Most of these studies had either asked women directly about their preferences or had them rate the attractiveness of different male figures that varied only in penis length. The penis doesn't exist in a vacuum, though, and biologists led by Brian Mautz, who was then at the Australian National University in Acton, wondered how penis size interacts with other body traits that are usually considered attractive or manly.
"The first thing we found was that penis size influences male attractiveness," Mautz says. "There's a couple of caveats to that, and the first is that the relationship isn't a straight line." Rather than the attractiveness rating consistently improving with each jump in penis size, the team found what Mautz calls "an odd kink in the middle." Attractiveness increased quickly until flaccid penis length reached 7.6 centimeters (about 3 inches) and then began to slow down, the team reports online today in the Proceedings of the National Academy of Sciences.
How to Live with a Huge Penis PDF.pdf
The reason, Mautz says, is that penis size isn't the only thing that matters. It interacts with other traits, and its effect depends on whether those other traits are already attractive to begin with. If one of the model men was tall and had a masculine, V-shaped torso with broad shoulders and narrower hips, for example, he was considered more attractive than his shorter, stockier counterparts, regardless of penis size.
An increase in penis size was also a bigger benefit to attractiveness, and a smaller penis was less of a detriment, to the taller, fitter figures than it was to shorter or potato-shaped ones. For example, a model that was 185 cm tall (about 6 ft) with a 7-cm-long (about 3-in-long) penis got an average score for attractiveness. To get that same score, a model that was 170 cm (about 5'6") needed a penis of about 11 cm (about 4.5 in) in length. Boost the taller guy's penis by just about centimeter, and the shorter guy needs double that to keep up and get the same attractiveness score. After that, the shorter male pretty much can't continue to compete. To really reap the benefits of a big penis, a guy needs to be attractive in the first place, Mautz says. If he isn't, even the biggest penis in the world won't do him that much good.
That size matters, and that it matters in the context of other traits, makes sense, because proportionate features are attractive, says Adam Jones, a biologist who studies sexual selection and mate choice at Texas A&M University in College Station and who was not involved in the work. But he cautions that projections on a wall are no substitute for real life. Just because a woman prefers a man with a large penis doesn't mean that she's going to find one. Outside the lab, there's greater variation and more traits to consider, so penis size might not be as important. That's good, Jones says, because hurdles like competition with other women and her own perceived attractiveness could place her with a man who comes up a little short.
As expected, a significant correlation was found between SPL and FPL. This finding is attributed to the fact that a person with a longer FPL may naturally have a longer SPL given the flexibility of penile tissue. Contrary to our data, showing that FPL was negatively correlated with penile stretched rate would suggest that the individual had a different penile extension rate. The same result was also noted in another report [13]. The elasticity of a small, flaccid penis may be greater than that of a large, flaccid penis.
While tacking hypermobile skin is often sufficient in patients with obesity, patients with more significant morbid obesity often face additional challenges to surgical repair. As patients gain weight, there is often a preferential deposition of adipose in the suprapubic area that persists even after weight loss or bariatric surgery (2). Since the phallus remains tethered to the pubis by the suspensory ligament, the redundant suprapubic fat pad eventually completely surrounds the penis. With burial of the glans and meatus, patients often have to sit to void due to dribbling. A combination of poor hygiene and persistent moisture trapped near the penis leads to chronic bacterial or fungal colonization. Chronic colonization can lead to inflammatory skin contracture and the formation of a phimotic ring of scar. This often results in invagination of the penile shaft skin and further burial of the phallus. Over time, the penile shaft skin will often break down and there will be a paucity of healthy penile tissue during time of surgical repair. Additionally, patients may have a degree of burial due to descended escutcheon or significant overlying pannus. In more severe cases of morbid obesity, surgical repair may include a formal panniculectomy, dermatolipectomy, and the tacking of the penopubic subdermis to the rectus fascia.
