Peter Weibl, Ralf Herwig
Aim: The aim of the study is to investigate two different approaches in the context of penile augmentation with autologous
fat trasfer (PAw/AFT) in the patient population with an actually normal sized penis.
Material and methods: The study cohort consisted of 17 and 48 patients (pts) who underwent PA via penoscrotal and
transverse infrapubic incision respectively. Altogether, 45 patients underwent surgery for girth enhancement using
AFT along the penile elongation. 5 patients opted for re-AFT procedure (within 9-24 months after previous procedure).
20 pts were indicated only for PA with/or without circumcision but without concomitant girth enhancement procedure.
Results: The mean follow up was 1.6 years (range 9-27 months). The mean IIEF-5 was 20.2 preoperatively, and 21.3 after
surgery at (6 to 9) months. The average injected volume of autologous fat was 31.2 ml (range, 25-47 ml). The average
preoperative length and girth values were (11.5+1.9/ 10.8+1.9; 6.4+1.1/6.9+1.5 cm) for penoscrotal and infrapubic approach
respectively. The average postoperative measurements in 6-9 months were (13.3+2.4/12.7+2.1; 7.7+1.2/8.1+1.8)
for length and girth purposes. The satisfaction rate was 58.8% and 72.9% for both groups consequently.
Conclusion: The use of PA w/without AFT for pure cosmetic reasons is a controversial procedure, and requires dedicated
patient counselling and informed consent. The PA without AFT via penoscrotal approach was more satisfactory because
of the need of a single incision and lower number of complications. However, during the early postoperative period
a significant number of patients with AFT in this group experienced the development of fibrotic changes in the
scrotal area. Therefore, according to our preliminary findings we do not recommend the concomitant AFT as a part of
PA, while using the penoscrotal approach.