The most effective of all currently known methods of increasing penis size is surgical correction.Other methods are either ineffective (miracle ointments, compresses, dietary supplements) or produce short-term results (vacuum pump - single use, injection - up to 12 months + possible side effects).The conservative method is to use a special device to extend the penis, that is, an extender, which gradually stretches the soft tissue and blood vessels of the cavernous body, but it must be worn for a long time (more than six months) and surgery cannot be performed.
Penile ligamentotomy is a relatively simple phalloplasty procedure that increases the length of a normally functioning reproductive organ.
Surgical intervention involves freeing the inner portion of the penile shaft, which is hidden in subcutaneous fat, by cutting the chondroid ligament that anchors it to the pubic bone.The restrictions removed in this way allow the reproductive organs to be extended by 3-5 cm.After surgery, to prevent the ligaments from fusing into their original positions along the incision line, a traction device is used, but the time is much shorter than with conservative treatment.
Penile ligament surgery allows you to change the physiological parameters of your penis for life.This has a positive impact on a man's psycho-emotional sphere and his sex life.
It is estimated that a total of 15,414 ligamentotomies were performed worldwide, with almost one fifth of these performed in Germany.
This surgery is simpler, safer, and cheaper than penile implants, but it may not be effective when a man suffers from severe erectile dysfunction in addition to a small penis size.
Indications
Ligamentotomy is only suitable for patients who have reached adult age and can be performed for health reasons in pathological cases:
- Congenital or acquired connective tissue hyperplasia of the penile ligaments that prevents the erect penis from straightening and causes painful erections (Peyronie's disease);
- Replacement of cells in the corpus cavernosum of the penis with connective tissue cells (cavernous fibrosis);
- Micropenis, when most of its shaft is hidden in subcutaneous fatty tissue - the visible part of the erectile organ is small in size, which objectively complicates sexual life;
- Injury to penis;
- Body dysmorphia phobia is an obsessive dissatisfaction in men with the size of their penis (which is quite normal from an anatomical point of view) in the absence of a more serious psychiatric disorder (patients may be refused surgical correction if the erect penis is 180 mm or more in length).
Men who complain of a small penis despite being long enough often suffer from Penile Dysmorphic Disorder (BDD) or Small Penis Anxiety (SPA).In both disorders, men consistently underestimate the size of their own penis and overestimate the average size of other men.
Indications for plastic surgery to increase the length of the male reproductive organ may be the patient's desire for aesthetic reasons (in the absence of contraindications), for example, if the apparent length of the erect penis is less than 120 mm.
Preparation
The preparation process begins with a consultation with a urologist, who will examine the patient to find out what prompted him to undergo surgical correction and to ensure that he does not have genitourinary diseases.As part of the preoperative examination, the patient undergoes blood tests: clinical, glycemic, biochemical composition, coagulation, blood group and Rh factor, presence of syphilis, hepatitis B and C, HIV infection.He will first undergo fluoroscopy and an electrocardiogram.
The list of studies before surgery can be expanded depending on whether the patient has a chronic disease.
The patient will speak with the anesthesiologist, who will be warned that since the surgery is performed under anesthesia, he cannot eat or drink for the next eight hours to avoid vomiting and suffocation.
Just before surgery, you will need to shave your pubic hair.
Ligamentotomy
The actual surgical intervention involves cutting the superficial cartilaginous ligaments that hold the penis in a specific position.This procedure allows you to pull the penis out from under the uterus without damaging its anatomical integrity.
When maximum release of the hidden part of the penile shaft is required, the surgery is performed openly through an incision, usually in the scrotal area (midline) or in the lower part of the pubic bone.Typically, the approach is discussed before surgery and 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 ligaments and stretching the penis to a certain length, up to 25-50 mm (depending on the length of the hidden part of the shaft).A stretcher is used to suture and secure elongated organs.
A more modern approach involves using the patient's fat, which is removed from where it accumulated during surgery.Fat is placed into the cavities of the anatomical ligaments (fat filling), thus promoting tissue healing and preventing adhesions.Then stitch.The second intervention takes slightly longer.
Complete release of the corpora cavernosa from the pubic rami is associated with a significant risk of disruption of the penile neurovascular bundle, leading to penile denervation and devascularization.
