Penile Lengthening Surgery

Overview

For some men, the length of their penis prevents them from having a fulfilling sex life. Some men perceive they have a short penis in the flaccid or erect state, even if they are of average size. This may prevent them from exposing themselves in a locker room or in a sexual situation. Men with a smaller than average penis may struggle with adequate insertion or even reaching orgasm—either for himself or his partner, which can take a toll on sexual relationships, self-esteem, and mental health. Men with larger penises may just wish to be even longer.

It is important to differentiate if the patient has a buried or hidden penis, which can have a significant effect on penile visualization and function. The surgery for the buried penis can be very effective. Please see our section on buried/hidden penis.

Increasing penile length requires releasing the suspensory ligament and wearing penile weights post-surgery. Releasing the ligament partially frees the penis from its pubic bone attachments, dropping it to a lower position, and possibly giving the allusion of increased length gain. However, true length gain from releasing the ligament only is minimal and is usually much less than an inch.

Procedure

Release of the suspensory ligament is a relatively minor operation performed on an outpatient basis in a surgical center. Dr. Alter typically performs the operation through a one and a half inch transverse (sideways) incision in the pubic hair. Many surgeons simply advance skin onto the shaft of the penis with VY advancement flaps. A V-shaped triangle of pubic skin is moved (advanced) to the base to the penis and closed in a Y-shape. However, a large VY flap based at the junction of the penis and pubic skin is not recommended, because it often produces a deforming hair-bearing hump at the base of the penis. It also is associated with a high incidence of wound breakdown and unsightly scars. The low transverse incision which Dr. Alter employs, does not cause such deformities. The skin is closed meticulously. Sutures are placed just below the skin, which improves the appearance of the final scar.

Post-Operative Procedure

Most patients report only minor discomfort after surgery. The patient should refrain from sexual activity and active sports for about a month post-surgery.

Ligament release alone may occasionally increase flaccid (soft) length a half an inch, but often no gain is achieved. Releasing the ligament frees more of the penis to be stretched. Weights are suspended from the penis several times daily for a period of months to years. Alternatively, various stretching devices can be used following different protocols. Flaccid (soft) and erect length gain is possible. Length increases of several inches are rare; these claims are usually based on misleading measurements taken from the apex of a V flap. However, some compulsive weight-users report anecdotal flaccid as well as erect gains of several inches. In fact, a one-inch gain is considered an unusual success even with the use of weights.

Each man’s penis varies as does his stretching protocol, so no guarantee can be made as to how much length gain will be achieved. In fact, many men gain nothing despite stretching and weights. Decreased length resulting from penis reattachment after ligament release is uncommon with Dr. Alter’s technique because he places living local fat in the free space. Weights can stretch the penis without surgery, but a greater incremental gain may result if the suspensory ligament is released. Data concerning the average gain possible has not been accurately documented or verified in peer review journals, so the procedure is considered investigational.