Ligamentotomy: what is it, indications, procedure

Indications for surgery

The main indication for ligamentotomy is the length of the penis up to 12 cm during full arousal. The most common reason for a small penis is the anatomical structure (congenital micropenis). But the operation is also performed in other cases:

• reduction in size after injury;
• hypospadias, in which the urethral opening is located incorrectly;
• curvature of the penis (Peyronie's disease);
• epispadias (the upper wall of the urethra is completely or partially split);
• replacement of the cavernous bodies of the organ with connective tissue (cavernous fibrosis);
• hereditary diseases - Kallman or Klinefelter syndrome.

Types of genital surgery

Penis size correction is carried out in several ways:

• Lengthening (course of conservative therapy, surgical treatment: ligamentotomy and corproplasty).
• Thickening (hyaluronic acid injections, implants).
• Head enlargement (hyaluronic acid injections).
• Surgical correction of curvatures (conservative therapy and surgical correction).

Intimate problems in men at the Angio Center clinic are solved at a professional level. We guarantee confidentiality and provide the most comfortable and safe conditions.

Contraindications to ligamentotomy

• The presence of mental illness at any stage;
• The location of the malignant tumor in the genital area;
• Presence of uncontrolled hypertension:
• The patient’s individual immunity to painkillers, anticoagulants, the presence of allergic reactions to metal seams, disinfectant solutions;
• Advanced infection of bacterial etiology;
• Inflammatory processes in the genital area;
• The presence of diseases characterized by poor blood clotting;
• Previous operations on this area and genital injuries;
• The presence of sexually transmitted diseases, infectious and inflammatory processes in the lower body.

Preparation for ligamentotomy

The duration of ligamentotomy depends on the method and takes 20-60 minutes. Before the operation, the man undergoes a standard examination, which includes:

1. Consultation with a urological surgeon and psychiatrist.
2. Blood tests (clinical and biochemical).
3. General urine analysis.
4. Urethral swab.
5. Blood test for syphilis, HIV infection and hepatitis.
6. Electrocardiogram.
7. Fluorography.
8. Examination by an anesthesiologist.

Preparation for the operation begins 10 hours in advance; the patient is advised not to eat or drink; his groin area is shaved.

Reviews

Evgeniy, 36 years old: “Almost my entire adult life I had a complex about the modest size of my penis, and in the end I decided to get fillers. Both the barrel itself and the head were chipped. Despite the anesthesia, discomfort was present, but quickly passed. He started having sex within a month. As a result of the operation, the penis became 2 cm thicker and 0.5 cm longer, and sexual intercourse almost doubled without loss of pleasure from the process.”

Dmitry, 29 years old: “Due to premature ejaculation, I decided to have the head injected with hyaluronic acid and did not regret it: sexual intercourse lasts 20-30 minutes, and the head itself has become clearly thicker. The effect lasted not for a year, as the doctor promised, but for two.”

How is the penis lengthened through ligamentotomy?

The operation is performed under anesthesia. A skin incision is made in the middle of the scrotum, through this incision the surgeon gains access to the penile suspensory ligament, which is cut with a scalpel. The duration of the operation is 0.5-1 hour. Absorbable sutures are placed on the skin of the scrotum.

Carrying out the operation

The course of the operation includes several stages:

• the patient is placed on a sterile couch;
• spinal anesthesia is administered; monitor the body's reaction;
• the surgeon makes a small incision;
• palpates the connective ligament;
• dissects it with a scalpel;
• with slow and careful movements, stretches the penis to the maximum length of the ligament (it is different for each person);
• the incision is sutured; a bandage is applied.

Ligamentotomy can be carried out according to the standard method, but in modern medicine another type of it is used - with the introduction of adipose tissue into the cavity to increase the diameter of the penis. Also, plastic surgery differs according to the type of excision - through the scrotum or pubis.

Excision in the scrotal area

This technique is considered the most modern and safe. If earlier access to the ligament was made through the pubis, now it is done through the scrotum, which opens up new possibilities:

• The operation time is reduced to 10-20 minutes;
• there is no scar;
• soft tissue trauma decreased;
• it became possible to perform surgical manipulations with a large amount of fatty tissue;
• maximum painlessness after and during surgery.

Features of the procedure:

• the skin is cut in the area of ​​the scrotum (the upper part of the seminal sac), after which the soft tissues are pulled apart;
• access to the ligamentous apparatus is opened;
• the superficial sling-shaped ligament is cut;
• the suspensory ligament is highlighted;
• hemostasis is performed.

During scrotal excision, the surgeon pays attention to the mobilization of the ligaments located next to the branches of the dorsal vein and the spermatic cords.

Dissection in the pubic area

This is the first method of penis enlargement that was used. Its distinctive feature is the following:

• excision is made in the pubic area;
• large scars remain;
• high level of soft tissue trauma;
• difficulties in operating if the patient is overweight;
• long rehabilitation period;
• the formed scar in many cases does not allow the penis to fully take the upward direction.

