The most effective among all currently known methods for increasing the size of the penis is its surgical correction.Other methods do not work (miracle ointments, compresses, dietary supplements) or have a short-term effect (vacuum pump - single use, injections - up to 12 months + possibility of side effects).A conservative method is to use a special device to lengthen the penis, an extender, which exposes the soft tissues of the corpus cavernosum and blood vessels to gradual stretching, but must be used without surgery for a long period of time (more than six months).
Penis ligamentotomy is a relatively simple phalloplastic operation that allows you to increase the length of a normally functioning reproductive organ.
Surgical intervention consists of freeing the internal part of the penis shaft, hidden in the subcutaneous fat, by cutting the cartilaginous ligament that fixes it to the pubic bone.The restriction thus eliminated makes it possible to lengthen the genital organ by 3-5 cm.After surgery, to prevent the ligament from fusing along the incision line to its previous position, traction devices are used, but for a much shorter period of time than in conservative treatment.
Penile ligamentotomy allows you to change the physiological parameters of the penis for the rest of your life.This has a positive effect on the man's psycho-emotional sphere and his sexual life.
It is estimated that a total of 15,414 ligamentotomy procedures were performed worldwide, with nearly one in five of all procedures performed in Germany.
This operation is much simpler, safer and cheaper than a penile prosthesis, however, when a man, in addition to the small size of his penis, also suffers from severe forms of erectile dysfunction, it can be ineffective.
Indications
Ligamentotomy is only performed on older patients and may be indicated for health reasons in pathological cases:
- congenital or acquired proliferation of the connective tissue of the penile ligament, which prevents the erect penis from straightening and makes the erection painful (Peyronie's disease);
- replacement of cavernous tissue cells in the body of the penis with connective tissue cells (cavernous fibrosis);
- micropenis, when most of its shaft is hidden in subcutaneous fatty tissue - the visible part of the erect organ is small in size, which objectively complicates sexual life;
- penile injuries;
- body dysmorphophobia is a man's obsessive dissatisfaction with the size of his penis (quite normal from an anatomical point of view) in the absence of more serious mental illnesses (if the length of the erect penis is 180 mm or more, the patient may be denied surgical correction).
Men who complain of a small penis despite having sufficient length often suffer from penile dysmorphic disorder (BDD) or small penis anxiety (SPA).In both disorders, men consistently underestimate their penis size and overestimate the average size of other men.
The indication for plastic surgery to increase the length of the male genital organ may be the patient's desire, caused by his aesthetic considerations (in the absence of contraindications), for example, the apparent length of the erect penis is less than 120 mm.
Preparation
The preparatory process begins with a consultation with a urologist, who will examine the patient, find out the reasons that led him to resort to surgical correction and check whether he has any diseases of the genitourinary organs.As part of the preoperative examination, the patient undergoes blood tests: clinical, blood glucose, biochemical composition, coagulation, blood group and Rh factor, presence of syphilis, hepatitis B and C, HIV infection.He will first undergo fluorography and electrocardiography.
The list of studies before surgery can be expanded based on the presence of chronic diseases in the patient.
The patient will talk to the anesthetist and he will be told that as the operation is carried out under anesthesia, to avoid suffocation due to vomiting, he should not eat or drink for the next eight hours.
The day before the operation, you need to shave your pubic hair.
Ligamentotomy technique
The surgical intervention itself consists of cutting the superficial cartilaginous ligament that holds the penis in a certain position.This manipulation allows you to remove the penis from the uterus without violating its anatomical integrity.
The operation is performed openly through an incision, which is often made in the scrotum region (in the midline) or in the lower part of the pubis, when greater release of the hidden part of the penis shaft is required.Typically, the approach is discussed before surgery and determined depending on the solution to the problem.
Modern operating rooms are often equipped with endoscopic equipment, in which case microincisions are made.
The classic method consists in cutting the ligament and stretching the penis to a certain length of up to 25-50 mm (depending on the length of the hidden part of the shaft).Suturing and fixing the elongated organ with a stretcher.
A more modern method involves using the patient's fat, which is removed from the places where it accumulates during surgery.Fat is placed in the cavity of the dissected ligament (lipofilling), which promotes tissue healing and prevents adhesions.After that, a suture is applied.The second type of intervention takes a little longer.
Complete release of the corpora cavernosa from the pubic ramus is associated with a significant risk of rupture of the neurovascular bundles of the penis, causing denervation and devascularization of the penis.
