EP 641: Is Everything Bigger In Texas? Dr. Bryan Kansas Discusses Penile Enhancement Surgery For Length and Girth

In this segment, Dr. Mistry and Donna Lee are joined by urologist Dr. Bryan Kansas of Urology Austin to discuss common concerns men have about the length, girth, and function of their penises. While many men are self-conscious about their appearance, most of them are actually average in terms of penis length and girth. However, there are several surgical enhancements that can make men more confident in the bedroom. Today, Dr. Kansas explains how ligament release, penile injections, and the Penuma penile implant have both risks and benefits, but also the potential to increase both length and girth. They also remind listeners that weight loss is one of the most effective ways to lengthen their penises. If you or someone you love would like to learn more about the Penuma procedure, please call to schedule your consultation with Dr. Kansas at (512) 231-1444 or online at urologyaustin.com.

Voted top Men's Health Podcast, Sex Therapy Podcast, and Prostate Cancer Podcast by FeedSpot

Dr. Mistry is a board-certified urologist and has been treating patients in the Austin and Greater Williamson County area since he started his private practice in 2007.

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Transcript

Speaker 1: 0:07

Welcome to the Armor Men's Health Show with Dr. Mystery and Donna Lee.

Speaker 2: 0:15

Hello and welcome to the Armor Men's Health Show. This is Dr. Mystery, your host, board certified urologist and , uh, semi-professional , uh, TV personality, no radio personality, maybe some type of personality <laugh> . I'm joined by my, by my co-host, Donnel Lee .

Speaker 3: 0:31

Hello. Thanks for listening in.

Speaker 2: 0:33

Business manager, professional comedian, and , uh, really the heart and soul of this show. And so all complaints should be sent to Donna. That's

Speaker 3: 0:39

Right. All the complaints are usually about you.

Speaker 2: 0:41

Yes, they are

Speaker 3: 0:42

<laugh> , but okay.

Speaker 2: 0:44

This show is brought to you by N AAU Urology Specialist. The urology specialty group that I started in 2007. Mm-hmm. <affirmative> , uh, Donna, why don't you tell people how to become patients of ours and how to get ahold of us ?

Speaker 3: 0:53

That's right. You can call us during the week at 5 1 2 2 3 8 0 7 6 2. You can even ask for me if you'd like. Our website is armor mens health.com, where you can see our shiny smiling faces there. You can also submit a question that will answer anonymously to armor mens health.com. We , our podcasts are wherever you listen to free podcasts. You know, we've had over 122,000 downloads in the short time. We've had the podcast

Speaker 2: 1:14

Only three years,

Speaker 3: 1:15

Uhhuh , almost three years. So that's a lot of dang downloads.

Speaker 2: 1:18

That's a lot of downloads. So, well, we're really happy to have our listeners on board , and you are not gonna want to miss this episode . Mm-hmm. <affirmative> , we are breaking new ground today, Donna. I know. You know, this is , this is the very first time that I've ever had a urologist that practices within stones throwing distance here. That was not part of my practice. Is

Speaker 3: 1:35

Our new nemesis friendly nemesis? Is that what

Speaker 2: 1:37

You're saying? It's almost like I'm growing as a man. Oh ,

Speaker 3: 1:40

<laugh> as a human.

Speaker 2: 1:42

I'm growing as a man. It's like, it's like when you allow your wife's ex-husband to come to Thanksgiving dinner . Oh, I see. That's kind of the energy here. I see, know what I'm saying? This

Speaker 3: 1:52

Group though, that our special guest is from, is the , what we always reference when we say we're the second largest group town.

Speaker 2: 1:57

That's correct. Town. So they're from the largest group largest I , Dr. Brian Kansas with us today. You welcome Brian . Thank you so for joining us today.

Speaker 4: 2:03

Hey, sunny , thanks so much for having me and Donna, great meeting you. We've been emailing and texting and whatnot . Uh, yeah, I never thought about that, but yeah, you are the second biggest group in Austin

Speaker 2: 2:14

<laugh> . Oh, thank you for not thinking about it. But you won't forget it now, baby, but

Speaker 4: 2:18

I think I think about you all the time, though. That's right. It's the second biggest, especially as we , uh, linger in the , uh, Seaton Northwest doctors lounge waiting around for stuff. And That's correct. We're playing jokes on each other, so . Oh, how funny . That's always fun.

