The most effective among all methods currently known to increase the size of the penis is its surgical correction.Other methods are either ineffective (magic ointments, compresses, supplements) or have a short-term effect (vacuum pump - single use, injection - up to 12 months + possible side effects).The conservative method is to use a special device to lengthen the penis, an extender, which exposes the soft tissue of the corpus cavernosum and blood vessels to gradual stretching, but it must be worn without surgery for a long period of time (more than six months).
Ligamentotomy of the penis is a relatively simple phalloplasty operation that allows you to increase the length of the normally functioning reproductive organ.
The surgical intervention consists in releasing the inner part of the penis shaft, hidden in the subcutaneous fat, by cutting the cartilage-like ligament attached to the pubic bone.The restrictions removed in this way make it possible to extend the genital organs by 3-5 cm.After surgery, to prevent the ligament from joining along the incision line to its previous position, a traction device is used, but for a shorter period of time compared to conservative treatment.
Ligamentotomy of the penis allows you to change the physiological parameters of the penis for life.This has a positive effect on the psycho-emotional sphere of a man and his sex life.
An estimated total of 15,414 ligamentotomy procedures have been performed worldwide, with nearly one in five of all procedures performed in Germany.
This operation is easier, safer and cheaper than a penile prosthesis, however, when a man, in addition to a small penis size, also suffers from a severe form of erectile dysfunction, it may not be effective.
Hint
Ligamentotomy is only performed in patients who have reached adulthood, and may be indicated for health reasons in pathological cases:
- congenital or acquired proliferation of the connective tissue of the penile ligaments, which prevents the tense penis from straightening and making a painful erection (Peyronie's disease);
- replacement of penile cavernous tissue cells with connective tissue cells (cavernous fibrosis);
- micropenis, when most of its stem is hidden in subcutaneous fat tissue - an erect part of the organ that looks small in size, which objectively complicates sexual life;
- penile injury;
- body dysmorphophobia is a man's obsessive dissatisfaction with the size of the penis (relatively normal from an anatomical point of view) in the absence of a more serious mental illness (if the erect penis length is 180 mm or more, the patient may be denied surgical correction).
Men who complain of a small penis despite its adequate length usually suffer from penile dysmorphic disorder (BDD) or small penis anxiety (PPA).In both of these disorders, men consistently underestimate their penis size and overestimate the average size for other men.
Indications for plastic surgery to increase the length of the male genital organ may be the desire of the patient, due to aesthetic considerations (if there are no contraindications), for example, the apparent length of the 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 prompted him to use surgical correction, and make sure that he does not have diseases of the genitourinary organs.As part of the pre-operative examination, the patient undergoes blood tests: clinical, glucose, biochemical composition, coagulation, blood group and Rh factor, the presence of syphilis, hepatitis B and C, HIV infection.He will undergo fluorography and electrocardiography first.
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, he will be warned that since the operation is performed under anesthesia, to avoid asphyxiation by vomiting, he cannot eat or drink for the next eight hours.
The night before surgery, you will need to shave your pubic hair.
Ligamentotomy technique
The actual surgical intervention consists of cutting the superficial cartilaginous ligament that holds the penis in a certain position.This manipulation allows you to remove the penis from under the uterus without violating its anatomical integrity.
The operation is performed openly through an incision, which is often made in the scrotal area (in the midline) or in the lower part of the pubis, when the greatest release of the hidden part of the penis is required.Usually, the approach is discussed before surgery and determined depending on the problem solving.
Modern operating rooms are often equipped with endoscopic equipment, where micro-incisions are made.
The classic method consists of cutting the ligament and stretching the penis to a certain length up to 25-50 mm (depending on the length of the hidden part of the shaft).Suturing and fixing elongated organs using a stretcher.
A more modern method involves the use of the patient's fat, which is taken from the place where it accumulated during surgery.Fat is placed into the cavity of the operated ligament (lipofilling), which promotes tissue healing and prevents adhesions.After that sutures are applied.The second type of intervention takes longer.
Complete release of the corpora cavernosa from the pubic ramus is associated with a significant risk of disruption of the penile neurovascular bundle, causing penile denervation and devascularization.
The operation itself lasts about 30-60 minutes, the patient stays in the clinic for a day, however, its success is facilitated by proper post-operative care, which is the second stage and necessary to lengthen the penis.
