Sunday Tribune

MANHOOD MAKEOVER

An increasing number of men are approachin­g plastic surgeons in search of a larger penis. Simon Usborne reports

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AVAST painting covers the wall above a marble mantelpiec­e on which rests a human skull. It depicts Maurizio and Roberto Viel, who are twin plastic surgeons, and a nude woman whose breasts they have augmented. The imposing work, called Creation, greets patients at the brothers’ clinic on Harley Street in London. But increasing­ly these patients are men and, increasing­ly, they come in search of a larger penis.

As the exposure of crotches and more on billboards (think David Beckham’s pants ads) as well as in magazines and pornograph­y helps to fuel a rising sense of inadequacy among many men, penis enlargemen­t has become, if you’ll pardon the pun, a growth business. But penises have evolved to withstand great stress and changes in size and they resist almost all attempts to make them permanentl­y bigger.

Viel says he has overcome these challenges and performs about 200 penoplasty operations a year. He draws a penis, including the suspensory ligament, which holds up the erect penis. By partially severing it, having accessed it by cutting away a flap of flesh covering the pubic bone, Viel causes the penis to drop, and hang lower by as many as two inches. The length of the erection is not increased and its angle is lower. “If I cut too much it will be like that,” Viel says, overlaying his drawing with a drooping outline, “and that’s not the best for sex.”

Viel also extracts fat, usually from the patient’s stomach, and injects it under the skin on the top side of the penis, increasing its circumfere­nce by more than an inch, whatever its state. Viel keeps some of the fat in his fridge for top-ups, in case it is reabsorbed. The whole procedure, which takes about 90 minutes and is performed under local anaestheti­c, costs about £5 000 (about R65 600).

Viel studied medicine in Milan and trained in France and America alongside his brother. They have worked for more than 20 years at their London Centre for Aesthetic Surgery.

Penis enlargemen­ts now make up half the Viels’ work, bringing in about £1m a year in revenue. The twins are accomplish­ed selfpublic­ists, and have appeared in dozens of magazines and newspapers.

Viel estimates he has performed 3 000 penis enlargemen­ts since 1991. He is licensed to carry out his procedure, inspired in part by the pioneering work in the 1980s of Dr Long Daochao, a Chinese surgeon. But it remains a niche technique. None of the 230 surgeons represente­d by the British Associatio­n of Aesthetic Plastic Surgeons (Baaps), which accounts for about 40 percent of the industry, offers penoplasty. The Viels are not members. Nigel Mercer, a consultant plastic surgeon and former president of Baaps, says: “It’s not something we say every surgeon should offer because there have been lots of unhappy patients.”

Marcus Drake, a senior lecturer in urology who specialise­s in reconstruc­tion surgery at the University of Bristol, says: “There is a reason for a ligament and if you cut it the associated joint or structure wobbles around. A bit of introspect­ion on any man’s part will soon make him recognise this is borderline risky.” Drake points out the lack of full clinical trials of penoplasty.

Viel says the limited availabili­ty of penis surgery is not due to risk but because “there is no formal training” for it. He adds: “I have developed and improved the technique using surgical techniques from different surgeries to put together a procedure I think is reliable and gives good results in a safe way. Nobody wants to take any risks, and I would not be so naive or stupid to put my name to a procedure that was not safe. Of course sometimes there are cases when people are not completely happy because of a misunderst­anding of expectatio­ns before the operation but the likelihood of this is very low.”

He also says he offers counsellin­g before and after surgery. “I say no if they want something I can’t give them. When they want it longer when erect – I can’t do that. Or when I think they don’t need it or they have underlying psychologi­cal issues.” Figures by Baaps showed 4 300 cosmetic surgical procedures were performed on men last year, a rise of six percent. Most popular was the nose job, with 1 000 incidences.

Penis enlargemen­t does not feature in the top 10, but writer Tracey Cox says she’s not surprised that demand is growing. “I do an online clinic where men can ask anything about

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