There are certain conditions that may enhance and optimize the results of Male Enhancement treatments. When one considers having a Penile Shaft (or Girth) Enlargement treatment there are several factors that can have a significant impact on the results, such as if you were uncircumcised, if you were circumcised but a lot if foreskin remains, have high retraction during the flaccid state, or even having a small glans in proportion to the penile shaft.

UNCIRCUMCISED VS. CIRCUMCISED (WITH EXTRA FORESKIN)

Regarding if one is uncircumcised, this is not favorable and it is highly recommended to have a circumcision done (with minimal foreskin retained) prior to having a Penile Enlargement treatment. Patients who do not want to be circumcised and have the penile shaft enlargement, only about 3 out of 10 patients will heal and shape well. The other 7 will need to have the circumcision done afterwards. In addition to the risk of potentially having to have the circumcision afterwards, the healing is more difficult and troublesome. There is an increased risk of skin sores and pain due to the thin and delicate nature of the foreskin. Below are some examples of uncircumcised patients and the difficulties we face with the foreskin remaining during the penile shaft enlargement treatment. Please note that the glans and scrotal areas can be treated without issue, but not the penile shaft for the uncircumcised.

 

The images above demonstrate a patient who has had a penile shaft enlargement treatment and is in the flaccid (soft) state, two views shown.

The image above shows the same patient with the penile shaft in the flaccid state (different view).

The image above shows the same uncircumcised patient trying to ‘manually’ pull out the glans (or head of penis). Note the thickened foreskin.

The image above shows the same uncircumcised patient pulling down the shaft skin exposing the thin zone of the foreskin area. This occurs because no filler material is placed under the foreskin nor can filler occupy this space, otherwise the foreskin will not function properly.

The image above shows the same uncircumcised patient in the erect state. Notice that the area under the glans, where the foreskin is located, is thinner than the rest of the shaft. This occurs because filler cannot be placed under the foreskin area, so the rest of the penile shaft, which has filler (which is not turned into permanent collagen), is enlarged.

The image above shows a different uncircumcised patient in the flaccid state. He has had 4 penile enlargement treatments and is quite large. Notice the foreskin area is thickened. Many patients do not mind this foreskin ‘thickening’, however you must be aware that it may occur.

 

The images above show a different uncircumcised patient in the flaccid state. He has had 2 penile enlargement treatments and is quite large. Notice the compressed foreskin area. The foreskin has been compressed by the shaft enlargement and collagen production moving into the foreskin ‘area’…which has caused less room for the foreskin and resulted in a compressed state not allowing it to cover the glans so easily if at all.

 

The images above show a different uncircumcised patient in the flaccid state. He has had 1 penile enlargement treatment. Notice the difficulty in getting the glans out, and the swelling or bulging area due to some filler entering into the thin foreskin.

Those who are circumcised may need to be ‘re-circumcised’ if there is too much foreskin left from the original circumcision. How can one judge if there is too much foreskin retained from the original circumcision? Just look on the penile shaft and identify the suture or stitch line where the penile shaft skin meets the foreskin. The skin directly under the glans, or head of penis, is the foreskin. You will notice that it is different, it is much thinner skin, and has a different color and quality.

If the foreskin is greater than the ¼ inch amount, what should one do? It is recommended to first send photos to Dr Loria for evaluation. If the foreskin amount is greater than ¼ inch (measuring from the very top of the penile shaft, just under the glans, and downwards), Dr. Loria may recommend having a re-circumcision to remove this excess foreskin.

Why is this important? When a penile shaft enlargement treatment is performed, there will be normal swelling. This swelling causes the penile shaft skin to stretch out, which is normal, however when the foreskin swells….it swells much more and balloons out because the foreskin is a very thin sheet of skin. This is significant because the foreskin area has a higher risk of malshaping….so the foreskin area will form collagen underneath it, like the rest of the shaft area, but may form with an inappropriate balance. This may cause asymmetry to the penile shaft. This bulging foreskin area can be controlled and formed to balance with the rest of the penile shaft, but not in all cases.

If the foreskin bulges or shapes differently than the rest of the penile shaft, will I still be able to functions sexually? Absolutely. The bulge may actually cause more sexual stimulation, but most patients want the penile shaft to ‘look’ cosmetically pleasing. In most cases the ‘bulging area’ may be more stimulated during intercourse and functionally it will be better, but cosmetically it will not.

Below are some examples of circumcised patients having had a penile shaft enlargement treatment and the difficulties we face when a lot of the foreskin remains (after the original circumcision).

The images above are patients in the flaccid state post a penile enlargement treatment, who also are circumcised with the recommended minimal circumcised foreskin remaining. Note the excellent balance and symmetry of the penile shaft, and the good proportional balance with the glans (or head of penis).

The images above demonstrate circumcised patients in the flaccid state who have had a penile shaft enlargement treatment. Note the minor bulging area just under the glans (or head of penis). The results were excellent, and this small bulge is presented here to show how the extra foreskin and cause shape irregularities. The underside view shows excellent balance with minimal ‘bulging’. The patients above were very happy with their results.