The operation itself lasts about 30-60 minutes, the patient stays in the clinic for a day, however, its success is facilitated by adequate postoperative care, which is the second and necessary stage of penis lengthening.
Contraindications for carrying out
The possibility of performing the operation is not considered until the patient turns 18.
He should not have mental illness, bleeding tendency, genitourinary diseases, malignant tumors or diabetes.
The operation is not performed during periods of acute infectious diseases in the patient and/or exacerbation of chronic diseases.
Consequences after the procedure
After ligamentotomy, the functions of the genital organ (urination and erection) are generally completely preserved;the muscle tissue, ligaments and vessels responsible for these functions are not affected during the operation.Lymphatic drainage during ligamentotomy should not be disturbed, as the lymphatic vessels should not be damaged if the operation is performed correctly.However, slight swelling in the surgical area, as well as bruising, is possible.Access through the scrotum is easier to tolerate, the suture heals faster, but the pubic incision is more often complicated by bruising and swelling.
The result of the use of general anesthesia is drowsiness and impaired coordination of attention usually disappears within 24 hours, even in the most sensitive patients.
Complications after the procedure
Paradoxically, the main side effects of this procedure are relapse, shortening of the penis and lack of penis support during erection, leading to difficulty in sexual intercourse and penetration.
Complications after the procedure are certainly possible.Still, this is an operation.If undesirable consequences occur, you should consult a doctor for advice on taking the necessary measures.
Seam sealing after ligamentotomy is a normal process.The forming scar is always dense;later it softens.The sutures heal in approximately three weeks.For some it is earlier, for others it is later.
Suppuration of the sutures indicates a bacterial infection and it is not necessary that “an infection was introduced during the operation”.Perhaps the patient had a chronic infectious process.The infection is usually treated with antibacterial medications.To prescribe them you need to consult a doctor.
Plaques should not appear after ligamentotomy.They, which cause curvature of the penis and its pain, are surgically eliminated during this operation.This is the proliferation of fibrous tissue in the tunica albuginea of the corpora cavernosa.It is said that the main reason for its appearance is microtrauma to the penis (usually during sexual intercourse) with the development of microbleeds, in the place of which areas of connective tissue form.If plaques reappear, you should, firstly, consult a doctor, and secondly, think with him about what causes their appearance.
A scar may appear after ligamentotomy, as postoperative scars form during any operation.Over time, they become smoother and more separated.Much depends on the quality of the patient's skin and the skill of the surgeon.Physiotherapy and other methods are used to resolve post-operative scars.If the scar bothers you a lot, you can consult a doctor about it.
Post-procedure care
Post-operatively, analgesics may be prescribed to relieve pain.Dressings are done every 2-3 days, sutures are usually removed 14 days after surgery.It is recommended to avoid sexual contact for 1-1.5 months.
A mandatory post-operative procedure for any type of operation is to first use a stretcher (for the first three weeks, sometimes for longer), then an extender;without this, the operation may become meaningless, as the ligament will heal along the line of rupture and the penis will return to its original position.In addition, lengthening the genital organ allows you to lengthen it by another 15-25 mm.
The minimum period for using the extender is two months.On post-operative days it is used for just one to two hours, then it is used for six to eight hours every day.Make sure you take it off at night.
The ligament heals under the influence of the stretcher, but not along the cut line, but in a stretched position.The presence of the patient's own fat in the incision cavity promotes rapid tissue granulation.
It is necessary to lengthen the penis gradually, carefully, avoiding pain, strictly following the doctor's recommendations.Only slight tension should be felt.
Reviews
Reviews about the operation are different.Some complain of complications, bruising and fever.Basically, these complaints are typical of the immediate postoperative period and should be referred to the doctor.Each body is individual and stitches need at least 10 to 14 days to heal.
The results of ligamentotomy were not always favorable.Patient and partner satisfaction levels range from 30 to 65%.On average, surgery increases the resting length of the penis by 1–3 cm.Low satisfaction rates make this surgical technique unfavorable for many patients.
Furthermore, people are often asked whether it is possible to lengthen the penis and increase its thickness at the same time.This is not recommended.Experts recommend first performing a ligamentotomy, and only after stopping all measures to lengthen the penis with an extender that firmly fixes the organ, which is unacceptable after increasing the thickness of the penis, can you move on to the next stage.