Patients who have lengthening usually leave for home the next day. You could probably return to an office environment in 3 days.
AlloDerm is like particle board, when immersed in body fluids, it swells and swells for several days. This spreading of the collagen fibers is helpful to permit ingrowth of a capillary bed and new cells of your own making.
Whereas AlloDerm comes from a cadaver, BellaDerm comes from a live donor. There are many subtle differences which require telephone explanation. I have not seen any communicable disease emerge with either product. AlloDerm is packaged dry and swells like particle board. BellaDerm is pre-packaged in solution and what you see after surgery is more or less what you get.
From surgery anticipate a 3/8″ increase in length and with dedicated use of traction, 8 hours a day in divided sessions, anticipate a 1/8″ gain each month such that after 6 months you’ll have 3/8″ plus 6 x 1/8″ or 9/8″. We say about an inch longer erection in 6 months. Flaccid lengths will be correspondingly longer. Whenever you stop using traction whatever you have gained is permanently yours. If you continue, more length gains will be accrued.
With AlloDerm, we can say quite conservatively you can anticipate a 3/4″ gain in circumference if you have not already had penile girth enhancement which is permanent as far as we know having followed patients for 8 years or so who have had AlloDerm.
Most patients will do a lot better than that.
Glans enhancement with AlloDerm produces a moderate result as overpacking could lead to vascular compression, infection, and necrosis. We avoid the neuro-vascular bundle by passing the AlloDerm up and over the corporal extension into the glans or under the neurovascular bundle.
Making an incision on the top side of the distal shaft will certainly result in cutting across the neurovascular bundle.
Please recognize that American Urological Association policy statement of 2008 remains unaltered: “The American Urological Association (AUA) and the Urology Care Foundation consider subcutaneous fat injection for increasing penile girth to be a procedure which has not been shown to be safe or efficacious. The AUA also considers the division of the suspensory ligament of the penis for increasing penile length in adults to be a procedure which has not been shown to be safe or efficacious.”
We do not do simultaneous surgery, such as any combination of length, girth of shaft, girth of glans, circumcision, or pubic liposuction. Hardly a week goes by when some disillusioned patient done elsewhere calls us for a revision. Generally speaking the penis does not appreciate simultaneous surgery with a few exceptions.
While you do not have to be circumcised for lengthening, you need to be circumcised for girth enhancement.
AlloDerm patients must be on strict bed rest with the exception of getting up to use the commode or eating in their room for 4 days. Surgery is the zero day.
Early mobilization is the great enemy of good graft take. Again plan on staying in your room, stocking up on food or sending out for food. Good Italian, Greek and Chinese restaurants abound with delivery service only a telephone call away. I’ve have been known to go shopping for some patients at Publix. You won’t starve.
Candidates who wish to schedule surgery with our facility are required to have phone consultation with a favorable response to questions of concern. All patents will require these blood tests: a recent CBC, platelet count, PT and PTT. This can be done at our office the day before surgery or in your home town.
If you are over 40 or are on medications, please call the office before scheduling surgery, as a letter of medical clearance may be required.
If you are a smoker, you must stop completely for 2 months before surgery (girth enhancement especially) and please never start again. Smoking causes vaso-spasm, impairs wound healing, produces excessive scarring, tissue necrosis, irritates and inflames pulmonary membranes and enhances anesthetic risk. However, most of our penile surgery is done under local anesthesia with IV sedation.
This goes also for any products containing nicotine or nicotine like agents including nicorette gum, nicotine patches, Nicotrol inhalers, and second hand smoke. Again not for 8 weeks before and not for 8 weeks afterwards. Hopefully never again.
Please no aspirin or aspirin products, no anti-inflammatory drugs such as Motrin, Advil, Alleve, or Cox 2 inhibitors such as Celebrex or Vioxx for a week before surgery. No Vitamin E or excessive alcohol or spices for a week before surgery as this may promote bruising. Bruising can be reduced (many believe) with Bromelain 500 mg 1 twice a day, Arnica montana (Boiron brand) dose 30C (take 4 small tablets sublingually, 4 times a day), vitamin C 500 mg (3 times a day) starting 1 week before surgery. Do take these medications unless there are specific reasons why you choose not to and let’s discuss it beforehand.