Speaker 2: 2:31

So Brian , um, you know , uh, you probably have the second best sense of humor for any urologist in this room, <laugh> . And so , uh, I , I , I thought that you would be a fascinating , uh, person to have on the show , uh, because you really exhibit a lot of the characteristics that make me , uh, love being a urologist. You're , uh, very lighthearted. You're an excellent surgeon and , uh, someone who I have , uh, tremendous respect for. So , uh, thank you so much for joining us today.

Speaker 4: 2:55

My pleasure, sunny . And yeah, I would actually say behind you, I'm the second funniest urologist and possibly in the world <laugh> . That's right . So, yeah, there you go.

Speaker 2: 3:04

He fits right in already. What I wanted to talk to you about today was , um, about males, men, and kind of their own opinion of the size of their genitals, because I feel like it's something that we hear about as urologists, and then not all of us take seriously as a complaint and not seriously have taken a lot of efforts in kind of , uh, addressing. So the first thing I wanted to talk about is, well , what do you think some of the most common complaints that you hear from men about their genitals?

Speaker 4: 3:38

Well, you know, the obvious ones are function. You know, that's the one that you hear the most. Um, it's cosmetic, sometimes different , uh, uh, issues with the skin, different issues with curvature. Um, so we're talking about erectile dysfunction and Peyronie's disease. Those are the common ones. But the one that we also as urologists see quite frequently is , uh, size complaints. Um, we have been able to address erectile dysfunction and Peyronie's for many, many years. Um , there's different therapies for all of those things as far as Ed is concerned. We have the old go-tos, like Viagra and Cialis, et cetera , vacuum pumps , um, injectable therapy, even shockwave therapy now, which I think both of our practices offer. Uh, and of course, penile implants and

Speaker 2: 4:29

Penile implants. The , uh, especially the three piece inflatable penile prosthesis is something that you've done literally thousands of. Right?

Speaker 4: 4:36

Uh, yeah. I've done about 1400 at this point in my career , um, going back and adding them all up. And so that's a pretty common procedure. And , and

Speaker 2: 4:44

It was invented where

Speaker 4: 4:45

In Houston at where, oh boy, I believe it was where you did your residence , was at Baylor. Baylor. Find

Speaker 2: 4:51

This institution. That's weird that I somehow can bring it in every conversation. It's

Speaker 4: 4:55

Weird. It always, it always comes back to Baylor Houston. Yeah .

Speaker 2: 4:58

Being, being invented at Baylor College of Medicine in Houston. It's, it's , uh, you should be really proud that my forefathers allowed you to have such an amazing career.

Speaker 4: 5:06

I am , I am glad to. I'm actually glad to tell people that the , the man who invented that was from Texas. That's right. Uh , so that's good. So that's pretty cool. It's unfortunate These are bigger in Texas.

Speaker 2: 5:17

In Texas. In Texas. That's right. Yeah. So these three piece penile prosthesis are machines that we install into the human body. There's not a lot of machines that we've been installing into the human body for 25, 30 years. Is that

Speaker 4: 5:30

Right? No, I mean , it's, it's , it's on the level of, you know, pacemakers and, you know, bladder stimulators as important fact . Well, actually, I think if you talk to most men, they would say it's far more important, more , um, would you rather your heart or your wiener work? And

Speaker 2: 5:43

It's the only reason that the heart exists is to pump blood , blood to

Speaker 4: 5:45

Pump blood to the wiener.

Speaker 2: 5:47

So, so , so when it comes to , uh, your experience with implants and prosthetics, this is something that not all urologists are necessarily comfortable with, right? Right.

Speaker 4: 5:57

Uh, no. I mean, I think that the, the more of them that , uh, a urologist does, the more comfortable they become, and , uh, being able to, you know, in my practice doing somewhere in the 80 to 120 a year , uh, range, it makes me super, super comfortable with them. So there are some of us that consider ourselves to be what are called prosthetic urologists, and that includes things like , uh, penile implants and artificial urinary sphincters for male incontinence. Um, and that leads you down the pathway when you do this, that you end up seeing a lot of Peyronie's disease. And so you become very comfortable with repairing Peyronie's disease surgically and even non-surgically.

