OUR SERVICES
Genital
For Men
Dr. Tawfik offers a variety of genital surgeries for men who are looking to improve the appearance and function of their genitals.
Erectile Dysfunction
Erectile Dysfunction, sometimes called ‘impotence’, is the repeated inability to get or keep an erection firm enough for sexual intercourse. The word ‘impotence’ may also be used to describe other problems that interfere with sexual intercourse and reproduction, such as lack of sexual desire and problems with ejaculation or orgasm. Using the term erectile dysfunction makes it clear that those other problems are not involved.
Damage to nerves, arteries, smooth muscles, and fibrous tissues, often as a result of a disease, is the most common cause of erectile penile dysfunction. Diseases such as diabetes, kidney disease, chronic alcoholism, multiple sclerosis, atherosclerosis, vascular disease, and neurologic disease, account for about 70 percent of erectile dysfunction cases. Between 35 and 50 percent of men with diabetes, experience erectile dysfunction.
Often, the onset of gynecomastia occurs during adolescence and may resolve on its own. However, in some cases gynecomastia can persist into adulthood, or develop with advanced age. Gynecomastia is most commonly caused by hormonal fluctuations. In addition, the ongoing use of certain medications (e.g., steroids) can stimulate hormonal changes that cause gynecomastia. Chronic use of certain drugs such as marijuana can also cause the development of gynecomastia, as can major weight fluctuations.
Dr Tawfik recognizes that gynecomastia can negatively impact individuals’ emotional wellbeing. The good news is that he offers male breast reduction surgery, or gynecomastia treatment. Male breast reduction is designed to sculpt the chest area, improving the contour of overly large male breasts. Treating gynecomastia does wonders to improve male patients’ self-esteem and confidence, as well as their overall quality of life.
My Story
What causes erectile dysfunction?
Defects preventing an appropriate erectile tissue response can interfere with reproductive capability. Erection of the penis is a hemodynamic action that tissue of the corpora cavernosa and the corpus spongiosum. This tissue consists of smooth muscle, endothelial cells, fibroblasts, and nerves that interact in order to enhance and maintain an accessory blood supply causing erection. Given the need for the blood flow during this response, it is clear that vascular insufficiency can decrease erectile capability. In fact, vascular insufficiency may be a common pathology of erectile dysfunction. It is estimated that up to 80% of the cases of erectile dysfunction can be attributed at least in part to a reduced blood flow, typically due to an underlying vascular disease. Pharmacological methods have been used to treat erectile dysfunction including the use of vasodilators. Such vasodilators include Viagra and Cialis. However, vasodilators induce only a temporary response and are not effective in many patients due to the underlying endothelial damage. Not to mention the fact that these medicine can have serious side-effects including heart attack, stroke and may even cause death. Therefore treatments like Platelet-Rich Plasma (PRP) Procedures that address tissue defects and/or vascular disease aspects of erectile dysfunction may provide a longer term therapy or even provide a permanent effect in comparison to other treatments.
Diabetes
Erectile dysfunction is significantly common in men who have diabetes which damages nerves and blood vessels. Erectile dysfunction can also be linked to other conditions common in men who have diabetes, such as high blood pressure and coronary artery disease. ED is three times more common in patients with diabetes mellitus. ED in diabetes strongly correlates with the level of glucose control, duration of disease and diabetic complications.
Some of the causes other than diabetes are:
- Metabolic syndrome (a condition involving increased blood pressure, high insulin levels, body fat around the waist and high cholesterol
- Obesity, chronic inflammation,
- Low testosterone levels
- Tobacco; Alcoholism and other drug abuse
- Heart disease, High blood pressure, neurological disease
- Peyronie’s disease (development of scar tissue)
- Parkinson’s disease, Multiple sclerosis disease
- Surgeries or injuries that affect the pelvic area or spinal cord
- Medications such as antidepressants, antihistamines and medications to treat high blood pressure, pain or prostate cancer.
- Emotional or psychological causes including Depression, Stress, anxiety or other mental health conditions
Erectile Dysfunction diagnosis
A comprehensive medical history and a physical exam are needed before we can diagnose and recommend appropriate treatment for ED.
Some of the tests that we may do to diagnose the underlying cause of you ED include:
- Blood tests to check for anaemia, diabetes, low hormone levels, liver or kidney disease and any other medical problems.
- Tests to diagnose any underlying vascular disease.
- Ultrasound to check blood flow to the penis. It involves using a wand-like device (transducer) held over the blood vessels that supply the penis.
- Test for Endothelial Integrity – This test is sometimes done in combination with an Ultrasound to determine if there is an increase in the blood flow in response to the medication.
Treatment for
Erectile Dysfunction
Drugs and pharmacological methods have been used to treat erectile dysfunction including the use of vasodilators. Nitrous Oxide enhance vasodilators include Viagra, Levitra and Cialis. However, vasodilators induce only a temporary response and are not effective in many patients due to the underlying endothelial damage. Not to mention the fact that these medicine can have serious side-effects including heart attack, stroke and may even cause death.
Other options include – Injectable medicine like Alprostadil, Caverjet, Edex, Alprostadil penis suppository intraurethral (MUSE) and Testosterone replacement (cream or injectable). Penile pumps or a vacuum constriction device and Penile Implants may be options for some patients.
