Penile Dual AugmentationTM Surgery Overview

Dr. Krakovsky receives the 100 Best Cosmetic Surgeons of the World Award for 2008.  Best Phalloplasty Surgeon Dr. Alexander Krakovsky

Penis Image Assessment ScalePenile Dual AugmentationTM surgery consists of two surgical procedures performed during the same surgery: penile lengthening and penile girth enhancement. Penile Dual Augmentation surgery was developed in order to satisfy customers who want to save time and money when undergoing these two surgeries. Men usually like to have their penises enhanced in several ways, and Penile Dual Augmentation surgery is the most popular choice for making the penis both longer and thicker.

In Penile Dual Augmentation surgery, the patient gains length and girth at the same time. The average length that a patient gains from penile lengthening surgery varies from person to person, and may or may not fall into the normal range of one-half to one-and-one-half additional inches in the flaccid position. Girth enhancement surgery can increase the circumference of the shaft of the penis from a 10% increase to a 30% increase over the existing pre-operative circumference size, depending on the number and size of the grafts used during this surgery. The majority of the Penile Dual Augmentation patients involved in a recent study reported that they felt much sexier after the surgery than before it.

In Penile Dual Augmentation, lengthening surgery is performed first. Increasing penile length requires releasing the suspensory and fundiform ligaments. The surgery begins with a curvilinear incision in the infrapubic region at the base of the penis. Once the surgeon has excised the suspensory and fundiform ligaments that hold the penis, as well as a few collateral ligaments that also need to be disconnected, the internal part of the penis is released. Following lengthening surgery, a physiotherapy stretching technique that involves wearing weights must be used by the patient to ensure the long-term effectiveness of the surgery. The success of the lengthening procedure depends equally on ligament detachment (performed by the surgeon) and physiotherapy (performed by the patient).
Penis Lengthening Surgery Part One
Penis Lengthening Surgery Part Two

Once lengthening surgery is complete, girth enhancement surgery begins with a second incision. This incision is on the neck of the penis, just below the corona, and is approximately one inch long. A graft is then placed in the appropriate area on the shaft of the penis. This area is usually the anterior three-fourths of the penile shaft.
Penis Widening Surgery Part One
Penis Widening Surgery Part Two

Currently, there are two types of permanent graft available to increase the thickness (girth) of the penis. The first type of graft uses the patient's own skin (dermal fat graft or DFG). Girth enhancement with dermal fat grafts (DFGs) requires peeling the epidermis from the harvested skin graft before placing it on the shaft of the penis. The second type of graft is AlloDerm (R). (For more information about AlloDerm, visit

Penile Dual Augmentation surgery is performed under general anesthesia. Pain resulting from this surgery is minimal. Most men require one week off work, although it is possible to return to work three to four days after surgery. This varies, depending on the individual and on the demands of the job. Sexual activity must be avoided for at least six weeks after surgery, and there should be no participation in sports for at least four weeks after surgery.

It is important to note that many patients have unrealistic expectations when undergoing this surgery. Despite what is written above, they think that after surgery their penis may increase two to three inches in length and two to three inches in circumference. These expectations are absolutely unrealistic and can create tremendous dissatisfaction for the patient. This dissatisfaction can, in turn, compromise the reputation of the surgeon and his techniques. The patient must have realistic expectations when undergoing this surgery.

Men have anatomical restrictions that prevent such large increases in penis length and girth. One of the anatomical restrictions to penis length is the length of that portion of the penis that exists inside the body and that can be freed up from its ligaments through surgical separation. This hidden portion of the penis varies in length from one-half inch to one inch. Another restriction is that the quantity of cells in every man's cavernous body is fixed. These cells do not multiply as a result of lengthening surgery. Yet another restriction is the amount of patient compliance with the stretching exercise program following surgery.

The main anatomical restriction to penis girth is the amount of space between the skin and the tunica albuginea that covers the cavernous bodies of the penis. Some men have enough space for three millimeters of graft(s); others have space for ten millimeters of graft(s). The surgeon works with the patient to help him to select a type and size of graft appropriate to his anatomical characteristics.

Penis lengthening and penis widening are safe surgical procedures that provide excellent results when performed by a qualified, trained surgeon. In 2005, Dr. Krakovsky was awarded the Outstanding Professional Award as one of the 100 Best Cosmetic Surgeons of the Millennium by The Second World Congress on Advanced Cosmetic Surgery. He is Vice President of the American Academy of Phalloplasty Surgeons. His practice is in San Diego, California. He follows the Academy’s standards and guidelines for the safety of phalloplasty surgeries, and, as a qualified surgeon, has completed the special phalloplasty surgery training the Academy requires for this surgery. Read more.

Dr. Krakovsky is also a very caring and compassionate surgeon, and he takes as much time as necessary to be sure that you are provided with the answers you need to make the right choice. He also provides you with all the guidelines and information you need to prepare for and follow up after any surgery you select. Dr. Krakovsky has developed a number of helpful tools for his patients, including checklists of timelines and guidelines to help you to stay on track with all aspects of pre-surgical and post-surgical requirements. These include everything from registration information and when to start and stop eating certain foods to what to pack for your overnight surgical stay, medical tests that need to be taken, how to follow up after the surgery, and much more. As soon as you become a patient of Dr. Krakovsky, you have access to the Patients Only section of his website, where your Patient Passkey makes these documents available to you.

Many plastic and cosmetic surgeons who have never completed special phalloplasty training are performing phalloplasty surgeries. As a result, thousands of men are faced with injuries for which reconstruction is very difficult, or even impossible, to perform. As you can see, it is extremely important to choose a qualified surgeon for this type of surgery, to learn about whether this surgery is right for you, and to follow pre-operative and post-operative instructions closely.

For your Penile Dual Augmentation surgery, you will need to be in San Diego the day before the surgery for your final pre-surgical appointment with Dr. Krakovsky and final preparations for the surgery, and you will need to stay overnight in San Diego after your surgery. The success of this surgery requires complete bed rest after the surgery and overnight, as well as regular follow up with Dr. Krakovsky, either in person, or by phone or email. See the Resources section of this website for hotel and car rental information.

AlloDerm (R) is a registered trademark of LifeCell Corporation.
Penile Dual AugmentationTM is a trademark of Alexander Krakovsky.

about the surgeon

Alexander Krakovsky, M.D., Ph.D., Dr.Sc. is among a select group of surgeons who have attained the highest level of achievement in cosmetic, plastic and reconstructive penile surgery. He is a dynamic and caring physician with the finest surgical training and experience. Dr. Krakovsky is known for his patience, and his warm and caring personality. He provides exceptional care with integrity, honesty and confidentiality, from the very first consultation to the last follow-up visit, in state-of-the art facilities. To learn more and to schedule an appointment, please call 1-858-224-3537.

contact us

Dr. Krakovsky is a world-renown plastic/cosmetic surgeon and lecturer with extensive experience. Dr. Krakovsky regularly teaches surgeons on the latest cosmetic techniques and performs surgeries around the globe. Dr. Krakovsky holds medical licenses authorizing his practice of medicine in United States - California, Florida and New York; United Arab Emirates – Dubai; Russia – Moscow, and China – Hong Kong. This makes it convenient for international clients to receive world-class service close to their home, saving them headaches associated with in visa requirements, and costly travel expenses.

Office phone number: 858-224-3537
Emergency phone number: 858-869-9556

Please contact Dr. Krakovsky’s offices for general information, a consultation or to schedule your appointment at the location nearest to you or via Google voice.


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Penile Triple AugmentationTM is a trademark of Alexander Krakovsky.

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