Speaker 2: 6:36

So when it comes to like a , a , a man's own like willingness to show you and , uh, describe issues that he has with his penis , uh, we also get to that issue of both length and girth. Uh , w what are some of the common concerns and complaints that you hear? How do men kind of approach you?

Speaker 4: 6:53

Well, you know, when we do an , uh, a consult for a penile implant, they have to realize that, you know, the girth is not gonna be exactly the same. The length is not gonna be exactly the same. However, when we have patients that come in that have perfectly normal erectile function, but they're concerned about the size of their penis, that is when we have specifically a length and girth discussion , um, as far as length and girth goes, there's really not a great procedure to increase the length. We have patients ask us all the time about, you know, cutting the suspensory ligament, which , uh, sometimes works and sometimes doesn't. The downside of the suspensory ligament , uh, release is that often it will scar and it will actually retract the penis and it will do the exact opposite. Um, in addition, if it does work, that suspensory ligament is responsible for the erect penis actually going up. So when we have a successful suspensory ligament release, they hang down the erection, they hang down, the erection actually points down. That's right. And so , uh, we have to describe that

Speaker 2: 7:55

To the , and when you , when you're lying on your back, you have to kind of use your hand to kind of bring it back up. I mean, allegedly , uh, yes , yes . To ,

Speaker 4: 8:04

To , well, I mean, yours, yours was a very successful release <laugh> . And besides that, though, yours was so big, it hung down anyway, right. <laugh> , it was so weird. It so , so weird . Don't do it. Um , so , uh, anyway , so I, I actually don't offer ligament release and I, I often talk patients out of ligament release , um, uh, when, when they do ask me about it. So that brings us to other , uh,

Speaker 2: 8:27

So we don't have a really great way of making it longer except for weight loss, which I cannot, I cannot underemphasize. And you also do the ectomy, which is the buried penis release, where you can kind of take away some of the fat at the base of the penis alt to give at least the visual appearance of length. But you're not necessarily, quote unquote making it

Speaker 4: 8:47

Longer. No, you're, you're correct. And oftentimes , I'll actually see a patient either for my penis, you know, the consult is for my penis is , is shorter, or , um, my , I , you know, I can't even see my penis. Um, what can I do? Um, and I'll do the consult and I'll examine them and they walk out. And the plan is just simply weight loss. And I tell patients all the time, every 25 pounds you lose, you're gonna pick up a half an inch of penis. And it's true, you can actually press on their super pubic fat pad and it sticks out an inch, inch and a half, two inches. And so it's interesting that men sometimes are not motivated to lose weight until they're told, Hey, your wiener can be bigger. And so they actually will go and they'll do that , uh, for some guys, did you just

Speaker 2: 9:33

Hire a woman that's very attractive in the office that looks at everybody's penis and says, you know what, you should lose 25 pounds? Oh

Speaker 4: 9:40

Lord , I vote, I vote that Donna does those concept.

Speaker 2: 9:43

Oh boy, Donna, I'm in second job saving , high

Speaker 3: 9:46

Up saving penis is one by one. That's right .

Speaker 2: 9:48

And those men that come to you and, and describe kind of a , uh, an inferior girth , inferior length, would you say that most of them probably have normalized penises?

Speaker 4: 9:57

Yeah, actually the, the vast majority of the consults that I see for any type of size enhancement, they have average size penises. Absolutely. Their length is between four and a half and five and a half , uh, inches erect. And their girth is somewhere between three and a half and four and a half , uh, circumferentially inches.

Speaker 2: 10:16

But nobody wants to be average. So we're gonna talk about , um, procedures that you perform that I do not perform, which is why my ego will allow you to be on this show <laugh> , uh, that , uh,

Speaker 4: 10:27

You're very honest ,

Speaker 2: 10:28

That you do for , uh, for penal gerth . Uh , so we'll be right back, but just before we leave, how do people get ahold of you? What is your website and your phone number?

Speaker 4: 10:35

So our website is urology austin.com and our phone number is (512) 231-1444.

