anatomy. The need of some men to enlarge and elongate their penile size is equivalent to the need of some women to ask for breast augmentation. The same method of transferring autologous fat into other parts of the body can be used in male patients for augmentative phalloplasty. The circumference of the penis increases 2 to 3 cm, and before of a heavier penis, the length increases 1 to 2 cm. If more lengthening is desired, subtotal dissection of the ligament fundiforme penis below the symphysis could be done, pull the corpus cavernosus out, and fix the tunica albuginea at the periost. At the root of the phallus, the skin can be elongated by V-Y-plasty, and the scrotal skin can be released by 1 or 2 Z-plasties. Combining both autologous fat transfer and ligament release allows for penis elongation of 3 to 5 cm. The authors have performed augentative phalloplasty on 88 patients since 1996. They have transplanted 40 to 68 ml of pure fat. Of the 88 patients, 57 underwent autologous fat transfer only, and 31 received additional ligament release. Penis length increased 1.5 to 4.8 cm (average, 2.42 cm), and circumference increased 1.4 to 4.0 cm (average, 2.65 cm). The initial penis lengths were 6.5 to 10.0 cm (average, 8.72 cm), and the circumference were 8.0 to 10.1 cm (average, 9.18 cm) not erected. This article details a simple operative procedure to enlarge the penis and simple postoperative bandages. Patients are advised to obstain from sexual activity for 5 weeks after the surgery. Two patients who disregarded this advice had an unsatisfactory result. In one patient too, much of the grafted fat had to be removed from the preputium. No other serious complications were observed. PMID: 16547638 [PubMed - indexed for MEDLINE] Check his site : www.oxygenzone.co.uk/?q=content/penis-enlargement-and-penis-lengtheningN.B. the chinese doctor (the one I mention before) use the double Z-plasty (also Dr.Panfilov mentioned that technique ) SM
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Post by smartman on Apr 30, 2011 10:47:22 GMT -5
There is another technique for lengthening which is of-course from China they use scrotal flap to repair the penile skin defect in penile lengthening .
You can read these two paper about it :
(1)
Saudi Med J. 2009 Mar;30(3):418-21. Clinical application of scrotal flap on penis lengthening. Zhuo Q, Li S, Wu J, Wang Z, Yang D, Tao L. Source Department of Plastic and Aesthetic Surgery, Southwestern Hospital, Third Military Medical University, Chongqing, China. Abstract OBJECTIVE: To investigate the clinical application of the scrotal flap on penis lengthening.
METHODS: One hundred and fifty-two patients were operated using the scrotal flap from July 1998 to January 2008 at the Department of Plastic and Aesthetic, Surgery Southwest Hospital, Chongqing, China. The procedure consisted of designing a positive sign shaped incision 1.5cm above the root of the penis, dissect and release the superficial suspensory ligament and part of the deep suspensory ligament, then cover the elongated cavernosum with proper scrotal flap.
RESULTS: Six-month to 5-year follow-up showed that all patients were satisfied with the good contour and function of the penis. The operation was successful.
CONCLUSION: The method of using scrotal flap on penis lengthening has the following advantages: simple operation, reliable blood supply of the flap, one-stage operation, and satisfactory postoperative results. It is a preferable operation technique for penis lengthening.
PMID: 19271074 [PubMed - indexed for MEDLINE]
(2)
Zhonghua Zheng Xing Wai Ke Za Zhi. 2002 Jul;18(4):206-8. [Repair of penile wounds in penis lengthening with the scrotal dartos musculocutaneous flaps]. [Article in Chinese] Liu Y, Li S, Li Y, Yang M, Zhao Z, Huo R. Source Plastic Surgery Hospital of CAMS, Beijing 100041, China. Abstract OBJECTIVE: To provide ideal materials for repair of penile wounds in penis lengthening.
METHODS: A skin incision was made between the penis and mons pubis. Penis lengthening was performed by complete releasing of the superficial suspensory ligament and partial releasing of the deep suspensory ligament of the penis. Resurfacing of the defects at the penile base was accomplished by transferring a scrotal dartos musculocutaneous flap pedicled on the anterior scrotal vessels.
