title: Efficacy and safety of penile girth enhancement by autologous fat injection for patients with thin penises.
abstract: BACKGROUND
  This study aimed to investigate the efficacy and safety of autologous fat injection (AFI) for penile girth enhancement (PGE) in patients with thin penises.
  
  
  METHODS
  This study investigated 52 patients with a small penile circumference who underwent AFI for PGE and were followed up for more than 6 months. The patients whose proximal one third (G1) and distal one third of their penis (G2) had a mean thickness of 7.4 cm or less were selected as subjects. After fat suction using a liposuction device, fat was evenly injected into the superficial, middle, and deep layers of the Colles' fascia. Patient age and operative time were analyzed. The G1, G2, flaccid (L1), stretched length (L2), and five-item version of the International Index of Erectile Function-5 (IIEF-5) before and 6 months after the surgery were compared. Postoperative complications were surveyed.
  
  
  RESULTS
  The patient mean age was 42.15 years (range, 22-56) years, and the operative time was 44.44 min (range, 37-49 min). The injected fat volume was 38.54 ml (range, 25-49 ml). Preoperatively, G1 was 7.01±0.39 cm, and G2 was 7.06±0.37 cm. Postoperatively, G1 was 9.29±0.82 cm (P<0.001), and G2 was 9.34±0.86 (P<0.001) cm 6 months after the surgery. The difference between L1 and L2 before and after the surgery was not significant. The IIEF-5 was 19.10±3.22 before the surgery and 19.90±3.05 after the surgery (P=0.001). The only complication was nodular fat observed in one case (1.92%).
  
  
  CONCLUSIONS
  The use of AFI for PGE in men with thin penises was effective and safe without major complications.
  
  
  METHODS
  This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors at www.springer.com/00266.
authors.affiliation: Department of Urology, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Dong Hyuk
authors.initials: DH
authors.lastname: Kang
authors.forename: Jae Hoon
authors.initials: JH
authors.lastname: Chung
authors.forename: Yong Jin
authors.initials: YJ
authors.lastname: Kim
authors.forename: Haeng Nam
authors.initials: HN
authors.lastname: Lee
authors.forename: Seung Hoon
authors.initials: SH
authors.lastname: Cho
authors.forename: Taek Hee
authors.initials: TH
authors.lastname: Chang
authors.forename: Seung Wook
authors.initials: SW
authors.lastname: Lee
mesh_terms: D020341:Absorbable Implants; D000273:Adipose Tissue / Q000637:transplantation*; D000328:Adult; D006801:Humans; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D017060:Patient Satisfaction; D010410:Penile Erection; D010413:Penis / Q000098:blood supply / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012039:Regional Blood Flow; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D013521:Urologic Surgical Procedures, Male / Q000379:methods*; D055815:Young Adult