Speaker 2: 10:43

And that's Dr . Brian Kansas. And we're gonna be right back after this small break. Hello and welcome back to the Arma Men's Health Show. This is Dr. Mystery , your host, board certified urologist. This is a men's health program brought to you by N A U Urology Specialist, the practice I started in 2007 to bring you holistic urologic care. I'm joined by my business manager and friend and co-host Donnel Lee .

Speaker 3: 11:06

That's right. Hello. Welcome to the show. I , um, was just talking about the dirty toss that we have.

Speaker 2: 11:11

Very nice <laugh>, but you do not get paid for on my die . Apparently not. So your tax dollars are not going for her. TikTok

Speaker 3: 11:17

<laugh> , I'm Dr. Donna, by the way. You're

Speaker 2: 11:19

Not Dr. Donna. Donna, how do people get ahold of us? How do become a patient

Speaker 3: 11:22

Of ours? You can call us during the week at 5 1 2 2 3 8 0 7 6 2 . You can even ask for me if you'd like, our website is armor mens health.com. You can submit your questions there, we'll answer them anonymously, and we just thrive on those questions. So thank you ahead of time for sending them. And we're located in Round Rock, north Austin, south Austin and Dripping Springs. We , they , they love dripping and we're trying to fix that. Don't know why they keep promoting that, but

Speaker 4: 11:43

It's typically fixable.

Speaker 3: 11:44

Yeah, right. We need to teach the people of dripping springs to not be dripping.

Speaker 2: 11:48

No , be dripping. So , um, we are joined again by a wonderful guest host , uh, Dr. Brian Kansas with Urology Austin. Brian , thank you for joining us today.

Speaker 4: 11:56

Thanks again for having me. Sunny . Whenever

Speaker 2: 11:58

I look at you, I think about small penis. So <laugh> , uh, I think that it's , uh, just an excellent idea that, that you would join us today. I'm sure that you've , uh, heard that from most of the women you've been with. Uh , I thought that we could talk a little bit about, oh geez , about male enhancement. It's something that we've brought up a lot on this show because I think a lot of men are embarrassed to bring it up even when it causes them significant distress. So I thought what we'd start with is what are some of the men that you think that suffer unnecessarily in silence when they're not happy with how they look or how they feel about their genital size?

Speaker 4: 12:34

Well, first of all, I think that , uh, judging by the cars that you and I drive, I think we both probably have small wieners, <laugh>. Um, but that's fine . Thank you

Speaker 3: 12:42

For getting him back, Dr . Curtis .

Speaker 4: 12:43

Not problem. Good job. Um, so anyway, the , the guys that we see, you know , again , like we talked about in the first segment, you know, most of the guys that we see are , are average. Uh, there's , uh, the , the implant that I use is called a Panum implant. Um, there are several things that , uh, can be done for size enhancement, mostly girth enhancement. And there are fat injections, fat flaps , uh, injections of hyaluronic acid , and there are some other injections. Most of the time, the fat injections and the fat flaps really, it's, it's near impossible to make them look , uh, smooth. Uh ,

Speaker 2: 13:12

They look real bumpy, right? They

Speaker 4: 13:13

Look very bumpy and lumpy. Um, the hyaluronic acid and the other types of injections , um, in the hands of somebody who's technically very skilled at that, they actually can , uh, look pretty good. Uh, so those, I've seen some of those and they actually look pretty nice, but it's a little few and far between. I believe that they're , that , uh, someone you work with does some injections, and I've seen some of those and they look, they actually look very, very nice. The downside of , um, some, some of the injectable stuff is that they're not , uh, a permanent solution, whereas panum is more of a permanent solution. It's more of a one and done . Um, the Pan Noa implant is a soft silicone implant, and the way that this is done is we make a small , uh, incision in the side of the scrotum, and then we flip the penis inside out, degloving it from the inside. I ask the patients , please don't watch the video, because it's rather terrifying. Yes . You

Speaker 2: 14:02

Wanna watch that video? Trust me. It's like seeing

Speaker 3: 14:04

The , is that like skinning a cat? It's

Speaker 2: 14:06

Like , it's , it's like seeing , it's like seeing a cat skinned and then re then , then reun skin . Oh my god,

Speaker 5: 14:11

My tee hurts and putting hurts and I don't have a tee

Speaker 4: 14:13

Tee . Oh , exactly. So , um, and then what we do is we take the implant and we edge it up as close to the head as we can. We sow it in distally. We custom trim the back of it to make it to the size of the penis. What we end up seeing is we end up seeing about an inch and a half to two extra inches of flacid length. We see about an inch and a quarter to an inch and a half more flacid and direct girth. We typically tell patients that the erect length stays about the same. There's a small percentage, maybe about 10 to 15% or so that we'll see some length enhancement over the course of a year. Uh, there's a very small percentage, about two or 3% of people that will lose a little bit of length. But we do all kinds of things to prevent that.

