The most effective of all currently known methods of increasing the size of the penis is its surgical correction.Other methods do not work (miracle ointments, tablets, dietary supplements) or give 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 device for penis enlargement, an extender, which exposes the soft tissues of the cavernous bodies and blood vessels to gradual stretching, but must be worn without surgery for a long period of time (more than six months).
Penile ligamentotomy is a relatively simple phalloplasty operation that allows you to increase the length of a normally functioning reproductive organ.
The surgery consists in freeing the internal part of the penile shaft, hidden in the subcutaneous fat, by cutting the cartilaginous ligament that fixes it to the pubic bone.The restriction thus removed allows you to lengthen the genital organ by 3-5 cm.After surgery, to prevent the ligament from fusing along the incision line in the 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 were performed worldwide, with nearly one in five of all procedures performed in Germany.
This operation is much simpler, safer and cheaper than the penile prosthesis, however, when a man, in addition to the small size of the penis, also suffers from severe forms of erectile dysfunction, it can be ineffective.
Directions
Ligamentotomy is performed only on 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 straightening of the penis when erect and makes erection painful (Peyronie's disease);
- replacement of the cells of the cavernous tissue of the body of the penis with cells of the connective tissue (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;
- penile injury;
- 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 equal to or greater than 180 mm, 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 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, 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 prompted him to resort to surgical correction and make sure that he has no 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 before surgery can be expanded based on the presence of chronic diseases in the patient.
The patient will speak to the anesthetist and will be advised that, since the operation is performed under anesthesia, to avoid asphyxiation from vomiting, he must not eat or drink for the next eight hours.
On the eve of the operation, you need to shave your pubic hair.
Ligamentotomy technique
The actual surgery consists of cutting the superficial cartilaginous ligament that holds the penis in a certain position.This manipulation allows you to extract 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 maximum 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 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).Suturing and fixing of the elongated organ using a stretcher.
A more modern method involves the use of the patient's own fat, taken from the places where it accumulates during the operation.Fat is inserted into 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 requires slightly more time.
Complete release of the corpora cavernosa from the pubic ramus is associated with a significant risk of rupture of the neurovascular bundles of the penis, causing denervation and devascularization of the penis.
The operation lasts about 30-60 minutes, the patient stays in the clinic for a day, however, its success is facilitated by adequate postoperative care, which is the second and necessary stage of penis enlargement.
Contraindications for implementation
The possibility of performing the operation is not taken into consideration until the patient turns 18.
He should not have mental diseases, bleeding tendency, 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 ones.
Consequences after the procedure
After ligamentotomy, the functions of the genital organ (micturition and erection) are usually completely preserved;the muscle tissue, ligaments and vessels responsible for these functions are not affected during the surgery.Lymphatic drainage during ligamentotomy should not be disturbed, since the lymphatic vessels should not be damaged if the operation is performed correctly.However, slight swelling in the surgical area is possible, as is bruising.Access through the scrotum is easier to tolerate, the suture heals faster, but the incision on the pubis is more often complicated by hematomas and swelling.
The result of the use of general anesthesia is drowsiness and impaired attention coordination that usually disappears within 24 hours, even in the most sensitive patients.
Complications after the procedure
Paradoxically, the main side effects of this procedure are recurrence, shortening of the penis and lack of support of the penis during erection, resulting in difficulty in sexual intercourse and penetration.
Complications are certainly possible after the procedure.However, it is an operation.If unwanted consequences occur, you should consult a doctor for advice on taking the necessary measures.
Sealing the seams after ligamentotomy is a normal process.The scar in formation is always dense;then it softens.The sutures heal in about three weeks.For some it is before, for others it is after.
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 drugs.To prescribe them you need to consult a doctor.
Plaques should not appear after ligamentotomy.Those that cause the curvature of the penis and its pain are surgically eliminated during this operation.This is the proliferation of fibrous tissue in the tunica albuginea of the corpora cavernosa.The main cause of their appearance would be microtraumas of the penis (usually during sexual intercourse) with the development of microhemorrhages, in place of which areas of connective tissue form.If the plaques appear again, you should, firstly, consult a doctor, and secondly, think about with your doctor what causes their appearance.
A scar may appear after ligamentotomy, as postoperative scars form during any operation.Over time they become softer and separated.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 scarring.If the scar bothers you a lot, you can consult a doctor about it.
Post-procedure assistance
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 stage for any type of surgery is to first wear a stretcher (the first three weeks, sometimes for a longer period), then an extender;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, the lengthening of the genital organ allows it to be lengthened by an additional 15-25 mm.
The minimum period for wearing an extender is two months.In the postoperative days it is worn only for one or two hours, thereafter 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 the tensioner, but not along the cut line, but in a stretched position.The presence of the patient's fat in the incision cavity promotes rapid tissue granulation.
It is necessary to lengthen the penis gradually, carefully, avoiding pain and strictly following the doctor's recommendations.You should only feel a slight tension.
Reviews
Reviews about the operation are different.Some complain of complications, bruising and fever.Basically such complaints are typical in the early postoperative period and should be addressed 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 levels range from 30 to 65 percent.On average, the surgery increases the resting length of the penis by 1–3 cm.Low satisfaction rates make this surgical technique unfavorable for many patients.
Furthermore, we often wonder 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 extend the penis in length using an extender that securely blocks the organ, which is unacceptable after increasing the thickness of the penis, you can move on to the next stage.