Penile enlargement surgery consists of 2 parts; penile thickening and penile elongation. While penis thickening can be performed alone, elongation surgery is not performed alone. Technically, the surgery will be incomplete, the image will be bad. In other words, fat injection must be performed. Thickening from these two parts (elongation and thickening) is the main complex part. In about 15 years, we have made many modifications on thickening, that is, fat injection, and we have had very different experiences. I believe that in the future revisions and new techniques will be developed to further improve the results of fat injection. The "elongation" part of penis enlargement, however simple, is somehow never understood in our country. Patients are unnecessarily afraid of elongation (cutting the suspensory ligament). Some surgeons are also afraid and do not perform; therefore, while many patients need elongation, it is not performed and buried penises are done only because fat injection is not performed. Some surgeons, on the other hand, abuse this fear of patients and perform ridiculous surgical procedures on patients who do not want the suspensory ligament to be cut(the lie of "We can elongate without cutting the suspensory ligament" lie). I'm astonished as I see these patients. Surgical procedures unrelated to elongation were performed, absurd sutures that did not comply with any technique were done, and as a result, not even 1 millimeter of elongation was achieved. I need to say a few words about that, so...

What's causing all this confusion is the "necessity to cut the suspensory ligament"... Interestingly, cutting the ligament is the simplest part of the penis enlargement surgery. It certainly does not cause any complications. As expected, it does not cause loss of sensation, erectile dysfunction, lowness of penis. These are completely improper fears. In fact, if there is a complication in penis enlargement, it is definitely related to fat injection, i.e. thickening. In addition, we have made a lot of additions and corrections to the surgical technique in the 15 years we have been dealing with this surgery, and all but one of them were related to fat injection, that is, thickening. Regarding the elongation process, we only made one modification. As I said, the "thickening" part of the surgery is the main complex part and is still being developed. If there are complications, it will be in fat injection.

The elongation part, on the other hand, is an extremely simple procedure that is impossible to cause complications, while both patients and surgeons are afraid of "cutting the suspensory ligament". The work done in the elongation process is very simple. The penis rises at bottom the pelvis, extends upwards from the front of the pelvis (this is the part that separates from the bone and slides out), and then extends outwards, i.e. there is a 3-4 cm portion inside, in front of the pelvis, that you can slide out. The procedure performed during surgery is to cut the suspensory ligament that attaches the penis to the bone in front of the pelvis. Also, a series of "push sutures" such as corsets are placed on the back to "push" the penis tissue separated from the bone out. This "cutting the suspensory ligament" procedure is extremely simple, sufficient and does not cause any complications. Therefore, in relation to this process, we have only made one modification in 15 years. That is, the suspensory ligament not completely to be cut. For the elongation process, it is sufficient to cut 80% of the suspensory ligament from the top. There is no need to cut the minimum 20%. I also think the complete separation of the ligament from the pelvis disrupts normal physiology. A man has intercourse with hip movement while having intercourse. So it pushes the pelvis forward, and the pelvis pushes the penis attached to it in front of it. This allows the male to have intercourse with the female. In order to preserve this physiology, the suspensory ligament should not be cut 100%. At this point, I would also like to point out that all books state that the suspended ligament should be completely cut when describing penis elongation. I think this is a faulty technique. Complete cutting of the suspensory ligament causes the pelvis support on the back to be removed during the intercourse. For this reason, it is necessary to cut only 80% of the suspensory ligament from the top and to leave the minimum 20% intact. There is no additional benefit of cutting 20% of the bottom anyway. Therefore, it is very unnecessary for me this ligament to be cut completely. I have another idea at this point; it is also a mistake to call this ligament a "suspensory ligament!". This ligament doesn't actually hang the penis, it just brings part of it in front of the pelvis. Its primary function is not to hang the penis; if so, the penis would be low in erection when the classical technique in the books is applied (when the "suspensory ligament" is completely cut). Between 2004 and 2009, I used the classic technique and cut the suspensory ligament completely. None of these patients came with low penis complaints. Complete cutting of the suspensory ligament is unnecessary, the lower part is difficult to cut, disrupts normal physiology. That's why I only recommend cutting 80% of it from the top.

So what are the wrong practices on this subject? What are the unfounded fears of patients? What is the right thing to do?

Let's keep them in the next section.

Don't forget to read second part of the article. I'll tell you all about my clinical experience.

Dr. Oytun İdil (Plastic and recontructive surgeon)
www.idilpenissurgery.com
oytunmd@gmail.com
+90 533 5690649
+90 505 2965569

Op. Dr. Oytun İdil

(Plastic aesthetic and reconstructive surgeon)

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• Op. Dr. Oytun İdil: +90 533 569 0649
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