Trouser Talk Part 1: Augmentation Phalloplasties – Locker Room Syndrome

‘Locker Room Syndrome’? Grower? Shower?

The aforementioned terms relate to men’s issues with their flaccid manhood – a topic which is increasingly gaining (pun intended) interest and is less taboo to discuss than in yesteryear.

Men are growingly feeling empowered to make very personal changes to their bodies, very much like women have felt since the 1980s. This is arguably due to the ‘wider’ exposure to suggestive images in the West’s increasingly less-conservative societies, with associated soft-porn creating a form of ‘aspirational ideal’.

As one of just a handful of surgeons in the world being able to offer various types of augmentation phalloplasty, and also being an international key-opinion leader in cosmetic medicine, I have been asked countless times by patients and peers to provide insight into key aspects of this very niche area of medicine. Accordingly, this article covering penoplasties, both non-surgical and surgical in approach.

Comparable to what happens in the world of breast enlargement, many men typically dabble with pills, potions, and pumps in their foray into the world of penile enlargement (augmentation phalloplasties). However, it is only possible to increase the length of the penis by a surgical procedure; this is because approximately one-third of the penis is buried under the skin and it is supported by ligaments which are, effectively, the continuation of the abdominal muscles, and these need to be cut.

There is absolutely no verified pill or potion which shall increase the size of the penis. Pills and potions typically contain vitamins, minerals, and herbs, and promise all manner of changes to the penis. Aside of preying on the finances of gullible men, there are actually a few reports of these products actually having the potential to cause harm by virtue of questionable ingredients and contamination. In fact, one American university found that some of the products contained traces of lead and animal faeces.

Owing to media spin and thanks to various celebrities endorsing the cosmetic use of PRP (platelet-rich plasma) and showing off their blood-stained faces as if they’ve been attacked by prickly pears, a variety of blood-based non-surgical interventions have ‘shot’ to popularity. There are many catchy/ trademarked names, such as ‘O Shot®’ and ‘P-Shot®’, and these essentially involve getting pricked and injected with plasma (effectively containing growth factors) extracted beforehand from the patient’s blood. There is no meaningful scientific validation regarding these ‘lifestyle’ interventions, and most doctors are, very rightly, sceptical.

Quite simply, they do not physically enhance the penis and any alleged improvement in length and strength of orgasms is, in my very strong opinion, simply psychological. In fact, the blood’s plasma which is injected into the penis shall, of course, temporarily add volume, but the penis’ blood flow shall wash it all away – and one could, logically, argue the injection of normal saline (= water with salts) to achieve similar transient aesthetics.

Vacuum devices have been around for many years and they do work, albeit temporarily. In essence, penis pumps involve placing a cylinder over the penis and then creating a vacuum by pumping out the air from inside it. This causes the penis to become engorged with blood, giving a temporarily larger manhood. These devices have a role for men suffering with impotence, but excessive and/ or long-term use may lead to the formation of ‘boggy’ penile tissues and a gradual weakening in the strength of an erection.

In summary, just as with prayers, there is no evidence that any of the aforementioned modalities provide any form of meaningful increase in penile size, beyond the power of suggestion!

A bit about me… I am a board-certified, multi-fellowship-trained aesthetic surgeon, with a background in general surgery and reconstructive plastic surgery, who undertook an extended period of training on cosmetic penile surgery with pioneering Australian urologist and cosmetic surgeon, Prof. Colin Moore – the surgeon who introduced dermal fat grafts to this field and holds various patents. I gained further experience in this field by spending time learning from luminaries based in America and Britain, and have proceeded to formulate my own approach to augmentation penoplasties.

<h4>Dr. Niro Sivathasan</h4><p>BSc (Hons), MB, BS (Lond), DRCOG, AesthMed Board Cert. (AAAM), GradDipAesthMed (UK), PGCert BA, MRCS (Eng), AFACP, DU (Paris), FCPCA, FFMACCS, FACCS, FASCBS, FAACS​</p>

Dr. Niro Sivathasan

BSc (Hons), MB, BS (Lond), DRCOG, AesthMed Board Cert. (AAAM), GradDipAesthMed (UK), PGCert BA, MRCS (Eng), AFACP, DU (Paris), FCPCA, FFMACCS, FACCS, FASCBS, FAACS​

Multiple postgraduate qualifications in general surgery, cosmetic surgery, and aesthetic medicine, were gained in America, Australia, and Britain. Now, ‘Dr. Niro’ is exclusively in private clinical practice and is a senior trainer and K.O.L. (key opinion leader) for the pharmaceutical and medical devices industries (since 2014).

He has published over 35 medical articles, spoken at conferences around the world, written book chapters, and is reviewer and editorial committee-member for various medical journals in addition to being a recognised medical educator on the national and international stage.