Fuuuucked up! This is from Enlargement FAQ (Version 2). Emphasis is mine.
What Is Saphenous Vein Graft Surgery?
Saphenous vein graft surgery involves removing a section of your saphenous vein and grafting it onto the tunica albuginea to enlarge its capacity. The saphenous vein, which runs down the inside of the thigh, is easy to access and sections of this vein have been used as the conduit of choice for heart bypass surgery for decades.
The tunica albuginea is the thin but very tough elastic tissue that encases the corpus cavernosa. If the penis were a blood vessel, the tunica albuginea would be its wall. More than any other component, it is the capacity of the tunica albuginea that determines your dick's size. The skin will stretch larger and the corpus cavernosa will grow to fill the space. Expand the tunica and you expand the dick. At least that's the theory.
The saphenous vein makes an ideal donor material for tunica grafts because the tissues are very similar in structure and thickness. Because it's so thin, the graft quickly establishes a blood supply from the underlying lumen of the corpus cavernosa. And because it's a vein, its endothilium lining releases anticoagulants that prevent the formation of hematomas which could cause contracture and bending.
It's a two stage procedure. Like dermal grafts, the first step is to harvest the donor material. Two small incisions, about one foot apart, are made in the upper thigh. The vein is cut one at one incision and pulled out through the other. It is then cut in half and each piece is dissected along its length. The resulting pieces flattened out are about half-an-inch by 6 inches.
Then, as in graft augmentation, a circumferential incision is made behind the glans and the penile skin is pulled back to the pubis. An incision is then made along the length of each corpus cavernosum from head to base. The grafts are then stitched into each side of these incisions. The overlying skin is then pulled back up the shaft and sewn into place.
Does Vein Graft Sugery Work?
According to one Egyptian doctor, a patient went from a girth of 11.5 cm (4.5") to 19.5 cm (7.7"). Just so you know. that's about the width of a beer can. Hmm. I emailed the doctor to ask for clarification on this figure but failed to get a response. I was prepared to write off the result until I stumbled across a follow-up study of 37 men who had undergone the operation. Measurements were taken 9 months after surgery and while there were no meaningful increases in flaccid diameter, the increases in erect diameter ranged from 1.1 cm (0.4") to 2.1 cm (0.84"). That's diameter, folks; presumably measured at the point of greatest width. In terms of circumference, that translates to a gain of 2 - 2.5 inches. If somebody's not fudging the results, saphenous graft surgery is by far the most effective means of girth enhancement currently available.
Another advantage vein grafts have over dermal or AlloDerm grafts is that you're not required to wear a dick stretcher for six months after the surgery. The penis also looks proportional when flaccid. No little wiener head sticking out of a bun.
What Is The Downside Of Vein Grafts?
It depends on what you want from the surgery. If you're looking to show off in the locker room, this isn't going to help you. This is also very invasive surgery. You're not just laying tissue over a de-gloved penis. You're actually slicing open the most important part of your dick. You're looking at a longer healing period for the penis itself and you'll have to contend with scarring at the incision sites, although these should be much less pronounced than with dermal grafts.
There is also the possibility, given the volume increase in the erectile chambers, that your erections will not be as hard as before. This has not been mentioned in the literature for girth enhancement, but it has been discussed as a side effect in other vein graft surgeries on the tunica albuginea.
How Much Does It Cost?
Hard to say. As yet there are no clinics (in North America, at least) that were offering this surgery. It's very new and still controversial. In fact, at the time of writing there was only one doctor in the world with extensive experience in this procedure. His name is Prof. Eduardo Austoni. He teaches urology at the University of Milan. If you're in town, look him up. At some point, barring unforeseen problems with the procedure, it will be performed around the world. Given the complexity of the work required you'll probably be looking at cost anywhere from US$6000 - US$12,000.