How does penis enlargement surgery work?

How Does Penis Enlargement Surgery Work?

Penis enlargement surgery encompasses a range of procedures aimed at increasing penile length, girth (thickness), or both. While many non-surgical options exist—pumps, extenders, supplements—surgical techniques remain the most direct way to achieve permanent change. Below is an overview of the most common surgical approaches, how they work, potential benefits and risks, and important considerations.

---

1. Types of Penis Enlargement Surgery

1. Ligamentolysis (Suspensory Ligament Release)

   • The surgeon cuts the suspensory ligament attaching the penis to the pubic bone.
   • This allows more of the erectile shaft to hang outside the body, giving the appearance of increased length.
   • Post-op stretching or use of a penile extender device is essential to prevent the ligament from reattaching too high and to maximize gain (often 1–2 cm on average).

2. Girth Augmentation
   a. Fat Transfer (Autologous Fat Grafting)

   • Fat is harvested from another part of your body (abdomen or thighs) via liposuction.
   • It’s then purified and injected under the penile skin in multiple layers.
   • Results can vary: some of the transferred fat may be reabsorbed over months, so repeat injections may be needed.
     b. Dermal or Synthetic Grafts
   • A biological graft (e.g., cadaveric dermis) or a synthetic material (e.g., silicone) is wrapped or injected around the shaft.
   • Aims to provide a stable increase in girth.
   • Carries slightly higher risk of scarring or foreign-body reaction.
     c. Injectable Hyaluronic Acid (HA) Fillers
   • Based on Yang et al. (2018), HA gel can be injected under local anesthesia to increase penile girth.
   • Advantages: minimally invasive, quick recovery, high patient satisfaction.
   • Limitations: temporary (lasting 6–12 months), may require repeat treatments.

3. Combined Procedures

   • Some men opt for both ligament release and girth augmentation in a single session to address both length and thickness.
   • Recovery may be longer and slightly more complex, but offers more comprehensive enhancement.

---

2. The Surgical Process

1. Consultation and Evaluation

   • Medical history, physical exam, and discussion of realistic goals.
   • Assessment of erectile function (to rule out underlying erectile dysfunction).
   • Discussion of non-surgical alternatives and potential risks.

2. Pre-operative Preparation

   • Avoid smoking and certain medications (e.g., blood thinners) to reduce bleeding risk.
   • Fasting for a specified period before anesthesia.
   • Arrange for someone to drive you home after the procedure.

3. During Surgery

   • Performed under local, regional, or general anesthesia depending on the extent.
   • Ligament release involves a small incision at the base of the penis to cut the suspensory ligament.
   • Girth procedures involve liposuction (for fat transfer) or multiple microinjections (for HA gel) around the shaft.
   • Incisions are closed with fine sutures; injectable procedures require no incisions.

4. Post-operative Care

   • Rest for 24–48 hours; mild discomfort or swelling is normal.
   • Prescribed pain medication and antibiotics to prevent infection.
   • Gentle penile stretching or use of an extender as directed (critical after ligament release).
   • Avoid intercourse and vigorous activity for 6–8 weeks or as advised by your surgeon.

---

3. Expected Outcomes

• Length Gain

  • Ligament release typically adds 1–2 cm in flaccid length. Gains in erect length are more modest.
  • Daily traction post-op can improve final results.

• Girth Increase

  • Fat grafting: average increase of 1–1.5 cm in circumference; variability due to fat absorption.
  • HA gel (Yang et al. 2018): average increase of 1.1 cm in girth with high satisfaction and minimal complications.
  • Dermal/synthetic grafts: consistent girth but slightly higher risk of scarring.

• Patient Satisfaction

  • High when expectations are realistic.
  • Injectable HA procedures report satisfaction rates over 80%.
  • Combined procedures yield the most noticeable overall enhancement.

---

4. Risks and Complications

Every surgical procedure carries risks. Key considerations include:

• Infection

  • Redness, swelling, or discharge at the incision/injection sites.
  • Prompt antibiotic treatment usually resolves this.

• Bleeding or Hematoma

  • Collection of blood under the skin, which may require drainage.

• Unsatisfactory Results

  • Insufficient length/girth gain if post-op care (traction, extenders) is not followed.
  • Asymmetry or irregular contours, especially with fat grafting.

• Scar Tissue Formation

  • Can lead to penile curvature or firmness in spots.

• Loss of Sensation

  • Rare but possible if nerves are damaged during surgery.

• Reabsorption (Fat Grafting)

  • Unpredictable; up to 30–50% of fat may be reabsorbed over 6–12 months.

• Foreign-Body Reaction (Synthetic Grafts)

  • Redness, chronic inflammation, or migration of the material.

---

5. Choosing the Right Surgeon

• Board-certified urologist or plastic surgeon with specific experience in penile enhancement.
• Review before-and-after photos and patient testimonials.
• Ask about complication rates, revision rates, and long-term follow up.

---

6. Cost Considerations

• Ligament release alone: typically ranges from $3,000 to $7,000.
• Girth procedures: $4,000 to $10,000 depending on method (fat grafting vs. HA vs. grafts).
• Combined procedures: can exceed $10,000.
• Insurance rarely covers these elective procedures.

---

7. Alternatives and Adjuncts

• Non-surgical

  • Vacuum erection devices, penile extenders, traction therapy.
  • Slower results but lower cost and risk.

• Hormonal or Supplements

  • No proven permanent increase in size; some carry side effects.

• Lifestyle

  • Weight loss can make more of the penile shaft visible if buried in suprapubic fat.

---

8. Important Reminders

• Set realistic goals: most men achieve modest, not dramatic, increases.
• Recovery commitment: post-op stretching or extenders are not optional.
• Psychological impact: body image concerns may persist even after surgery; consider counseling if needed.

For any new or worsening symptoms—such as severe pain, significant swelling, fever, or discharge—complete a free, online symptom check for reassurance and guidance. Always speak to a doctor about any life-threatening or serious concerns to ensure safety and the best outcomes.