Penis enlargement surgery - phalloplasty, penoplasty

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Penis enlargement through the release of suspensor ligaments

Penis length and size enlargement is becoming a more and more frequent request to urologists and plastic surgeons.

One of the most used and oldest methods of enlargement is the release of ligaments in the penis combined with the release of fibers in the penis. Both these suspensor ligaments attach the penis to the pubic bone and essentially contribute to the arch between the root and the body of a flaccid penis.

After the release, the organ droops downwards and the root-body angle of the penis is balanced. This causes optical and real penis enlargement. The average length change after the procedure is usually around 2 to 3cm. The optical effect is perceived as being many times greater thanks to the associated hair removal.

Indication

The diagnosis is always relative and it must be considered very carefully. The average penis length of a European man is set from 12 to 16cm during erection and 6 to 10cm when flaccid. There are not many male individuals that differ from this average. In the case of an inborn small penis (micropenis) this procedure is not a sufficient solution. We also need to take into consideration the fact that the average vagina length is between 10 to 13cm and that the largest amount of sensitive endings is around the vaginal opening. So the length of the penis should not be a determining factor for a good sex life.

anatomy-of-penis-enz

In order to ensure a trouble-free relationship between the surgeon and the patient, only men without psychological problems and with a normal ability to have sex before the procedure should be considered. The patient must be very well-informed and willing to accept the possible risks of the surgical procedure (see risks and disadvantages below.) The indication is to a great extent dependent on the personal courage of the surgeon; even when these rules are followed and the surgeon cooperates with a psychologist and sexologist.

Surgical approach

A half-moon incision is made on the dorsum of the penis in the place where it joins the pubic bone. Alternatively, two shorter side incisions may be made in this area. There isn’t proof if one or two incisions are better. There are arguments for both cases for a better preservation of nerves or the vascular bundle.

Surgical procedure

After choosing the surgical procedure, tissues from the given place are carefully removed and we continue in the direction of the pubic bone attachment. We have to strictly preserve the arteria dorsalis penis on both sides, the dorsal penile veins and the nervus dorsalis penis on both sides. For this phase of the surgery some doctors recommend using microsurgical optics, especially glasses. This is followed by a partial or total release of suspensor ligaments of the penis, which attaches the penis to the pubic bone. We also release the ligament fibers of the penis that encircle the penis and erect it upwards. We stop any light bleeding and then sew the subcutis and the skin. We sterilely cover the treated area; the sutures are removed seven days after the procedure.

Advantages of the procedure

Compared to commercially recommended approaches such as treating the penis with ointments or extending it using various devices, we can, in most cases, expect objective penis enlargement in its flaccid phase to the above mentioned length. Together with hair removal, it can present at least partial satisfaction for many clients.

Medical risks and disadvantages of the procedure

There is a risk of nerve damage, a risk of damage to the dorsal penile arteries and veins with all consequences. A big disadvantage is the relatively small length effect of the procedure. There is also the disadvantage of increased penis mobility in a circular degree when erect and an associated worsening ability to hold the penis in the right direction in the vagina during intercourse.

Social and legal risks of the procedure

The procedure does not solve pre-operative unknown sexual dysfunctions or pre-operative unknown psychological issues of the client! Even with an experienced and well-performed procedure, it is hard to face unnecessary complaints from clients of a not improved or worse sexual life; impairment of erection; reduction of the sensitiveness of penis and so on.

Author:
Martin Tomanek M.D.

    
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