The most effective among all currently known methods of increasing the size of the penis is its surgical correction.Other methods either do not work (miracle ointments, compresses, dietary supplements) or give a short-term effect (vacuum pump - single use, injections - up to 12 months + possibility of side effects).A conservative method is the use of a special device for lengthening the penis, an extender, which exposes the soft tissues of the corpus cavernosum and blood vessels to gradual stretching, but 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 normal reproductive organ.
The surgical intervention consists in freeing the inner part of the shaft of the penis, hidden in the subcutaneous fat, by cutting the cartilage-like ligament that fixes it to the pubic bone.The restriction removed in this way allows the extension of the genital organ by 3-5 cm.After the operation, in order to prevent the joining of the ligaments along the incision line to the previous position, traction devices are used, but in a significantly shorter period of time than with conservative treatment.
Ligamentotomy of the penis allows you to change the physiological parameters of the penis for life.It has a positive effect on a man's psycho-emotional sphere and his sexual life.
It is estimated that a total of 15,414 ligamentotomy procedures have been performed worldwide, with almost one in five procedures performed in Germany.
This operation is much simpler, safer and cheaper than a penile prosthesis, however, when a man, in addition to a small penis size, also suffers from severe forms of erectile dysfunction, it can be ineffective.
Indications
Ligamentotomy is performed only in adult patients, and for health reasons it may be indicated in pathological cases:
- 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 cavernous tissue of the body of the penis with cells of connective tissue (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 makes sexual life difficult;
- penile injuries;
- body dysmorphophobia is a man's obsessive dissatisfaction with the size of the penis (anatomically quite normal) in the absence of 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 being of sufficient length usually suffer from penile dysmorphic disorder (BDD) or small penis anxiety (SPA).In both of these disorders, men consistently underestimate the size of their own penis 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 make sure that there are no diseases of the genitourinary organs.As part of the preoperative examination, blood tests are performed on the patient: clinical, glucose, biochemical composition, coagulation, blood group and Rh factor, presence of syphilis, hepatitis B and C, HIV infection.First, he will 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 anesthesiologist who will be warned that, since the operation is performed under anesthesia, in order to avoid asphyxiation by vomiting, he must not eat or drink for the next eight hours.
Before the operation, you must shave your pubic hair.
Ligamentotomy technique
The real surgical intervention consists of cutting the superficial cartilaginous ligament that holds the penis in a certain position.This manipulation allows you to pull out 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 area of the scrotum (in the central line) or in the lower part of the pubis, when the greatest release of the hidden part of the shaft of the penis is required.Usually, the approach is discussed before the operation and is determined depending on the solution of the problem.
Modern operating rooms are often equipped with endoscopic equipment, in which case microincisions are made.
The classic method consists of cutting the ligament and stretching the penis to a certain length of 25-50 mm (depending on the length of the hidden part of the shaft).Suturing and fixing the elongated organ with the help of a stretcher.
A more modern method involves using the patient's fat, which is taken from the place 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 lasts a little longer.
Complete release of the corpora cavernosa from the pubic ramus is associated with a significant risk of disruption of the penile neurovascular bundles, causing penile denervation and devascularization.
The operation itself lasts about 30-60 minutes, the patient stays in the clinic for one day, but its success is contributed by proper postoperative care, which is the second and necessary phase of penis lengthening.
Contraindications for performance
The possibility of performing the operation is not considered until the patient turns 18 years old.
He should not have mental illness, bleeding tendency, genitourinary diseases, malignant tumors or diabetes.
The operation is not performed during the period of acute infectious diseases in the patient and/or exacerbation of chronic ones.
Consequences after the procedure
After ligamentotomy, the functions of the genital organ (urination and erection) are usually 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 area of the operation, as well as bruising, is possible.Access through the scrotum is easier to bear, the suture heals faster, but the cut on the pubis is more often complicated by hematomas and swelling.
The result of the administration 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 support for the penis during erection, which leads to difficulties in intercourse and penetration.
Complications after the procedure are certainly possible.Still, this is surgery.If unwanted consequences occur, you should consult a doctor for advice on taking the necessary measures.
Sealing of sutures after ligamentotomy is a normal process.The scar that forms is always thick;it softens later.The sutures heal in about three weeks.For some it is earlier, for others later.
Suppuration of the sutures indicates a bacterial infection and is not necessarily an "infection introduced during surgery".Perhaps the patient had a chronic infectious process.The infection is usually treated with antibacterial drugs.For their prescription, it is necessary to consult a doctor.
Plaques should not appear after ligamentotomy.Those, which cause the curvature of the penis and its pain, are surgically eliminated during this operation.It is a proliferation of fibrous tissue in the tunica albuginea of the corpora cavernosa.The main reason for their appearance is microtrauma of the penis (most often during sexual intercourse) with the development of microhemorrhages, where areas of connective tissue are formed.If the plaques reappear, you should first consult a doctor, and secondly, discuss with your doctor what is causing them to appear.
A scar 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 postoperative scars.If the scar bothers you a lot, you can consult a doctor about it.
Care after the procedure
In the postoperative period, analgesics can be prescribed for pain relief.Bandages are applied every 2-3 days, stitches are usually removed 14 days after surgery.It is recommended to avoid sexual contact for 1-1.5 months.
The mandatory post-operative phase for any type of surgery is first wearing a stretcher (for the first three weeks, sometimes longer), then an extender;without it, the operation may be pointless, 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 lengthen it by an additional 15-25 mm.
The minimum period for wearing the extender is two months.In the postoperative days, it is worn for only one to two hours, later it is worn for six to eight hours every day.Be sure to 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 incision cavity promotes rapid tissue granulation.
You must stretch the penis gradually, carefully, avoiding pain, strictly following the doctor's recommendations.You should feel only a slight tension.
Reviews
Reviews about the operation are different.Some complain of complications, hematomas and fever.Basically, such complaints are typical in the early postoperative period and should be addressed to the 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 length of the penis at rest by 1-3 cm.Low satisfaction rates make this surgical technique unfavorable for many patients.
In addition, questions are often asked whether it is possible to simultaneously lengthen the penis and increase its thickness.This is not recommended.Experts recommend performing a ligamentotomy first, and only after you stop all measures to stretch the penis lengthwise with an extender that tightly squeezes the organ, which is unacceptable to do after increasing the thickness of the penis, you can proceed to the next stage.