Plastic Surgery Enters the Bedroom
by David Constantine

New technologies are rejuvenating the love lives of many

more and more people are turning to plastic surgery to improve and rejuvenate their love lives.  Innovative new procedures for formerly unmentionable body parts are making it possible.  And these new surgeries offer more than just cosmetic change – the psychological aspect of improving self-image is driving patients toward these “bedroom” procedures. 

Just as implants made woman’s breasts a more open topic of conversation than they once were, penis enlargement may be doing the same for men. Penis enlargement surgery, or phalloplasty, is becoming increasingly common in our society.  Still, while many have seen the advertisements for phalloplasty, few know much about the subject. 

Modest solutions to small problems

The penis, always celebrated, yet shrouded in mystery, is now fair game in popular culture. TV shows like Ally McBeal and Sex and the City feature female characters that aren’t afraid to discuss the male organ. It seems that men are now facing the same issues women have traditionally had to deal with – poor self-image based on feelings of physical inadequacy, wondering if your partner is unhappy with your body, and having to compete with unrealistic physical ideals perpetuated in the media.  This includes penis size, and some men have turned to plastic surgery to help them overcome their problems. 

Some good doctors are responsibly and professionally helping the right patient-candidates get genuine improvements. “Guys are starting to feel really insecure about their manhood.  Women want equality in the boardroom and the bedroom.  Guys were getting comments about it and they didn’t know how to deal with it,” says Dr. Robert Stubbs, MD, of the Cosmetic Surgicentre in Toronto, Canada.  Dr. Stubbs has performed hundreds of phalloplasty procedures and has published papers on the subject.  “An area which was once taboo to discuss or touch or operate on is now the subject of cocktail discussion.  Plastic surgeons are trained basically to listen to a patient and determine whether their skills will help that individual with their self-esteem and their quality of life.  We are not intimidated by any anatomical location.”

Phalloplasty is used to increase both length and circumference of the penis. Options for cosmetic penis enhancement include dermal fat grafting, fat injection, and penis lengthening.

During the dermal fat grafting procedure, a doctor takes a strip of skin from another part of the body that has fat attached to it, and transplants it to the penile shaft.  Dermal fat grafts are usually smoother and more uniform than fat injections.  They are also less prone to re-absorb than fat injections.  The major drawback is the scarring left at the location the fat was taken from, usually the buttocks.  Also, thin men may have trouble finding an adequate amount of donor fat.

Penis lengthening surgery can extend the length of a man’s penis by .5” to 2” in length.   The average gain is about 1.”

Fat injection moves fat cells from another part of the body to the penis.  Doctors can control the amount of fat and increase in penis size.  They can only increase shaft size, and not the head of the penis.  One major drawback to fat injection is that most gains in penis girth are lost because the body reabsorbs more than 50% of the fat.  Survival rates of fat cells are unpredictable in the body.   As with dermal fat grafting, skinny men may have difficulty locating donor fat on their bodies.  The procedure is faster and easier than dermal grafting.

Penis lengthening surgery can extend the length of a man’s penis by .5” to 2” in length.   The average gain is about 1”.  Incisions are made at the base of the penis, and the suspensory ligament that connects the penis to the pubic bone is severed.  This causes the penis to hang lower and further away from the body.  Penile weights must be worn for weeks after surgery.  Urination and ejaculation are typically unaffected.  The angle of the erection may be more horizontal after the surgery.

“Over 90% of my patients are heterosexual,” says Dr. E. Douglas Whitehead, MD, Associate Clinical Professor of Urology at the Albert Einstein College of Medicine in New York, and the President of the American Academy of Phalloplasty Surgeons.   “My patients come from all socioeconomic levels -- college professors, physicians, lawyers, and at the other end of the spectrum, taxi drivers - the whole gamut, from all social and economic strata.  Half of my patients are from overseas.” 

Dr. Whitehead has been performing the operation for five years. “Initially I was not an advocate.  This was when it was in its early stages.  Since then, the field has evolved and there are techniques that work very well.  The techniques now really do work.”   

Not just for men

Bedroom surgeries are not just for men.  Procedures are also available for women who feel they need to change the look of their genitalia.  Many older women are now undergoing surgery to revitalize the vagina.  As a result of childbirth, aging, or some other medical condition such as chronic cough, obesity, or a congenital defect of the supporting tissues around the pelvis, nearly 30 million American women suffer from the symptoms of vaginal relaxation.   Vaginal relaxation can lead to problems controlling the bowels and general discomfort.  Muscles, fascia, and ligaments hold the pelvic organs – the vagina, uterus, bladder, and the rectum - together.  When these tissues are damaged, one or more of the organs may sag.  One of the unfortunate consequences of vaginal relaxation can be the inability or difficulty to achieve orgasm.

The reconstruction process focuses on those areas important to sexual gratification.  These include the outer third of the vagina (labia majora and labia minora), the orgasmic platform (the clitoris and its supporting structures), internal and exterior vaginal diameters (the width of the vagina), the vaginal opening, and the perineal body (the muscles directly below the vagina).  A laser is used during the procedure to enhance the structural integrity of the vagina.

Another procedure, designer laser vaginoplasty, is the aesthetic surgical enhancement of the vulva structures.  These include the labia minora, labia majora, and the mons pubis.  This kind of vaginoplasty is done for strictly cosmetic purposes, not for enhancement of sexual sensations.  Examples of vaginoplasty procedures:

Procedure Description
Labia minora reduction------ For a more youthful looking vagina.
Labia minora sculpting------ For a more aesthetically pleasing vagina.
Thinning of the labia minora-- For labia that have expanded in size due to childbirth.
Microsurgical liposculpting-- Removing fat from around the vagina
Hymen reconstruction---- For women from cultures in which an intact hymen is important for marriage

Standby procedures help, too

More traditional plastic surgery procedures can rejuvenate your love life as well.  Jane, a 38-year-old doctor, had minor plastic surgery last summer.  “I just had the very tip end of my nose done, nothing major.  I think people at work can tell that something is different about me, but they can’t put their finger on it.”  In this case there is not a dramatic physical effect that others can perceive, but rather a small change in appearance that causes a huge difference in self-image.  “I never think about my nose anymore.  It has helped my love life because now I feel more confident.  Before, when I met an attractive guy, I would always worry about my nose.”

Teresa, 36, from North Carolina, had breast augmentation and abdominoplasty last August.  Thirteen months after having her fourth child, Teresa decided to have the procedures.  “I live on a beach, where everyone runs around in bathing suits all the time, and I did not feel comfortable.  I had four C-sections, and I breast fed my kids.  Surgery has helped my self-esteem, I’m not embarrassed to go to the beach, and I’m not embarrassed to have sex with my husband with my clothes off.  The last pregnancy did me in.  And living here, you can’t cover up what you can cover up other places.”


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