Long Term Results in Augmentation Phalloplasty through a 2-cm Incision: Technique, Anatomical Description in a Human Cadaver and Satisfaction Assessment

Objective: An increase in the length of the penis is feasible with techniques that either divide the penis' ligaments (fun- diform and triangle) or use grafts to increase the size of the corpora. Girth enhancement can be done with fat autoin- jection or with dermal grafts. We present our technique to- gether with an anatomical description in a human cadaver. Patients and Methods: Forty patients underwent augmen- tation phalloplasty. To increase the length of the penis the ligament was divided through a small 2-cm incision at the base of the penis. Girth enhancement was achieved through fat autoinjection with fat taken from the inner thighs. The dissection of the ligament was also demonstrated in a hu- man cadaver to allow for more explicit presentation of the anatomy of the area. A questionnaire was used to assess the patients' satisfaction. Results: Before operation all patients had a normal penis with a length 9.5 ± 2.2 cm (8.1-13.5 cm) in the flaccid state and 11.8 ± 1.9 cm (10.9-17.2 cm) in the erect state. The mean circumference was 9.9 ± 2.3 cm (7.6- 11.8 cm). The increase in length 12 months post-operatively was 3.5 ±1.3 cm (2.3-5.1 cm) in the flaccid state, 1.8 ± 1.4 cm (1.4-3.2 cm) in the erect state and 3.5 ± 1.4 cm (2.1-5.2 cm) in girth. There was a statistically significant difference (p <