If you are from Australia (as I am) you may want to pay a visit to Dr. David Caminer in Bondi Junction in Sydney. He is a plastic surgeon, practices Phalloplasty and is highly recommended. Dr. Caminer prefers fat injections which he claims to have had good results with. He says that he believes inserted dermis fat grafting or alloderm into the penis is fraught with danger as one can lose parts of the penile skin when degloving the penis to insert the dermis fat graft or the alloderm.
In the U.S. I would recommend Dr. Gary Alter who is a certified plastic surgeon and urologist. But at the moment he will not perform any girth enhancement procedures.
Dr. Alter says: "Injected fat tends to disappear over time. Large amounts of injected fat can cause penile distortion, fat nodules and lumps, and irregularity. The dermal fat graft procedure works very well most of the time and tends to stay permanently. However, some significant problems can occur, such as curvature and shortening. Alloderm has the advantage of avoiding the donor scar from the dermal fat graft. It is promising, but it is too soon to know if it will permanently last. Alloderm can also become infected or can cause shortening and possible curvature."
Fat transfer or penile fat injection is becoming a dated procedure due to the recent advances in treatment options, but many surgeons still commonly use this technique because of its verified history of success an inexpensiveness. FFT includes the acquisition of fat through liposuction or removal from areas such as your abdominal or thighs. Once acquired, your fat is then sanitized/purified and then injected into your penis.
Up to 50% or more in width expansion can be achieved with FFT, but the disadvantage of this procedure is the unpredictability over time. There is the issue of keeping the fat "alive" and fat is often reabsorbed back into your body leading to a loss of girth. What's worse it that your body may reabsorb the fat at an unbalanced rate – resulting in lumps, unevenness, and a visually unappealing look.
IMO I would stay away from Dermal Fat Grafts because they include unsightly scarring occurring from the incisions required to obtain the necessary grafts – largely around six inches by two inches. These large incisions need a considerable amount of time to heal.
IMO I would stay away from Alloderm also. As Dr. Alter says, Alloderm has the advantage of avoiding the donor scar from the dermal fat graft but it can also become infected and can cause shortening and possible curvature. There are other issue also.
Alloderm is a type of graft obtained from a cadaver. The tissue itself is processed from a deceased human being, disease free according to reports issued from tissue banks that supply it, abiding by FDA regulations and AATB general rules. As a patient, you should consider asking your doctor where he intends on acquiring the sheets (grafts) of Alloderm to ensure safety measures are enforced. Bear in mind that some surgeons have reported inconsistencies in grafting materials sent from providers, leading practitioners to avoid Alloderm grafting treatments all together.
Before surgery the doctor prepares a predetermined amount of Alloderm for the procedure. Using a deceased person’s tissue excludes removing fat from your own body and in most cased does not cause scar damage due to the fact it is injected, reducing the total length of your operation and also eliminating the potential occurrence of pain or illness – according to doctors who have performed successful procedures.
Alloderm grafts are layered upon one another to reach a set width. Once inserted into the penis, your body will start to introduce new cells into the Alloderm tissue, causing blood vessels to grow into the grafts, then becoming part of your penises structure. Note that excessive layers of Alloderm can restrict blood circulation within your penis, causing portions of grafting material to die and lead to fibrosis. If fibrosis occurs, Alloderm tissue may gradually die, slowly hardening and consequently shortening your erect length.
Belladerm is made from grafts from live donors that is customized by your surgeon for your procedure exclusively. Observed expansion measurements have reached up to 1.5 inches with minimal to no scarring involved. Belladerm is not cadaver tissue, rather healthy animated donor tissue, similar to the involvement of your donated tissue via another dermal grafting procedure. Because of how Belladerm is acquired, this type of tissue does not contain nerves/vessels, which could result in a prolonged recovery period.
I hope this information helps. IMO PMMA is still currently the best method for girth enhancement, or if not PMMA, the use of a temporary filler which has the advantage of removal without surgery should any major complication occur such as a negative immune response.