Fat transfer has been used by Cosmetic Surgeons for filling other areas of the body for many years. It was typically obtained, or harvested, during liposuction, and because it was a person’s own tissue, there was no chance of tissue rejection. In the early years of fat transfer, surgeons observed that some of the fat graft, for various reasons, would disappear over time . . . in many cases reabsorbed by the person’s body. To compensate for this loss, typically the surgeon would add extra fat, or “overfill” the area. This usually worked well where a small amount of fat was used such as the cheek, lips, or deep facial wrinkles. The problem arose when a few high profile doctors, using this theory of “overfill” put excessive fat in the penis and the body could not develop a good blood supply to the grafted fat quickly enough. Some of the fat died and was absorbed into the body. Unfortunately the fat was not evenly absorbed, leaving lumpy, distorted penises that were difficult to correct—thus leaving Free Fat Transfer Phalloplasty to be criticized by unhappy patients.

Some clinics such at the Aesthetic Plastic Surgery International (APSI), where I have scheduled my surgery, have abandoned the overfill techniques. Instead, Dr. Giunta has fabricated surgical instruments to harvest the best size pieces of fat and developed methods for placing these harvested fat tissues properly in the penis in two stages at least three months apart. In addition he uses a proprietary combination of special nutrients to help the fat from being absorbed and to promote increased blood supply to the graft.

As Shown in the diagram below, much of the Penis itself is actually on the inside of the body. By cutting the Suspensory Ligament it actually enables a portion of the penis that would normally be on the inside of your body to hang farther outside and give the Penis a longer length.

Penis Enlargement by cutting the Suspensory Ligament

In this procedure, no actual length is created, rather, the internal portion of the penis is “advanced” or “externalized,” exposing greater length.

In many cases, another 3-4″ of the penis is located INSIDE the body. This penile root actually arches upward inside the body and by resecting the suspensory ligaments, this upward arch is extended forward. A simple 1″ curvilinear incision in the pubic area is all that is required to gain access to the ligaments. For overweight men, removal of some of the fat in the pubic area will also add to the perceived length increase of the penis. There is a small percentage (3-4%) of men who get no length gain at all in the erect state and rarely may even lose a bit of length due to scar tissue formation and retraction.