DERMAL-FAT GRAFTING - QUESTIONS AND ANSWERS
Because informed patients are so important to the success of any plastic surgery, Dr. Robert H. Stubbs, a Canadian and American Board Certified Plastic Surgeon has prepared this web info for you. It may not answer all of your questions, but it will help you understand what dermal-fat grafting surgery involves. Although this technique has been used by plastic surgeons to fill and patch for over 50 years, its recent utilization for penis augmentation will be the primary focus of this web page.
Q: WHAT IS DERMAL-FAT GRAFTING?
A: Dermal-fat grafting (DFG) is a two step surgical procedure. The first step involves the removal of a strip of skin with the underlying fat still attached. The outer skin layer (epidermis) is removed and the lower skin layer (dermis) is retained with the fat. The second step involves the insertion or transplantation to another location on the same patient's body. There will, therefore, be scars in both the donor (where the DFG came from) and the recipient (where it went) sites.
Q: WHERE IS THE BEST DONOR SITE?
A: This varies with each patient. Most choose the lower abdomen just above the pubic hairline. Many men have a bit of redundancy in this region and the surgery gives them the added benefit of a mini tummy-tuck. Other men prefer the crease under their buttocks. This location can be a problem if the scar is thick and uncomfortable, as the patient will be sitting on the area.
Q: IS DFG BETTER THAN FAT INJECTION SURGERY?
A: DFG is probably more reliable. It would be like comparing dry walling to the old wet plaster technique. With DFG the fat is attached and supported by the leather or dermis component. Whereas fat injection, grafts only the liquid cells which may shift during the healing phase. There also appears to be scientific evidence that the dermal component may increase vascular ingrowth and survival.
Q: IS DFG A SAFE PROCEDURE?
A: DFG is major surgery. As such, it involves more risk than fat injection. The long-term cosmetic result may be superior to fat injection. Therefore the risk/benefit ratio for each patient has to be considered. Please read the Special Consent to Dermal-Fat Grafting Surgery where the risks are outlined in detail.
Q. HOW LONG DOES THE SURGERY TAKE?
A: The procedure usually takes 3 hours. The patient then remains at the Surgicentre for at least another 3 hours of observation before discharge. All patients must have someone stay with them the first post-op night.
Q: WHAT IS THE RECOVERY PERIOD?
A: The recovery period involves a number of stages. The first week is very important. This is the time that the new blood supply connects to the DFG. Patients should therefore reduce their activities and not return to work for at least 7-10 days post-op. The next stage is the early healing phase with associated swelling and incision bonding. This lasts for a couple of weeks more and sexual activities should be avoided until after this period. From the first to approximately the sixth post-op month, the graft settles in. It is during this time that the swelling disappears and the graft often loses a bit of its bulk.
Q: IS POST-OP PHYSIO IMPORTANT?
A: The use of traction with weights or an elastic band after penis lengthening surgery is very important to prevent the ligament from reattaching during the healing period. The same principle applies to DFG. Traction helps to keep the graft out to length. As the graft itself is somewhat elastic, less force than with penis lengthening is necessary. Any tight penis shaft compression is to be avoided, as this might strangle the graft especially during its early healing phase.
Q:WHAT ARE THE RESULTS
A: Please see the Surgical Art Gallery for an examples of this procedure.
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