The most effective of all currently known methods of penis enlargement is surgical correction.Other methods either do not work (miracle ointments, compresses, dietary supplements) or have a short-term effect (vacuum pump - one-time use, injections - up to 12 months + possibility of side effects).A conservative method is to use a special penis lengthening device, an extender, which subjects the soft tissues of the erectile tissue and blood vessels to gradual stretching, but must be worn for a long period of time (more than six months) without surgery.
Ligamentotomy of the penis is a relatively simple phalloplastic operation that allows you to increase the length of a normally functioning reproductive organ.
During surgery, the inner part of the shaft of the penis, hidden in subcutaneous fat, is exposed by cutting the cartilage-like ligament that attaches it to the pubic bone.The restriction thus removed allows the genital organ to be lengthened by 3-5 cm.To prevent the band from sticking to its previous position along the incision line after surgery, traction devices are used, but for a much shorter period of time than with conservative treatment.
Penile ligamentotomy 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 sexual life.
It is estimated that a total of 15,414 ligamentotomy procedures were performed worldwide, with almost one in five procedures being performed in Germany.
This operation is much easier, safer and less expensive than a penile prosthesis.However, if a man suffers from severe forms of erectile dysfunction in addition to the small size of the penis, it may be ineffective.
Notes
Ligamentotomy is performed only on adult patients and may be indicated in pathological cases for health reasons:
- congenital or acquired proliferation of the connective tissue of the penile ligament, which prevents the erect penis from straightening and makes erection painful (Peyronie's disease);
- Replacement of cells of the erectile tissue of the penis body with connective tissue cells (densile fibrosis);
- Micropenis, when most of its shaft is hidden in the subcutaneous fatty tissue - the visible part of the erect organ is small, which objectively complicates sexual life;
- penile injuries;
- 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 despite having sufficient length usually suffer from either penile dysmorphia (BDD) or fear of a small penis (SPA).In both conditions, men consistently underestimate the size of their penis and overestimate the average size of other men.
An indication for plastic surgery to lengthen the male genital organ may be the patient's desire, which is determined by his aesthetic considerations (provided there are no contraindications), for example, if 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 surgical correction and make sure that he does not have any diseases of the urogenital organs.As part of the preoperative examination, the patient undergoes a blood test: clinical examination, glucose, biochemical composition, coagulation, blood group and Rh factor, the presence of syphilis, hepatitis B and C, HIV infection.He will initially undergo fluorography and electrocardiography.
The list of examinations before surgery can be expanded depending on the presence of chronic diseases in the patient.
The patient will speak to the anesthesiologist and will be advised that since the operation will be performed under anesthesia, he or she must not eat or drink for the next eight hours to avoid choking from vomit.
On the eve of the operation, you must shave your pubic hair.
Ligamentotomy technique
The actual surgical procedure involves cutting the superficial cartilage ligament that holds the penis in a certain position.This manipulation allows you to pull the penis out from under the uterus without violating its anatomical integrity.
The operation is performed openly through an incision often made in the scrotal area (in the midline) or in the lower part of the pubic bone when the greatest exposure of the hidden part of the penile shaft is required.Typically, the procedure is discussed before the operation and determined depending on the solution to the problem.
Modern operating rooms are often equipped with endoscopic equipment where micro-incisions are made.
The classic method is to cut the ligament and stretch the penis to a certain length, up to 25-50 mm (depending on the length of the hidden part of the shaft).Stitching and fixing the elongated organ with a stretcher.
A more modern method involves removing the patient's fat from the areas where it accumulates during surgery.Fat is introduced into the cavity of the severed ligament (lipofilling), which promotes healing of the tissue and prevents adhesions.A suture is then created.The second type of intervention takes a little longer.
Complete release of the corpora cavernosa from the pubic region is associated with a significant risk of disruption of the neurovascular bundles of the penis, resulting in denervation and devascularization of the penis.