If a morbidly obese patient presents with significant escutcheon that limits examination of the glans, meatus, and penile skin, we counsel the patient extensively preoperatively regarding the potential for there to be a deficiency of penile skin and possible need for local flap or graft coverage. Additionally, patients are counseled about the risk of encountering undiagnosed meatal or urethral stricture associated with chronic inflammation and LS at the time of surgery since it is difficult to discern between the voiding symptoms of a buried penis alone compared to that of a buried penis associated with a urethral stricture. Additionally, if there is significant escutcheon or overlying pannus that will need to be surgically removed, a concomitant escutcheonectomy or panniculectomy may be indicated at the time of buried penis revision. In cases that involve panniculectomy, it is our preference to include the expertise of a plastic surgeon. Many patients have concomitant comorbidities such as diabetes, hypertension, and chronic obstructive pulmonary disease (COPD) that increase their risk of perioperative complications and every attempt should be made to optimize patients medically preoperatively and insure the risk of surgery is acceptable.
In patients with voiding symptoms or the appearance of involvement of the urethral meatus, it is important to evaluate the urethra with Bougie-a-boule calibration, cystoscopy, and when there is confirmation of a stricture, urethral imaging with a retrograde urethrogram and possibly a voiding cystourethrogram. In cases of LS where there is a buried penis associated with phimosis and the meatus is not visible to permit an evaluation of the urethra, our preference is to use a technique we developed for these specific cases. The objective is to increase the circumference of the area of phimosis at the expense of skin length without removing skin which would lead to skin deficiency. This could be accomplished by a long dorsal longitudinal slit with transverse closure. However, when there is a tight constriction, considerable dorsal penile skin length loss would be required to provide adequate resolution of the phimosis. Our preference is to make four longitudinal incisions with incisions dorsally, ventrally, and bilaterally of equal length (Figure 2A) with transverse closure so that the length loss is evenly distributed along the circumference of the penis (Figure 2B). Once the glans is delivered and visible, the urethra can be evaluated. We include consent for meatotomy or extended meatotomy so that if a very short stricture is identified, it can be definitively treated at the time of surgery. In a retrospective review of 43 patients with limited involvement of LS, the aggressive use of topical steroids with minor procedures to relieve high pressure voiding may prevent disease progression (8).
The treatment generally involved the removal of the subcutaneous tissue masses and any hard scar tissue adherent to the tunica albuginea via a circumcising and/or peno-scrotal incision. If this skin appears viable, primary closure with either native skin or with advancement of local skin flaps is possible. However, there is a risk that the involved genital skin can then contract or become swollen, requiring subsequent surgery to excise the involved skin and use STSG for coverage. Alternatively, if it is apparent that the remaining penile skin is not viable, skin grafting can be performed at the time of the treatment of the buried penis.
Buried penis repair after penile and scrotal enlargement surgery. (A) There is significant buried penis after injection of silicone into the penile and scrotal skin due to scarring and tissue masses; (B) relatively normal appearance of the penis immediately postoperatively after excision of scar tissue and abnormal penile and scrotal skin; (C) normal postoperative appearance of the scrotum associated with abnormal appearing penile skin tissue; (D) subsequent operation with excision of contracture penile skin with STSG; (E) appearance of the penis and scrotum several months postop. STSG, split thickness skin grafting.
Staged surgical repair of MLL of the scrotum. (A) Preoperative appearance of MLL of the scrotum; (B) T-incision marked out on the scrotum; (C) the spermatic cord and testicles are first isolated prior to removal of any lymphedematous tissue to prevent injury; (D) after the patient has healed from scrotectomy with primary closure, he is brought back into the operating room in a staged fashion to resect residual affected tissue; (E) after all remaining affected tissue is resected, STSG are placed on the penis and scrotum; (F) final cosmetic appearance after skin grafting. MLL, massive localized lymphedema; STSG, split thickness skin grafting.
A three-pieced surgically inserted penile implant includes a narrow flexible plastic tube inserted along the length of the penis, a small balloon-like structure filled with fluid attached to the abdominal wall, and a release button inserted into the testicle.
The penis remains flaccid until an erection is desired, at which point the release button is pressed and fluid from the balloon rushes into the plastic tube. As the tube straightens from being filled with the fluid, it pulls the penis up with it, creating an erection. 2ff7e9595c
Comments