The images above demonstrate circumcised patients in the flaccid state who have had a penile shaft enlargement treatment. One image shows the skin pulled back, and the other in its natural flaccid state. Note the ‘turtling’ affect due to the high flaccid recoil or pull from the penile shaft. This ‘shrinkage’ or retractile force can cause this affect. This can be remedied by placing a flaccid insert under the penile shaft skin.

FLACCID LENGTH MATTERS

Another condition that enhances and improves the results of a penile shaft enlargement treatment is the flaccid length. The flaccid length of the penis is the length when the penis is ‘soft’ or non-erect. If one has a longer flaccid length, the results are generally better. Why is this? During the filler treatment, the permanent filler material is placed into the penile shaft (subcutaneously) we then place a gauze wrap to keep the penile shaft extended out as long as possible. The reason for this ‘soft gauze cast’ holding the penile shaft out, like in its erect state, is that we want the filler material to stimulate collagen in a proportionate and even manner along the entire length of the penile shaft.

Now, considering the penile shaft has the tendency to pull and shrink back, this pulling force must be counter balanced and prevented. Why is this important? If the penile retraction force is very strong (those whose flaccid length is less than 3 inches, or less than 50% of the erect length), this may cause a shift in the filler location and possible cause what is called a ‘turtling’ affect. To help prevent this, we stabilize the penile shaft after the treatment by wrapping it with stretch gauze to prevent the penis from contracting into a short flaccid state. The ‘soft gauze cast, or gauze wrap, is there to prevent the penis from contracting into its short flaccid state. This will help the filler material remain evenly distributed throughout the penile shaft. Please refer to the images below and images 1-7 above which demonstrate many patients with longer flaccid states.

The patient in the images above demonstrates significant length in the flaccid state. The flaccid pre-procedure circumference is noted.

The images above demonstrate the post procedure results, flaccid and erect. The gains were greater than average, but notice the symmetry and balance of the entire penile shaft.

By keeping the penile flaccid length to its maximum, which the gauze wrap assists with, the filler will stimulate collagen production, and this collagen will distribute more evenly throughout the penile shaft. Even though there is a gauze wrap on the penile shaft to help prevent this flaccid pulling, the gauze wrap is not always successful and the flaccid pull might be too strong and causes two things to happen: The first is the strong flaccid pulling force can actually push some of the filler out of the penile shaft and into the pubic and scrotal areas. This is not dangerous, but the idea is to keep the filler in the penile shaft so the enlargement can be maximized. Secondly, when the flaccid pull back is strong it may cause an uneven distribution of filler material and subsequent collagen formation. It may cause the foreskin area to bulge more…so if there is more foreskin left over from the circumcision, then a bulging may potentially develop….which ultimately results in the aforementioned turtling affect.

Does this affect intercourse and function? No, absolutely not. It is all cosmetic…not functional. It is only a temporary issue if the head of the penis, or glans, is submerged under the bulging skin of the penile shaft during the flaccid state. When the penis becomes erect, the glans comes out and all looks much better and proportioned. So, what is the issue? It is cosmetic, not a functional problem.

Is it possible to correct this flaccid shortening issue? Yes. Dr Loria does recommend, during the penile shaft enlargement treatment, having a Flaccid Insert placed. The Flaccid Insert is a small thin medical grade rubber silicone pen-like implant that is inserted under the skin of the penis. This rubber silicone implant (which is the same material used for cheek, chin, and face implants) will now prevent the penis from retracting, acting as a ‘splint’. This implant will permanently remain under the penile shaft skin and incorporate within the new collagen production. This Flaccid Insert is highly recommended and will improve and optimize results.

GLANS (OR HEAD OF THE PENIS)

The Glans, or head of the penis, can be modestly enlarged. The reason for modest gains is due to the actual structure of the Glans itself. It will not allow a lot of filler to be placed, and that is why it takes several treatments to enlarge the Glans to a significant size. Who is the best candidate? Well, this is near impossible to tell until the treatment is being performed. When the procedure is being done, Dr. Loria will, at that time while injecting the filler material, see how much filler the glans will allow in. The amount that will be injected will be proportional to the amount of space available in the Glans, and whatever space is available is filled. There is nothing that can be done to assist in getting more filler to ‘fit’ in the glans…whatever space is there is the limiting factor.

Keep in mind that the Glans can be treated several times, which gives us the opportunity to build it up over time. There are no particular conditions that will alter in favor for greater results regarding this procedure.

To see before and after images of Glans treatments, please go to the Photo Gallery.

SCROTAL TREATMENTS

Scrotal treatments are typically performed for those who have either a small scrotal appearance or have a scrotum that constantly pulls/contracts which makes the patient feel very uncomfortable. Another consideration for scrotal treatment is for one who has a very loose scrotal sac. By adding filler material, the scrotal sac will ‘tighten up’ and become more firm.

By adding permanent filler to the scrotal skin, it will cause the whole scrotal area to enlarge, help prevent scrotal contraction, and help ‘tighten up’ on the loose appearing scrotal sac.

There are no particular conditions that will alter in favor for greater results regarding this procedure.

To see before and after images of Scrotal treatments, please go to the Photo Gallery.

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