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In this article we report the results of a retrospective study of 355 cases of cosmetic elongation, enlargement and combined elongation and enlargement phalloplasty. We found a significant improvement in length at rest, stretched length and circumference at rest at 2, 6 and 12 months post-surgical procedure (all p\u2009&lt;\u20090.0001). 5-item International Index of Erectile Function (IIEF-5) was also increased at 12 months post-surgery compared to baseline (p\u2009&lt;\u20090.0001). This was consistent with an IIEF-5 improvement of 6.74% compared to baseline. This study is clinically relevant due to the large cohort of patients included and because it is the first study to use an inverse periosteal-fascial suture not described previously as part of the surgical methodology.<\/jats:p>","DOI":"10.1038\/s41598-019-41652-w","type":"journal-article","created":{"date-parts":[[2019,4,19]],"date-time":"2019-04-19T10:02:29Z","timestamp":1555668149000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Cosmetic penile enhancement surgery: a 3-year single-centre retrospective clinical evaluation of 355 cases"],"prefix":"10.1038","volume":"9","author":[{"given":"Alessandro","family":"Littara","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Melone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julio Cesar","family":"Morales-Medina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tommaso","family":"Iannitti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beniamino","family":"Palmieri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,4,19]]},"reference":[{"key":"41652_CR1","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1037\/1524-9220.7.3.129","volume":"7","author":"J Lever","year":"2006","unstructured":"Lever, J., Frederick, D. & Peplau, L. 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