title: Original technique for penile girth augmentation through porcine dermal acellular grafts: results in a 69-patient series.
abstract: BACKGROUND
  Although different techniques for augmentation phalloplasty have been reported in the medical literature, this issue is still highly controversial, and none of the proposed procedures has been unanimously approved.
  
  
  OBJECTIVE
  The aim of this study is to describe an innovative surgical technique for penile girth augmentation with porcine dermal acellular grafts, through a small transverse incision at the penile base, along the penopubic junction.
  
  
  METHODS
  Between 2000 and 2009, 104 patients were referred to our institution for penile enhancement. After a preoperative psychosexual consultation and a general medical assessment, 69 patients were deemed suitable good candidates for surgery. The average penis circumference was measured at the mid-length of the penis and was 8.1 cm (5.4-10.7 cm) and 10.8 cm (6.5-15.8 cm) during flaccidity and erection, respectively. All patients received penile augmentation with porcine dermal acellular grafts.
  
  
  METHODS
  Results evaluation of an innovative technique for penile girth augmentation through exogenous porcine grafts and small penobubic incision.
  
  
  RESULTS
  Postoperative measurements were performed at 6 and 12 months. At the 1-year follow-up, the average penis circumference was 11.3 cm (8.2-13.2 cm, 3.1 cm mean increase) during flaccidity and 13.2 cm (8.8-14.5 cm, 2.4 cm mean increase) during erection. No major complications occurred in the series. Minor complications were resolved with conservative treatment within 3 weeks. Sexual activity was resumed from 1 to 2 months after surgery. The psychosexual impact of the operation was beneficial in the majority of cases.
  
  
  CONCLUSIONS
  Penile girth enlargement with acellular dermal matrix grafts has several advantages over augmentation with autogenous dermis-fat grafts: the elimination of donor site morbidity and a significantly shorter operation time. With this approach, through a short dorsal incision at the base of the penis, the scar is concealed in a crease covered by pubic hair and thus hardly visible.
authors.affiliation: Department of Plastic Surgery, Sapienza University of Rome, Rome, Italy. giovanni.alei@uniroma1
authors.forename: Giovanni
authors.initials: G
authors.lastname: Alei
authors.forename: Piero
authors.initials: P
authors.lastname: Letizia
authors.forename: Francesco
authors.initials: F
authors.lastname: Ricottilli
authors.forename: Pierfranco
authors.initials: P
authors.lastname: Simone
authors.forename: Lavinia
authors.initials: L
authors.lastname: Alei
authors.forename: Francesco
authors.initials: F
authors.lastname: Massoni
authors.forename: Serafino
authors.initials: S
authors.lastname: Ricci
mesh_terms: D000328:Adult; D000818:Animals; D001672:Biocompatible Materials / Q000627:therapeutic use*; D001828:Body Image; D006801:Humans; D008297:Male; D008875:Middle Aged; D010410:Penile Erection; D010413:Penis / Q000033:anatomy & histology / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods; D013552:Swine; D016896:Treatment Outcome
chemical_list: D001672:Biocompatible Materials