Differences between techniques

Pain sensations with these two methods differ: with the first option, exit through the scrotal area is characterized by safety and painlessness for the patient, but certain difficulties for the surgeon. In the second option, it is easier for the doctor to excise the ligament through an incision above the pubic area, but this promises pain for the patient.

Plastic surgery is done under local anesthesia. The duration of the operation is about 50 minutes. Upon completion, a bandage is applied to the postoperative area. The sutures are removed after 2 weeks.

Rehabilitation after ligamentotomy. Extender

An extender is a device that is a prerequisite after ligamentotomy, without which the postoperative effect will not be observed, and the operation will be in vain.

The device must be used for more than 3 months for 4 or more hours daily. It is generally accepted that most of the lengthening process occurs between the third and sixth months.

Composition and main brands of intimate fillers

Fillers are drugs that are injected under the skin to increase tissue volume. Products based on hyaluronic acid are considered the safest from the point of view of acceptance by the body. Fillers use artificially synthesized stabilized hyaluronic acid. This avoids complications such as material rejection and allergic reactions.

For intimate plastic surgery, viscoelastic gels are used. They remain at the injection site rather than migrate to nearby areas. Most clinics prefer Bellcontour G-visc from the Swiss concern Hyal Intertrade SA. It has optimal viscosity (228,370 kPa) and elasticity (963 Pa).

Packaging of G-visc filler

1 ml of gel contains 24 mg of highly purified bound hyaluronic acid (acid concentration per 1 ml is the density, which directly affects the rate of biodegradation). The kit includes 3 0.8 ml syringes and 6 atraumatic needles made in Japan. The drug is completely absorbed after 9-12 months. The duration of the effect depends on the quality of the blood supply to the tissues. For example, when a filler is introduced into the glans, it biodegrades after 7-12 months, into the body of the penis - from 1.5 to 2 years. The procedure will have to be repeated after 2.5 years.

Some clinics use hyaluronic fillers Reneall Secret Life with a density of 20 mg, Macroline, Restylane (all made in Switzerland). The last two belong to the first generation drugs and are the most affordable. Experts do not recommend using them for intimate plastic surgery, since these fillers are more suitable for correcting the breasts, buttocks, legs, and scars. There is a high probability of them migrating and clumping into clumps. Removing such formations is quite difficult.

Results: before and after ligamentotomy

None of the methods can guarantee 100% penis enlargement. Even men who decide to have surgery cannot boast of the result they expected. In most cases, elongation of the genital organ is observed, but these indicators barely reach 2-3 cm. For example, if a guy’s penis length in its normal state barely reaches 12-13 cm, then after excision of the suspensory ligament it will increase to 4 cm. But this does not mean that this result will be achieved by everyone who performs a ligamentotomy.

In this case, continued wearing of the extender plays an important role. If you wear it in strict accordance with the diagram drawn up by the doctor, the growth of the phallus will be much more noticeable than if you deviate from it. Ligamentotomy, the results of which directly depend on the individual characteristics of the structure of the penis, is an effective way to enlarge the shaft, but at the same time, the effectiveness of the procedure is determined by the patience and diligence of the patient. After all, wearing an extender every day for many months is difficult. Not every person is able to use the device every day.

Corpoplastic

Surgical intervention involves not only increasing the length, but also eliminating anatomical curvatures of acquired or congenital etiology.

The method of performing corporeplasty depends on the degree of curvature:

• Plication (curvature angle more than 45 degrees) - application of tightening sutures on the side of the deformity. The technique is used only if the length is sufficient (from 9.5 cm at rest).
• Flap - involves excision of the tunica albuginea and closure of the resulting defect using a transplant (skin flaps, donor materials, synthetic implants). This method of surgical intervention is used for short lengths to correct complex anomalies.

Sexual activity is permissible no earlier than after 2 months.

Is it worth performing a ligamentotomy?

So, to do or not to do? Not every man can decide to have a ligamentotomy. Firstly, this is a responsible decision, and secondly, it is quite expensive. In the Russian Federation, the cost of ligamentotomy is 30,000-90,000 rubles; this difference is determined by the qualifications of the plastic surgeon, the rating of the clinic and the price of the extender.

For obvious reasons, any patient-respecting urological center that performs ligamentotomy provides detailed information about this intimate operation on its website. Plastic lengthening of the penis by cutting the suspensory ligament is considered a simple and relatively safe operation. But no clinic will give an absolute guarantee. Therefore, the choice is yours - to have surgery or try to solve the problem not so radically.

Which clinics offer augmentation services?

As a rule, these are private medical centers and clinics dealing with men's health issues. There are such in Moscow, St. Petersburg, Kazan, Novosibirsk, Tyumen, Krasnoyarsk, Barnaul and other cities of Russia. You can find out about the location of such centers from a urologist or andrologist at a state clinic.

Surgery to enlarge the penis at affordable prices is performed in Ukraine, Belarus, Kazakhstan and other neighboring countries.

Surgical treatment is successfully performed in clinics in Israel, Germany, the USA, and Latin American countries.

You can get help in foreign clinics thanks to the developing medical tourism.