Speaker 2: 14:50

So wait, wait, wait, wait, wait. You're telling me that there's a surgery where we can implant essentially a silicone penis implant? Is that right,

Speaker 4: 14:58

Brian ? It's a breast implant, but for the wiener, oh ,

Speaker 2: 15:01

I mean, this

Speaker 4: 15:02

Is spectacular shaped differently. It's shaped

Speaker 2: 15:04

Differently,

Speaker 4: 15:05

Shaped like a wiener, and it's shaped like

Speaker 3: 15:06

A wiener

Speaker 2: 15:07

<laugh> . It's , it takes all the scientific knowledge that we have gained from making women's breasts bigger to make our penis bigger. And I think that's spectacular because it's almost like all surgeries are for us.

Speaker 3: 15:18

Wow. Well , at least it wasn't shaped like a breast. What do ,

Speaker 2: 15:21

For the winter , what do you think

Speaker 4: 15:21

That would look bad?

Speaker 2: 15:22

What do you think are some of the, the , the things that, that, that kind of limit the medical profession in general, adopting this type of kind of scientific and surgical pursuit?

Speaker 4: 15:36

Well, anytime a new surgery comes out, there are hardships. Um, when people started putting breast implants in, that was difficult. When Dr . Uh, Scott in Houston came out with a penile implant, that was terrifying experience and very difficult. And there were a lot of naysayers. You know, Dr. Jim Ellis invented this. He lives out in Los Angeles, he's been putting them in for about 15 years. He started training other surgeons only about four or five years ago. I've been doing this for about two and a half years , um, at this point. Uh, so there's a lot of naysayers. So when we go to sexual medicine society meetings, there's a lot of pushback. But as we expand, and there are more and more surgeons that are doing it , the plan is to, right now there's 11 surgeons I believe that do these around the country. What

Speaker 3: 16:18

Is their argument? The opposition? What ,

Speaker 4: 16:20

What do they say ? Um , the , the potential downsides, you know, if these get infected or if they scar, they retract or potentially cause ed, although the ED rates are incredibly low , um, the sensitivity loss rates are incredibly low as well. So it's, it's the potential side effects. So the potential side effects of breast implants with infection or capsular contraction, those are the things that were dealt with years and years ago. Same thing with penile implants. The infection rates were incredibly high in the beginning , uh, but now infection rates for penile implants are in the neighborhood of 1% or so. Infection rates for panum are low. It's about a percent and a half.

Speaker 2: 16:57

I think that there's a bigger kind of , uh, reticence to do anything that helps men feel and look better because it's not considered necessarily life-threatening. And in some degree, I think people think that it's predominantly psychological thing that, that, that men's penises are small. But I think that, you know, the argument when it comes to women's plastic surgery and things of that nature, I think we've gotten past that. Mm-hmm . <affirmative> how people want to feel about themselves is more important than necessarily what society thinks you should think is important.

Speaker 4: 17:27

No , I, I agree with that a hundred percent. And now though, that there are several hundred thousand boob jobs done a year in the United States, and in fact, a lot of girls get boob jobs for their 16th birthdays. Um , so why can't a man have the same thing?

