Penis enlargement surgery is a relatively simple, safe operation performed on an outpatient basis.

Surgery actually involved two separate procedures. Both are completely natural and do not involve the introduction of implants or other foreign materials.

The first, a lengthening procedure, was originally developed more than 20 years ago to treat boys suffering from microphallus, an abnormally small penis. The other proceedure is a fat transplant process adapted and perfected by Cosmetic Surgery International from traditional facial plastic surgery techniques.

In the lengthening procedure, the doctor releases the suspensory ligament that connects the penis to the pubic bone, which allows access to the section of the penis hidden behind the skin wall. He is then able to extend the length of the penis in proportion to the length of the organ's internal section.

Once the additional erectile tissue is exposed, the ligament is reattached to prevent retraction. A flap of skin from in front of the pubic bone is brought down to cover the newly-exposed section.

The increase in length varies depending on a patient's anatomy. However, results generally range from 1" to more than 2 1/2". The average additional length is 1 1/2" to 2". The limiting factor is the length of a patient's suspensory legament. There is no way to predict what the length will be prior to surgery.

The enlargement procedure involves a simple transfer of fat cells from the patient's lower abdomen into the tissue region between the skin and the erectile tissue of the penis. A patient's own fat cells are used for augmentation because they do not run the risk of rejection by the body.

The result is a penis of the same shape and length but greater in circumference. Because the penile shaft is narrower than the maximum diameter of the head, the doctor usually fills out the shaft slightly beyond the head's maximum diameter to maintain proper proportion.

Circumference can be increased by 30-50 percent, depending on the results desired by the patient.

In each procedure, increases occur in both the flacid and erect state, although length gain in the flacid state is generally greater.

Lengthening and augmentation procedures take approximately 25 minutes each; surgery involving both procedures usually runs no more than 55 minutes.