Contraindications to exercise
The possibility of performing surgery is not considered until the patient is 18 years old.
He should not have mental illness, tendency to bleed, genitourinary disease, malignant tumor or diabetes.
Surgery is not performed during the period of acute infectious disease in the patient and/or exacerbation of chronic disease.
Consequences after the procedure
After ligamentotomy, the function of the genital organs (urination and erection) is usually completely preserved;muscle tissue, ligaments and vessels responsible for this function are not affected during the operation.Lymphatic drainage during ligamentotomy should not be disturbed, because the lymphatic vessels cannot be damaged if the operation is performed correctly.However, slight swelling in the surgical area is possible, as well as bruising.Access through the scrotum is easier to tolerate, sutures heal faster, but the incision in the pubis is more often complicated by hematoma and swelling.
The result of the use of general anesthesia is drowsiness and impaired coordination of attention usually disappear within 24 hours, even in the most sensitive patients.
Complications after the procedure
Paradoxically, the main side effect of this procedure is recurrence, shortening of the penis and lack of support for the penis during erection, which leads to difficulties in intercourse and penetration.
Complications after the procedure are definitely possible.However, this is an operation.If unwanted consequences occur, you should consult a doctor for advice on taking the necessary measures.
Suture sealing after ligamentotomy is a common procedure.The scar formed is always dense;it will be limp.The stitches heal in about three weeks.For some it is earlier, for others it is earlier.
Suppuration of the suture indicates a bacterial infection, and there is absolutely no need for "infection to be introduced during the operation."Perhaps the patient has a chronic infectious process.Infections are usually treated with antibacterial drugs.To prescribe them, you need to consult a doctor.
Plaque should not appear after ligamentotomy.They, which cause the curvature of the penis and pain, are surgically removed during this operation.This is a proliferation of fibrous tissue in the tunica albuginea of the corpus cavernosum.The main reason for their appearance is said to be microtrauma of the penis (usually during sexual intercourse) with the development of microhemorrhages, in the place where the connective tissue area is then formed.If the plaques reappear, you should, first, see a doctor, and secondly, think with your doctor about what caused their appearance.
Scars may appear after a ligamentotomy, as postoperative scars form during any surgery.Over time they become softer and separate.Much depends on the quality of the patient's skin and the skill of the surgeon.Physiotherapy and other methods are used to resolve scars after surgery.If the scars bother you a lot, you can see a doctor about this.
Post-procedure care
In the postoperative period, analgesics may be prescribed to relieve pain.Dressing is done every 2-3 days, sutures are usually removed 14 days after surgery.It is recommended to avoid sexual intercourse for 1-1.5 months.
The mandatory postoperative stage for any type of operation is to wear a stretcher first (the first three weeks, sometimes for a longer time), then an extender;without this, the operation may be meaningless, because the ligament will heal along the rupture line and the penis will return to its original position.In addition, stretching the genital organ allows you to extend it by an additional 15-25 mm.
The minimum period to wear an extender is two months.In the days after the operation it is worn for only one to two hours, then it is worn for six to eight hours every day.Make sure you take it off at night.
The ligament heals under the influence of a stretcher, but not along the cut line, but in a stretched position.The presence of the patient's own fat in the incisional cavity promotes rapid tissue granulation.
You need to stretch the penis gradually, carefully, avoiding pain, strictly according to the doctor's recommendations.Only a little tension should be felt.
Reviews
Reviews about the operation are different.Some complain of complications, hematoma, and fever.Basically, such complaints are typical in the initial period after surgery and should be addressed to the doctor.Every body is individual, and stitches need at least 10-14 days to heal.
Ligamentotomy results are not always encouraging.Patient and partner satisfaction levels range from 30 to 65%.On average, the surgery increases the resting length of the penis by 1-3 cm.The low satisfaction rate makes this surgical technique unprofitable for many patients.
In addition, the question is often asked whether it is possible to lengthen the penis and increase its thickness at the same time.This is not recommended.Experts first recommend performing a ligamentotomy and, only after stopping all measures to stretch the penis in length using an extender that clamps the organ tightly, which is unacceptable after increasing the thickness of the penis, you can proceed to the next stage.