The field of penoplasty comprises two separate procedures, one of which enlarges the length of the penis, Extension penoplasty (or phalloplasty), while the other, Enlargement, increases the girth or circumference of the penis.
Both of these procedures can be undertaken at the same time, and, in both cases, can either be performed under general anaesthetic or with local anaesthetic with sedation. The procedure takes between one to two hours to complete, depending upon whether one or both are performed. Enlargement penoplasty aims to increase the girth and volume of the penis, both at rest and erect.
This is undertaken by injecting fat which has been harvested from the body via liposuction (a process known as Lipostructure or Lipofilling) through a small incision in the penis.
The fat, which is usually taken from the lower part of the abdomen, preferably the pubis, is then shaped into the shaft of the penis. The liposuction itself can create an improved impression of the penis as men tend to accumulate fat in this region.
The gains are immediate and, in many cases, impressive. A small stitch may be needed to close the incision. A support garment will be applied after the procedure. This garment may be required to be worn for up to one week post-operatively.
If the foreskin is long Mr Marcellino may also advise you to have a circumcision. Normally, around 30% of the fat injected into the penis is re-absorbed into the body in a few months. The remainder is usually permanent. In a number of patients top-up procedures (3-4 stages surgery) may be necessary in order to maintain the results.
There is a limit to the thickness of the fat grafts that can be applied in the first instance as it is necessary to ensure adequate blood flow to the grafts. Sometimes it is therefore necessary to perform top ups of fat in 3-4 subsequent treatments.
In some cases (around 10%) the penis may appear asymmetrical due to the position of the fat, or lumps may occur due to fibrosis or hyper reaction to the grafted fat cells. These problems are normally resolved with massage or cortisone injections.
In rare cases corrective surgery may be required. Swelling to the head of the penis can sometimes occur and some pain or discomfort is possible for the first 12-24 hours or more. Instead of fat it is now possible to use a hyaluronic acid called Macrolane. This procedure has the benefit of being quicker and far easier to perform. Please read the relevant page to find out more.

The field of penoplasty comprises two separate procedures, one of which enlarges the length of the penis, lengthening of penis (extension penoplasty or phalloplasty), while the other, Enlargement, increases the girth or circumference of the penis.
Both of these procedures can be undertaken at the same time, and, in both cases, can either be performed under general anaesthetic or with local anaesthetic with sedation. The procedure takes between one to two hours to complete, depending upon whether one or both are performed. Extension Penoplasty (or phalloplasty).
This procedure works by releasing the suspensory ligament which connects the penis to the pubic bone. In some men this ligament is very developed and is constantly contracting the member, not allowing it to reach its full dimension.
This surgical technique enables the penis to become more visible, the severing of this ligament usually freeing up around 1 to 2 inches of the ‘inner’ penis. This is because in pre-operative men, only about half of the penis shows externally and the rest is hidden inside of the body.
The suspending ligament itself is something of an ‘evolutionary leftover’ and has no remaining function in a man’s body – the support and orientation of the male erection controlled entrely by hydraulic pressure.
It is not possible to predict the exact amount of gain in each case, as this depends on the anatomical makeup of your penis. The lengthening procedure is permanent and very difficult to reverse. It is very important for those considering this procedure to understand that it does not increase the length of penis in the erect state, only in the flaccid state. As such, any improvement will be aesthetic rather than functional.
There procedure will leave a small but permanent scar, shaped like an inverted ‘Y’, in the pubic area. The pubic hair will usually cover this where it is allowed to re-grow (you will be required to shave the pubic area in preparation for your surgery).
In most men there will be no change in the angle of erection. However, some patients (around 15%) may experience a slightly lower angle of erection.
Mr Marcellino will also advise on some complementary physiotherapy which will need to be performed after your procedure to ensure that the gains you make are maintained. The technique is extremely safe and straightforward, with the minimal possibility of complications which, where there they occur, are usually easy to resolve.

Some patients who experience extreme weight loss have a large redundancy of skin in the lower abdomen which can cover the penis.
To treat these cases, Mr Marcellino has developed a particular technique called a ‘T scar pubis lift’, where removal of the excess skin is combined with release of the suspensory ligament. All the skin of the pubis is lifted, with the skin of the lower abdomen removed and re-draped, restoring total exposure to genitals, a flatter, lower abdomen and a visibly longer penis.
The combined procedure takes between 2 and 3 hours to complete, and can be performed under sedation as a day case or under general anaesthesia with an overnight stay in hospital. The recovery time is typically about 10-12 days. In some cases Mr Marcellino may also apply liposeletion to the pubis to further shape the area.

In some cases the penis is hidden, either partially or completely, by a large fat pad. Many patients may, of course, benefit from making lifestyle changes, such as taking more exercise or eating a healthier diet, but, in many cases, these prove insufficient and liposuction is the only answer.With his wide experience in administering this technique, Mr Marcellino offers a definitive solution, using the latest ultrasound liposuction device called Vaser. The procedure itself firstly involves making a small incision, with the area then prepared with an injection of fluid.

Ultrasound energy is then applied using a probe, melting the fat which is then aspirated. Other structures, such as vessels, nerves and collagen fibers, are left undisturbed. The main advantages of this technique are improved recovery times, smooth results and excellent skin retraction compared with standard liposuction.

The procedure is carried out under local anaesthetic and sedation, and takes between one and two hours to complete, with the patient discharged on the same day. The results are visible after a couple of weeks. Some swelling and discomfort may be present at first. By removing the fat and achieving maximum skin retraction in the pubis the outer portion of the penis is then fully exposed and no longer hidden. After two months the patient may then wish to further enhance the results with a penis enlargement procedure.

Some men have an absence of one or both testicles. This can be as a result of various conditions such as criptorchidism, localized trauma, or following surgery for the removal of tumors, etc. In the latter case, it is of paramount importance to check with your GP or urologist that you don’t have any suspect tissue left before proceeding with implants.
The procedure itself is fairly simple and consists in making an incision in the middle of the scrotum, creating a surgical ‘pocket’ and inserting a silicone implant that has very similar shape and consistency to a real testicle. The operation takes about 45 minutes to perform and can be done under local anaesthetic with sedation as a day case.
Some swelling and discomfort are likely to be present for around 10 days. Infection , contraction of the pocket (capsule), opening of the wound and extrusion of the implant are the main risks to be avoided within the first two weeks.

Circumcision is rarely performed at adult age unless there is a specific problem such as a tight foreskin, phimosis, or recurrent infection.
In some cases of enlargement when the foreskin is too long or too loose Mr Marcellino may advise you to be circumcised in order to achieve better aesthetic and functional results and avoid future problems.The circumcision takes about 30 minutes to perform.
Following the procedure, Mr Marcellino will carefully apply sutures, which will be removed after around 12 days. Swelling, bruising and a difference in sensitivity are normally reported for the first few weeks.