The surgery itself lasts approximately 30-60 minutes and the patient remains in the clinic for a day, however, proper post-operative care contributes to the success of the surgery and is the second and necessary stage of penis enlargement.
contraindications
The possibility of surgery is not considered until the patient reaches the age of 18 years.
He should not suffer from mental illness, bleeding tendencies, genitourinary diseases, malignancy or diabetes.
The procedure is not performed while the patient is suffering from acute infectious diseases and/or exacerbation of chronic infectious diseases.
consequences after surgery
After a ligamentotomy, the functions of the reproductive organs (urination and erection) are usually fully preserved; the muscle tissue, ligaments, and blood vessels responsible for these functions are not affected during the procedure.Lymphatic drainage during ligamentotomy should not be disturbed, as lymphatic vessels will not be damaged if performed correctly.However, there may be slight swelling and bruising in the surgical area.Access through the scrotum is easier to tolerate and sutures heal more quickly, but suprapubic incisions are more prone to hematoma and swelling.
The consequences of using general anesthesia are drowsiness and impaired attention and coordination that usually resolve within 24 hours, even in the most sensitive patients.
Complications after surgery
Paradoxically, the main side effects of this surgery are recurrence, shortening of the penis, and lack of penile support during erection, making intercourse and penetration difficult.
Complications are certainly possible after surgery.Still, it's a surgery.If adverse consequences occur, you should consult your doctor to take necessary measures.
Seam sealing after ligament incision is a normal procedure.The scar that forms is always dense; later it softens.The sutures heal in about three weeks.For some it's earlier, for others it's later.
Purulent sutures indicate a bacterial infection, and there is no need to say "infection during surgery" at all.Perhaps the patient has a chronic infectious process.Infections are usually treated with antibiotics.To get a prescription, you need to consult a doctor.
Plaque should not appear after ligamentotomy.They cause curvature and pain in the penis and are surgically removed in this procedure.This is the proliferation of fibrous tissue within the tunica albuginea of the corpus cavernosum.It is said that the main cause of its appearance is microtrauma to the penis (usually during sexual intercourse) with the appearance of microbleeds and subsequent formation of areas of connective tissue.If the plaque reappears, you should first see your doctor and, second, work with your doctor to think about what caused the plaque to appear.
Scarring is likely to occur after a ligament incision, as any surgery will result in postoperative scarring.Over time, they become softer and separate.This largely depends on the quality of the patient's skin and the skill of the surgeon.Use physical therapy and other methods to eliminate postoperative scars.If scars are bothering you, you can talk to your doctor.
Postoperative care
During the postoperative period, analgesics may be prescribed to relieve pain.Dressings are changed every 2-3 days, and sutures are usually removed 14 days after surgery.It is recommended to avoid sexual contact for 1-1.5 months.
The mandatory post-operative phase of any type of surgery is to first wear a stretcher (for the first three weeks, sometimes longer) and then an extender; otherwise, the surgery may be pointless as the ligaments will heal along the break line and the penis will return to its original position.Additionally, stretching the reproductive organs can lengthen them by an additional 15-25 mm.
The minimum period for wearing an extender is two months.Wear it for only one to two hours for a few days after surgery, and six to eight hours a day thereafter.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 within the incisional cavity promotes rapid granulation of the tissue.
You need to stretch your penis gradually and carefully, avoid pain, and strictly follow your doctor's recommendations.You should feel only slight tension.
Comment
Reviews of the surgery were mixed.Some people complain of complications, hematomas and fever.Basically, such symptoms are common in the early postoperative period and a doctor should be consulted.Every body is unique and stitches take at least 10-14 days to heal.
The results of ligamentotomy are not always satisfactory.Patient and partner satisfaction rates ranged from 30% to 65%.On average, surgery increases the resting length of the penis by 1-3 cm.Low satisfaction makes this surgical technique disadvantageous for many patients.
In addition, people often ask whether it is possible to lengthen the penis and increase its thickness at the same time.This is not recommended.Experts first recommend a ligamentotomy, and only after stopping all measures to stretch the length of the penis using an extender that tightly clamps the organ (this is unacceptable after increasing the thickness of the penis) can you proceed to the next stage.