The most effective among all currently known methods of increasing penis size is its surgical correction.Other methods either do not work (miracle ointments, compresses, food supplements) or give a short-term effect (vacuum pump - single use, injections - up to 12 months + possibility of side effects).A conservative method involves using a special device for lengthening the penis, an extender, which exposes the soft tissues of the corpora cavernosa and blood vessels to gradual stretching, but it must be worn without surgical intervention for a long time (more than six months).
Penile ligamentotomy is a relatively simple phalloplastic operation that increases the length of a normally functioning reproductive organ.
The surgical procedure involves freeing the inner part of the penis shaft, hidden in the subcutaneous fat, by cutting the cartilaginous ligament that attaches it to the pubic bone.The restriction thus removed makes it possible to lengthen the genital organ by 3 to 5 cm.After surgery, in order to prevent the ligament from fusing along the incision line to its previous position, traction devices are used, but for a much shorter period than with conservative treatment.
Penile ligamentotomy makes it possible to modify the physiological parameters of the penis for life.This has a positive effect on the psycho-emotional sphere of a man and on his sex life.
It is estimated that a total of 15,414 ligamentotomy procedures have been performed worldwide, with almost one in five in Germany.
This operation is much simpler, safer and cheaper than penile prosthesis, however, when a man, in addition to small penis size, also suffers from severe forms of erectile dysfunction, it may turn out to be ineffective.
Indications
Ligamentotomy is performed only in adult 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 straightening of the erect penis and makes erection painful (Peyronie's disease);
- replacement of the cells of the cavernous tissue of the body of the penis with connective tissue cells (cavernous fibrosis);
- micropenis, when most of its shaft is hidden in the subcutaneous fatty tissue - the visible part of the erect organ is small in size, which objectively complicates sexual life;
- injuries to the penis;
- Body dysmorphophobia is a man's obsessive dissatisfaction with the size of the penis (completely 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 refused surgical correction).
Men who complain of a small penis even though it is long enough usually suffer from either penile dysmorphic disorder (BDD) or small penis anxiety (SPA).In both disorders, men systematically underestimate the size of their penis and overestimate the average size of other men.
An indication for plastic surgery to increase the length of the male genital organ may be the patient's desire, motivated by 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 prompted him to resort to surgical correction and make sure that he does not suffer from diseases of the genitourinary organs.As part of the preoperative examination, the patient undergoes blood tests: clinical, blood sugar, biochemical composition, coagulation, blood group and Rh factor, the 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 depending on the presence of chronic diseases in the patient.
The patient will discuss with the anesthetist, he will be warned that the operation being carried out under anesthesia, in order to avoid asphyxia by vomiting, he should neither eat nor drink for the following eight hours.
On the eve of the operation, you must shave your pubic hair.
Ligamentotomy technique
The actual surgical procedure involves 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 carried out openly through an incision, which is often made in the area of the scrotum (on the midline) or in the lower part of the pubis, when greater release of the hidden part of the penile shaft is required.Typically, the approach is discussed before surgery and is determined based on the solution to the problem.
Modern operating rooms are often equipped with endoscopic equipment, in which case micro-incisions are made.
The classic method involves 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).Suture and fix the elongated organ using a stretcher.
A more modern method is to use the patient's fat, extracted 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 which a suture is applied.The second type of intervention takes a little more time.
Complete release of the corpora cavernosa of the pubic ramus is associated with a significant risk of disruption 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 proper postoperative care, which is the second and necessary stage of penis enlargement.
Contraindications to carrying out
The possibility of carrying out the operation is only considered when the patient reaches the age of 18.
He should not suffer from mental illnesses, bleeding tendency, genitourinary diseases, malignant tumors or diabetes.
The operation is not carried out 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 tissues, ligaments and vessels responsible for these functions are not affected during the operation.Lymphatic drainage during ligamentotomy should not be disrupted, as the lymphatic vessels should not be damaged if the operation is performed correctly.However, slight swelling of the surgical area is possible, as is bruising.Access through the scrotum is easier to tolerate, the suture heals more quickly, but the incision at the level of the pubis is more often complicated by hematomas and swelling.
The result 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 relapses, shortening of the penis and lack of support of the penis during erection, leading to difficulties during sexual intercourse and penetration.
Complications after the procedure are certainly possible.However, it is an operation.If undesirable consequences occur, you should consult a doctor for advice on taking the necessary measures.
Sealing the seams after a ligamentotomy is a normal process.The forming scar is always dense;later he softens.The sutures heal in about three weeks.For some it’s sooner, for others it’s later.
Suppuration of the sutures indicates a bacterial infection, and it is not at all 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 must consult a doctor.
No plaque should appear after ligamentotomy.These, which cause the curvature of the penis and its pain, are surgically eliminated during this operation.This is the proliferation of fibrous tissue at the level of the tunica albuginea of the corpora cavernosa.The main reason for their appearance would be microtrauma to the penis (usually during sexual intercourse) with the development of microhemorrhages, in the place of which areas of connective tissue are then formed.If plaques appear again, you should first consult a doctor, and secondly, think together with your doctor about the causes of their appearance.
A scar may well appear after a ligamentotomy, since postoperative scars form during any operation.Over time, they become softer and separate.It all depends on the quality of the patient's skin and the skills of the surgeon.Physiotherapy and other methods are used to resolve postoperative scars.If the scar bothers you a lot, you can consult a doctor about it.
Post-operative care
In the postoperative period, 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 postoperative step for any type of intervention is first wearing a stretcher (the first three weeks, sometimes longer), then an extension;without this, the operation may be meaningless, since the ligament will heal along the rupture line and the penis will return to its original position.In addition, stretching the genital organ allows it to be lengthened by an additional 15-25 mm.
The minimum period of wearing an extender is two months.On postoperative days, it is worn for only one to two hours, then for six to eight hours each day.Make sure to 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.
You need to stretch the penis gradually, carefully, avoiding pain and strictly following the doctor's recommendations.Only slight tension should be felt.
Notice
Opinions on the operation are different.Some complain of complications, bruising and fever.Basically, such complaints are typical at the beginning of the postoperative period and should be addressed to a doctor.Each body is individual and stitches need at least 10-14 days to heal.
The results of ligamentotomy were not always favorable.Patient and partner satisfaction levels range from 30 to 65%.On average, the operation increases the resting length of the penis by 1 to 3 cm.Low satisfaction rates make this surgical technique unfavorable for many patients.
In addition, we often wonder if it is possible to lengthen the penis while increasing its thickness.This is not recommended.Experts recommend first performing a ligamentotomy and, only after stopping all measures aimed at stretching the penis in length using an extender that tightly squeezes the organ, which is unacceptable after increasing the thickness of the penis, you can proceed to the next stage.