Speaker 2: 17:42

And so, you know, to make yourself feel better about yourself, to make yourself feel better about how you look when you're naked, how to make yourself feel , uh, more sexually kind of appetizing or appealing to others. I think these are, you know, things that a man has to kind of explore on their own. And so I think that's a lot about the re , you know, speaks to the reticence of people kind of pursuing this. So, so essentially somebody's gonna go , come to you and want a consultation who would not be a candidate for a

Speaker 4: 18:08

Panum? So, I'll, I'll, I'll kind of backtrack a little bit. The screening process for a panum, there's an initial , uh, soft psychological evaluation and then potentially a , uh, a , a meeting with a psychologist as well to make sure that people are mentally prepared for this. The screening that goes on for panum is actually far more intense than the screening for any female cosmetic procedure in certainly in most people's opinions. Okay. So basically the only , uh, we have to have a circumcised penis. So patients , uh, if they're uncircumcised , uh, they have to get circumcised first, and we certainly can do that. Um, the downside to the uncircumcised penis is the skin does not roll back over the much larger girth. And so it just doesn't look quite good. Dr. Ellis did some early, early on, and they just did not come out good.

Speaker 2: 18:54

So if they want auma, they may have to have a

Speaker 4: 18:56

Circumcision, they may have to have a circumcision. And then we also, as far as other enhancements that have been done, if somebody's had fat graft or if they've had hyaluronic acid or other injections , uh, we used to tell people that that was an absolute exclusion criteria. Uh, we, we take them on a case by case basis at this point. Um, we will , you'd

Speaker 2: 19:16

Like to have virginal tissue plans when you put it in?

Speaker 4: 19:18

Exactly. And we tell patients that, look, the dissection may be really hairy. We may get through the skin, we may have to stop, but by exam we can see and feel whether or not they would be a candidate.

Speaker 2: 19:28

How long does the surgery take? They

Speaker 4: 19:30

Take about 45 to 60 minutes. Oh ,

Speaker 2: 19:32

Wow. And then afterwards , uh, what's the recovery like before you can actually use it or take it out for a spin?

Speaker 4: 19:37

So I te <laugh> , I tell patients that , uh, we do these , uh, I do them on Tuesdays or Wednesdays. Uh, I leave a wrap on the penis and scrotum. Uh, they can take in my practice, they can take that off the next day and take a shower. I leave a bulb suction JP drain for two nights. I take the drain out. They use a product called Euro Wrap , um, which is a compressive dressing. It's like a sleeve that goes over the , uh, penis. It's like pulling a sock up over your calf. Nice. We do that. I'm actually wearing one right now, Sonny <laugh> . Um, and , uh, can't you tell? And uh, we do that for about six or seven weeks, and then I follow up with them at seven weeks and I clear them for , uh, sex. I tell them for about the first four months, the capsule has not completely formed around the implant. And so it potentially could shift. So they should use a little bit of lube, have gentle, what I refer to as gentle married people, sex <laugh> . And then I tell them

Speaker 2: 20:30

Basically in God's case, that's not , that's just watching television. <laugh> .

Speaker 4: 20:35

Yes. Do we live in the same house? <laugh> ? Um, and uh, then I tell them , uh, at six months, Vegas sex is perfectly legal, so they can just do whatever they want .

Speaker 2: 20:44

Wow. God , that's crazy. God , I know my foreplay

Speaker 3: 20:46

At the house is hurry up and I got things to

Speaker 2: 20:49

Do. Hurry, I got things to do. This is an out-of-pocket procedure about how much do you charge

Speaker 4: 20:53

For it? So this, yeah, it is out of pocket . Uh , I charge a total of 16,000 , uh, which covers anesthesia, the surgery center, the implant itself, and then my surgeon's fee. Well ,

Speaker 2: 21:04

Uh, Brian , this is truly revolutionary in terms of just kind of the idea of introducing implants in for penile growth. I , I really can't thank you enough for introducing our listeners to it. I'd love to have you back some time to talk more about it. As your experience kind of gets better and you have more to share with our patients. How do people get ahold of you if they're interested in a panum consult ?

Speaker 4: 21:23

Y yet , it's Dr. Brian Kansas with urologyAustin@urologyaustin.com and our number is 5 1 2 2 3 1 1 4 4 4.

Speaker 2: 21:34

Brian , we can't thank you enough for joining us. Thank you so much. Thanks

Speaker 4: 21:36

So much , sunny. This was great.

Speaker 1: 21:37

The Armor Men's Health Show is brought to you by NAU Urology Specialist. For questions or to schedule an appointment, please call 5 1 2 2 3 8 0 7 6 2 or online@armormenshealth.com.