Penis Enlargement Surgery Leads to Man's Death: What Went Wrong?

A man in Sweden died just after penis enlargement surgery, according to a new report of the case.

As a part of the procedure, doctors injected fat into the healthy 30-year-old man's penis, according to the report, written by pathologists who examined the man's body after his death. Some of this fat entered the man's veins, and then traveled through the blood to his lungs. When fat droplets enter the small blood vessels in the lungs, they can cause blockages, and the body can't properly absorb oxygen, leading to death.

This type of blockage, called a fat embolism, is a known risk of moving fat from one part of the body to another, said Dr. Lee Zhao, a urologist at NYU Langone Health in New York City, who was not involved in the man's case. Still, "it's an extremely rare event," Zhao added. [8 Wild Facts About the Penis]

But it's not clear from the case report exactly where in the penis the fat was injected, Zhao told Live Science.

"The penis works by filling erectile tissue with blood," Zhao said. "If the fat was injected into the erectile tissue, then the risk of fat embolism would be much higher." Instead, fat should be injected just under the skin of the penis, rather than into this tissue. But it's unclear whether the plastic surgeon involved in the man's case "inadvertently" injected the fat into the erectile tissue, he said.

Zhao also noted that this type of "penile enhancement" surgery had limited benefits.

The type of procedure that the man had involves two steps, Zhao said. During the first step, surgeons cut a penis ligament called the suspensory ligament, which makes the penis appear longer in its flaccid state. In the second step, the surgeons inject fat to increase the bulk of the penis.

Neither part of the surgery improves a man's erectile function; instead, the procedure alters only the appearance of the penis when it is flaccid, Zhao said. In addition, the procedure may in fact have a negative impact on sexual function, because doctors need to cut the suspensory ligament. This "ligament acts to allow the penis to aim forward, and cutting [it] can cause the penis [to] hang downwards," Zhao said.

It's not clear how many patients undergo this type of surgery in the U.S., Zhao said. Because the procedure is generally not covered by insurance, many patients opt to have the operation in other countries, where it may be cheaper, he said.

"I specialize in treating the complications of this procedure, and I find that many of my patients had surgery in Mexico," Zhao added.

The report was published July 27 in the Journal of Forensic Sciences.

Originally published on Live Science.