RESULTS: 16 patients with short penis were treated with the method. All scrotal dartos musculocutaneous flaps survived and 4-4.5 cm extra length of the penile shaft was achieved. Appearance and function of the penis were improved.
CONCLUSIONS: The scrotal dartos musculocutaneous flap is one of the best materials to repair the penile skin defects in penile lengthening operation. The advantages of the flap are: 1. good blood supply; 2. thin and lacking of subcutaneous fat; 3. extensibility with the scrotal dartos muscle.
PMID: 12382568 [PubMed - indexed for MEDLINE] Publication Types, MeSH Terms
In summary : There are two successful techniques published for surgical lengthening after cutting the superficial and the deep ligaments :
A: Double Z-Plasy. B: Scrotal flap.
SM
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Post by razor101 on Apr 30, 2011 10:55:38 GMT -5
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Post by smartman on Apr 30, 2011 11:30:17 GMT -5
razor101,
I know this clinic I have contacted them around 1.5-2 years ago but they wouldn't do the surgery for anyone:
1- Who was operated before,or 2- Who has used a stretching device before.
If you ask them to show pic. before and after they will refuse.
SM
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Post by smartman on Apr 30, 2011 11:43:50 GMT -5
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Post by sheldon on Apr 30, 2011 18:40:03 GMT -5
razor101, I know this clinic I have contacted them around 1.5-2 years ago but they wouldn't do the surgery for anyone: 1- Who was operated before,or 2- Who has used a stretching device before. If you ask them to show pic. before and after they will refuse. SM I can understand why they would not accept someone who was operated on before - dealing with another surgeon's mistake, but I don't understand if you used a stretching device (such as the Bib, thegrip, or autoextender) why they would refuse you. Would they refuse a patient who just tried one of these devices just once??
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Post by sheldon on Apr 30, 2011 18:56:27 GMT -5
In the dating scene, I have never had much going on for me. I have never been facially attractive, tall, smart, funny, the popular guy in school, rich, blessed with any talent, well endowed, etc. but for some reason I still had a tiny bit of confidence that lasted for a short segment of the first half of 7th grade. I refuse to believe that - " you never had much going for you". You had confidence, and I hope some of the threads on this forum can help you regain that confidence of yours and inspire you as well. Take a look at that Keenan Cahill guy. Some women say he is a weird looking midget/troll, but other woman say he has a certain cuteness factor, but he doesn't care, he just does his thing - the man wants to become an actor. I am sure you have some things going for you. I hope you were able to read the PMMA/Dr. C thread as well as talking a look at Dr. Giunta's and Dr. Reed's site as well as thegrip and autoextender. Did you see what one of our newer members posted: www.texaspenilesurgery.comThis site has some animation on how lengthening is supposed to work. Hope you are inspired by EP and others' progress threads.
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Post by new1inch on May 1, 2011 17:20:28 GMT -5
Good postings guys. the ones that stand out for me are 1Dr.Panfilov 2.texas penile surgery Do you guys thinks its reallly possible to attain erect length. this is really giving me hope. I wonder why no one have ever spake of these doctors. Also cutting the ligs are nothing new. I thought it didnt work. What make these any different?
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Post by smartman on May 1, 2011 18:39:55 GMT -5
New1inch,
By ONLY cutting the ligaments wont give you a great gain in length you might have no increase or sometimes you might get a decrease in length and you have to do physiotherapy > 6 months post op. to prevent that.
But these doctors tried to add more techniques to increase the length (e.g. by pulling the hidden corpus cavernosum and suturing the tunica to the periosteum and closure of the skin by either double z-plasty or scrotal flap or other techniques) to prevent any failure (of course they tried only to cut the ligaments before but they had failures so that why they modified it) .
new1inch check the post-op pic.(http://www.oxygenzone.co.uk/?q=content/penis-enlargement-and-penis-lengthening) , you see the increase in flaccid length and the shaft's skin covering part of the glans i.e. they did not stretch the penis before taking the pic.?? like other doctor would do , if you see other sites of other phalloplastic surgeons you will see the flaccid penis is stretched post-op before they take the pic.
The only thing I wanted is to see is the scar ( it is covered with pubic hair) (which is common in v-y plasty)
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