The most effective among all currently known methods to increase penis size is its surgical correction.Other methods 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 to use a special device to lengthen the penis, an extender, which subjects the soft tissues of the corpus cavernosum and blood vessels to gradual stretching, but it must be used without surgery for a long period of time (more than six months).
Penile ligamentotomy is a relatively simple phalloplastic operation that allows the length of a normally functioning reproductive organ to be increased.
The surgical intervention consists of releasing the internal 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 eliminated in this way allows the genital organ to be lengthened by 3 to 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 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.
An estimated 15,414 ligamentotomy procedures have been performed worldwide, of which almost one in five have been performed in Germany.
This operation is much simpler, safer and cheaper than penile prostheses, however, when a man, in addition to the small size of the penis, also suffers from severe forms of erectile dysfunction, it may be ineffective.
Indications
Ligamentotomy is performed only in patients who have reached the age of majority, 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 cells from the cavernous tissue of the shaft of the penis with cells from the connective tissue (cavernous fibrosis);
- micropenis, when most of its shaft is hidden in the subcutaneous adipose 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 the 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.
An indication for plastic surgery to increase the length of the male genital organ may be the patient's desire, caused 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 led 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, glucose, biochemical composition, coagulation, blood group and Rh factor, presence of syphilis, hepatitis B and C, HIV infection.You will first undergo fluorography and electrocardiography.
The list of studies prior to surgery can be expanded depending on the presence of chronic diseases in the patient.
The patient will talk to the anesthesiologist, he will be warned that since the operation is performed under anesthesia, to avoid suffocation from vomiting, he should not eat or drink for the next eight hours.
On the eve of the operation, it is necessary 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 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 midline) or in the lower part of the pubis, when the greatest release of the hidden part of the shaft of the penis is required.The approach is usually discussed before surgery and determined based on the solution to the problem.
Modern operating rooms are usually equipped with endoscopic equipment, in which case microincisions 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).Suture and fixation of the elongated organ using a stretcher.
A more modern method is to use the patient's fat, which is removed from 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 30-60 minutes, the patient remains 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 for carrying out.
The possibility of performing the operation is not considered until the patient turns 18 years old.
You must not have mental illnesses, a tendency to bleed, genitourinary diseases, malignant tumors or diabetes.
The operation is not performed during periods of acute infectious diseases of the patient and/or exacerbation of chronic diseases.
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 should not be disturbed during ligamentotomy, as 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 incision in the pubis is often complicated by bruising and swelling.
The result of using general anesthesia is drowsiness and poor coordination of care usually resolves 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, making sexual intercourse and penetration difficult.
It is certainly possible for complications to arise after the procedure.Still, this is an operation.If undesirable consequences occur, you should consult a doctor for advice on how to take the necessary measures.
Sealing seams after ligamentotomy is a normal process.The scar that forms is always dense;then it softens.The sutures heal in approximately three weeks.For some it is sooner, for others it is 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 it is necessary to consult a doctor.
Plaques should not appear after ligamentotomy.They, which cause the curvature of the penis and its pain, are surgically removed during this operation.This is the proliferation of fibrous tissue in the tunica albuginea of the corpora cavernosa.It is said that the main cause of its appearance is microtrauma of the penis (usually during sexual intercourse) with the development of microhemorrhages, in whose place areas of connective tissue form.If the plaques appear again, you should first consult a doctor, and secondly, think with your doctor about the causes of their appearance.
A scar may appear after ligamentotomy, as postoperative scars form during any operation.Over time they become softer and separate.Much depends on the quality of the patient's skin and the skill of the surgeon.Physical therapy and other methods are used to resolve postoperative scars.If the scar bothers you a lot, you can consult a doctor about it.
Post-procedure care
Postoperatively, analgesics may be prescribed to relieve pain.Dressings are placed every 2 to 3 days and sutures are usually removed 14 days after surgery.It is recommended to avoid sexual contact for 1-1.5 months.
A mandatory postoperative for any type of operation is to first carry a stretcher (the first three weeks, sometimes longer), then an extender;Without this, the operation may be meaningless, since the ligament will heal along the tear 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 to 25 mm.
The minimum period to wear an extender is two months.In the postoperative days it is used only for one or 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 favors rapid granulation of the tissue.
It is necessary to stretch the penis gradually, carefully, avoiding pain and strictly following the doctor's recommendations.You should only feel a slight tension.
Reviews
Opinions about the operation are different.Some complain of complications, bruising and fever.Basically, this type of discomfort is typical in the early postoperative period and should be consulted by a doctor.Each body is individual and the stitches need at least 10 to 14 days to heal.
The results of ligamentotomy were not always favorable.Patient and couple satisfaction levels range between 30 and 65%.On average, the surgery 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, doubts often arise as to 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 stretch the penis in length using an extender that firmly holds the organ, which is unacceptable after increasing the thickness of the penis, can you proceed to the next stage.