Swedish physicians are warning plastic surgeons about the first case of a man killed by penis enlargement surgery.
Like many plastic surgery procedures, penis enlargement relies on transplanting “autologous” fat cells from a body part where they are not wanted to one where they are. About 8,400 "penile enlargement" surgeries are performed worldwide every year to increase girth, according to international plastic surgery statistics. (The stats don’t include the number of elongation surgeries, partly because they’re sometimes done at the same time as enlargement, despite some surgeons recommending that they happen weeks apart.)
And now it’s killed a man in Stockholm, Sweden.
"This is the first described case where a seemingly simple and safe procedure of penis enlargement by autologous fat transfer caused sudden death in a healthy young man," reports the Journal of Forensic Sciences case study.
The healthy 30-year-old had wanted both a penile elongation and a penile enlargement, using fat cells taken from his belly. The surgeons performed the elongation, which requires an incision to loosen a ligament at the base of the penis, and then started the enlargement, an injection of two fluid ounces of fat cells into the patient’s penis.
They had almost finished the injection when the man's heart began racing, his oxygen levels dropped, and his blood pressure plunged. Within a half-hour, he had a heart attack. The plastic surgeons performed CPR and sent the man to an emergency room, but he died less than two hours later.
This is the first reported death from this kind of surgery. But it often leads to other serious problems, experts say.
“It’s a completely useless procedure that never works and disfigures men, and could kill you,” urologist Tobias Kohler of the Mayo Clinic in Rochester, Minnesota, who was not part of the study, told BuzzFeed News. “This is the worst case, but there are lots of other horrible consequences, from disfigurement to permanent erectile disfunction to even worse.”
“If you end up with something that nobody recognizes as a penis,” he added, “that is what we call sub-optimal.”
Since 1994, the American Urological Association has warned patients that penile enlargement "has not been shown to be safe or efficacious."
“The majority of men seeking penile elongation treatment have a normal penile size, which is functionally adequate,” a 2017 scientific review adds, despite its origins as a surgery for men with true deficiencies. The review suggests that most patients likely suffer from body dysmorphic disorder, an inability to see their body accurately, similar to some eating disorders.
An autopsy of the Swedish patient revealed no heart defects or genetic problems that might explain his death, and his arteries lacked the plaques that usually cause heart attacks. But his lungs were filled with blood and burst arteries.
The man died of a lung embolism, the forensic team concluded, where fat loosened during surgery traveled in punctured veins to the lungs and ruptured blood vessels there, causing death. Kohler said the mechanism seems completely reasonable and is a worry in other procedures as well. A 2015 Mexican study similarly traced 13 deaths from butt lifts.
It appears that the key risk in the Swedish surgery was that the man had also had the penis elongation procedure just before the fat injections intended to increase girth. Some of the fat meant to increase the girth of his penis leaked into his veins cut during the first procedure, traveled to his lungs, and killed him.
In their conclusion, the study team warned surgeons about the risks of combining the two procedures, something they say is “becoming more in demand every day.”