The operation itself lasts about 30-60 minutes, the patient stays in the clinic for a day, but success is facilitated by proper aftercare, which is the second and necessary phase of penis lengthening.
Contraindications to implementation
The possibility of surgery is only considered at the age of 18.
He should not have any mental illnesses, bleeding tendency, genitourinary diseases, malignant tumors or diabetes.
The operation is not performed if the patient has acute infectious diseases and/or chronic infectious diseases worsen.
Consequences after the procedure
After a ligamentotomy, the functions of the sexual organ (urination and erection) are usually completely preserved;The muscle tissue, ligaments and vessels responsible for these functions are not affected during the operation.The lymphatic drainage during ligamentotomy should not be disturbed, as the lymphatic vessels must not be damaged if the operation is carried out correctly.However, slight swelling in the surgical area and bruising are possible.Access through the scrotum is easier to tolerate, the suture heals faster, but the incision on the pubic bone is more often complicated by hematomas and swelling.
The use of general anesthesia causes 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, penile shortening and lack of penile support during erection, leading to difficulty in sexual intercourse and penetration.
Complications after the procedure are certainly possible.Nevertheless, this is an operation.If undesirable consequences occur, you should consult a doctor for advice on the necessary measures.
Suture sealing after a ligamentotomy is a normal process.The scar that forms is always dense;later it will be softer.The stitches will heal in about three weeks.For some it is earlier, for others it is later.
Suppuration of the sutures indicates a bacterial infection, and it is by no means necessary that “an infection was introduced during the operation.”The patient may have had a chronic infectious process.The infection is usually treated with antibacterial medications.To prescribe them, you must consult a doctor.
No plaques should appear after a ligamentotomy.They, which lead to curvature of the penis and thus pain, are surgically eliminated in this operation.This is the proliferation of fibrous tissue in the tunica albuginea of the erectile tissue.The main cause of their occurrence is said to be microtrauma to the penis (usually during sexual intercourse) with the development of microbleeds, in which areas of connective tissue then form.If plaques appear again, you should, firstly, consult a doctor and, secondly, think with your doctor about what is the cause of their appearance.
A scar can certainly occur after a ligamentotomy, as post-operative scars occur with every operation.Over time they will soften and loosen.Much depends on the quality of the patient's skin and the skill of the surgeon.Physiotherapy and other methods are used to eliminate postoperative scars.If the scar bothers you very much, you can consult a doctor about it.
Care after the procedure
In the postoperative period, analgesics may be prescribed to relieve pain.The bandage is applied every 2-3 days, and the stitches are usually removed 14 days after the operation.It is recommended to avoid sexual contact for 1-1.5 months.
A mandatory postoperative period for any type of surgery is wearing a stretcher (in the first three weeks, sometimes for a longer period) and then a stretcher;Without this, the operation may be pointless as the ligament along the rupture line heals and the penis returns to its original position.In addition, stretching the genital organ allows you to lengthen it by another 15-25 mm.
The minimum period to wear an extender is two months.On postoperative days it is only worn for one to two hours, later six to eight hours daily.Be 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 and carefully, avoiding pain and strictly following the doctor's recommendations.Only a slight tension should be felt.
Reviews
Reviews of the operation are different.Some complain of complications, hematomas and fever.In principle, such complaints are typical in the early postoperative phase and should be referred to a doctor.Every body is unique and stitches take at least 10-14 days to heal.
The results of ligamentotomy were not always favorable.Patient and partner satisfaction ranges between 30 and 65%.On average, the operation increases the resting length of the penis by 1-3 cm.Low satisfaction rates make this surgical technique unfavorable for many patients.
In addition, the question is often asked whether it is possible to lengthen the penis while increasing its thickness.This is not recommended.Experts recommend performing a ligamentotomy first.Only after stopping all measures to stretch the penis with an extender that clamps the organ, which is unacceptable after increasing the thickness of the penis, you can proceed to the next stage.