Today, Regenerative Medicine offers you a new approach : Stem cells from your own fat or bone marrow, Platelet rich plasma (PRP) from your own blood can be used to repair the problem.
Stem Cells
Stem cells are cells found in every part of the body. These cells function as regenerative and repair cells in our bodies, replacing damaged cells and repairing injured tissues.
This procedure, we use your own adult bone marrow stem cells as well as mesenchymal stem cells found in high concentrations in the fat are used to rejuvenate, to repair and to regenerate the penile tissues.
We only use your own (Autologous) Adult stem cells. All of your cells are used during this same procedure. We do NOT store or culture these cells. Also, we do NOT add any medicine (e.g. growth hormone or any sort of steroids) or chemicals or modify or manipulate these stem cells, and we do NOT use LED or other light source.
Most physicians in United States do NOT practice stem cell therapies as we do. It is important to follow safe and FDA allowed guidelines when performing these procedures.
Because YOUR OWN bone marrow, fat and blood cells are being used at our clinic, there is no risk of any transmissible infection or tissue rejection by your body.
Adult (Autologous)
Stem cells – Your Own Cells
Stem cells are distinguished from other cells by a few important characteristics:
they have the ability to self-renew and they have the ability to divide for a long period of time
- In appropriate conditions, they can differentiate into other specialized cells including heart cells, liver cells, bone cells, cartilage cells, nerve cells and other cells.
Adipose (Fat)
Derived Stem Cells – ADSC
Adipose Tissue (Fat) is very rich in stem cells; primarily mesenchymal stem cells. Fat harvesting for ADSC therapy is done with a very simple process called lipoaspiration. It is important to understand that lipoaspiration is vastly different from liposuction. Liposuction removes a very large volume of fat and is intended for a cosmetic result. Lipoaspiration uses the BODY-JET Technology to harvest 75cc of your own fat, the harvested fat goes into the safest and most sophisticated apparatus in the world called the Q-Qraft, collecting 30cc of stem cells containing millions of cells collected just by mechanical separation and no collagenase used
Bone Marrow Stem Cells
Bone marrow contains stem cells; primarily hematopoietic stem cells. Bone marrow is harvested from the hip (iliac crest) using local anaesthetic and a specialized needle. It is important to understand that bone marrow harvesting for BMAC is vastly different from bone marrow harvesting for transfusion for cancer therapies. In bone marrow harvesting for transfusion, a haematologist, oncologist, or surgeon removes a very large amount of bone marrow. BMAC requires only a very small amount of bone marrow. Surprisingly, the procedure is not painful, takes under ten minutes, and causes only mild soreness afterward. It has an excellent safety profile.
Platelet-Rich Lysate (PRL)
PRP is an acronym for Platelet-Rich-Plasma, which is essentially blood without the red blood cells. Platelets are cells found in the blood that are essential for clot formation and wound healing. PRP, the mix of concentrated platelets and serum, contains factors that promote repair of tissues. PRP is injected into the targeted area for repair.
Packed with growth and healing factors, platelets initiate repair and attract the critical assistance of stem cells. PRP therapy natural healing process, by providing required growth factors, intensifies the body’s efforts to renew and rejuvenate your aging face. To create PRP therapy, a small sample of your blood is drawn (similar to a lab test sample) and placed in a centrifuge that spins the blood at high speeds, separating the platelets from the other components. The concentrated platelet rich plasma (PRP) is then injected into and around the point of injury, jump-starting and significantly strengthening the body’s natural healing signal.
Results are usually visible in 2 to 4 weeks and improve gradually over months with improvement in erection and performance. Expect minimal swelling, bruising and redness for 12-24 hours after the procedure. There can also be some pinkness or redness of the skin following the therapy. Treatment results vary and some patients may require PRP booster, however in most patients the results last for several years.
No. There are no scalpel or knives used in the procedure. Specially designed blunt instruments are used to inject the fat and stem cells to sculpt the body areas as desired.
No. The procedure is minimally invasive and does not require general anaesthesia. We use local anaesthetic solution (lidocaine) to numb your skin. For very anxious patients, an oral sedative may be given.
Yes. Since it is your own body’s tissues that are used, there is no allergic or adverse reaction or rejection that can happen from the stem cells. Also, since there is no need for general anaesthesia, serious risks associated with general anaesthesia and being put to sleep are eliminated.
Most patients report feeling mild pressure during the injection that is controlled with local anaesthesia and Pronox. There may be some soreness in the areas treated for up to 5 to 7 days after the procedure that does not require pain medication.
You will be able to resume your normal daily life immediately, limited by the degree of swelling that you experience after the procedure. Most patients have noticeable swelling in the areas treated from 5 to 7 days depending on the extent of the procedure and individual healing response.
The results should last for several years. The results are affected by your lifestyle, habits and genetics. Smoking and weight fluctuations diminish the results.
FDA does not regulate medical procedures performed by qualified and licensed doctors. Currently, there are no clear protocols to treat any disease with adult stem cells in the U.S. We ONLY use your own adult stem cells (not Embryonic stem cells) and we don’t alter, manipulate or store your stem cells and we use your cells during the same procedure – therefore FDA does not object to these procedures.