Testicular Enhancement Surgery

Dr. Solomon, do you perform testicular enhancement surgery? If so, how do you go about enlarging the scrotum and/or testicles? If not, what are your reservations with approaching this part of the anatomy?

I do perform testicular enhancement. This is one of the areas where I will use fat grafting. I work with a urologist in Beverly Hills to assure that the fat is placed in the proper plane around the testicle. The fat provides a natural feel along with a modest augmentation. Most men who seek this treatment have been taking testosterone and note a change in the size and consistency of their testes. I will occasionally place implants in the scrotum, again, working with a urologist in my Beverly Hills location. These can be placed along side of the existing testes or for men who have had their testicle removed. These implants are firmer than normal testes. I do not place caps on the testicle because they make it difficult to examine men for testicular tumors.

Dr. Solomon, if I wanted multiple procedures done (i.e. any combination of lengthening, girth, scrotal webbing, etc), can they all be done on the same day at your Clinic?

Is it possible combining procedures all on the same appointment would increase the risk for edema, a longer recovery, and/or major complications? What are your thoughts?

I do perform multiple procedures in one sitting. However, I tell patients that the recovery is prolonged due to swelling. Most of the swelling arises from the girth procedure. When girth surgery is performed along with other procedures, the swelling takes longer to resolve than if the procedures were performed separately. In my practice, the risks of complications are low. Length and web procedures have few complications and they tend to be minor. Girth procedures have a more complicated operative course, so complications may occur. I have only had 3 patients who lost their grafts in more than 25 years. My style of practice is very “hands on.” I require my patients to stay in a hotel near my office (in either location) and I see patients every day until they return home. This is usually anywhere from 3-6 days after surgery. This allows me to manage drains, dressings and other concerns that patients have after surgery. It also minimizes swelling since patients are largely at bed rest and in the hotel, rather than out of the room. I find that early control of swelling reduces the overall recovery time. For patients who travel a distance for surgery, I advise staying in a hotel for 1-2 weeks. Patients often feel well in the hotel and then have issues when they arrive at home. This is due to the stresses of travel, the amount of walking needed to travel through an airport, greater swelling and the general anxiety created when patients are at a distance from me. While it can be inconvenient to stay in a hotel for 1-2 weeks, the value is that your activities are very limited. This limits the swelling and enhances the healing. Obviously, I cannot force anyone to stay longer, but I encourage boredom as a part of recovery from these procedures, which are real surgery with real potential for complications.

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