There are two ligaments in the penis, the suspensory ligament and the fundiform ligament, which hold the penis at the base and which are attached at their other ends to the abdominal wall and the pubic bone, respectively.
In this way, the ligaments are the cause that, when the penis is erect, it extends out of the body to a specific and constant distance.
It is the more superficial of the two. The fibers of the fundiform ligament originate in the fibers of the superficial fascia of the penis or Colles fascia around the base of the penis and end up forming bundles (narrower structures) on the sides of the penis, giving lateral support to the penis.
It is the deepest and the strongest of the two.
The suspensory ligament originates at the base of the penis by the conversion of Buck’s fascia and the tunica albuginea on both sides of the penis, forming a bundle of fibers in the dorsal part that extends towards the symphysis pubis.
Penis enlargement surgeries
Penis enlargement (augmentation phalloplasty) is a relatively simple surgery, with local anesthesia plus sedation or spinal, in which the suspensory ligament and fundiform ligaments are divided, releasing a segment of the penis of about 3 cm that is internalized in the pelvis, achieving an increase in the external length of the penis of 2 to 4 cm, especially when it is flaccid and somewhat less in a state of erection (a greater extension of the penis is allowed when it is in an erect state by not having the ligaments that act as a stop).
In the same procedure, a V-Y closure of the surgical wound is performed on the skin that allows tubularization of the section of skin gained in the penis enlargement to achieve a more natural effect and reduce the risk of subsequent retraction. In cases where the skin is sufficiently elastic and a better aesthetic result is desired in the pubic scar, the incision instead of inverted V with posterior closure with VY advancement plasty can be performed through a small transverse incision at the base pubis, leaving a minimal posterior aesthetic scar.
With this technique, the direction of the penis in the erect state can be lowered by about 10º of angulation with respect to that prior to surgery, and it does not entail any functional problem when having sexual intercourse.
No silicone prosthesis or other filling materials are inserted in order to avoid possible retraction; For this, a special internal suture is performed that reduces the risk of this complication without the possible adverse effects that the prostheses could give.
In addition to this surgery, other procedures can be performed in the same act:
On the same day of the surgery, he is discharged home.
The postoperative period, if surgery or filling treatment with hyaluronic acid has not been carried out, only requires a certain relative rest (do not perform physical activities that require effort, care of the surgical wound (washing with soap water and application of Betadine) and exercise of extension to avoid a possible retraction from the second week after the intervention.
A penis extender can be used postoperatively to consolidate the result of the intervention and as adjunctive treatment to achieve an additional 1-2 cm in the final length of the penis.
The thickening of the penis consists of an increase in the circumference of the penis both at rest and in erection during the same act of penis enlargement or in isolation, using different techniques.
There are temporary techniques, and other permanent ones. All of them can be performed on an outpatient basis with local anesthesia.
The advantage of thickening is that in addition to increasing the visual size of the penis, it adds a functional improvement by filling the vaginal walls more and therefore stimulating the sensitive endings more.
Obtaining abdominal fat from the patient himself and processed through the exclusive Lipogems system to obtain ultrafiltered fat enriched with stem cells, which allows to increase the vitality of the fat and reduce the rate of reabsorption of the same, and later inject it into the penis (lipotransference ).
Obtaining abdominal fat at the level of the pubis, creating “covers” of fat through our own technique and autologous autograft of said fat on the Buck’s fascia of the penis.
Layers of a type of completely biocompatible resorbable collagen mesh of the latest technology, with a very low rate of complications, guaranteeing a permanent result.
These sheets are remodeled using their own technique to achieve an optimal individual adaptation for each penis and achieve a more natural result.
Experience has allowed me to develop my own technique so that the result is more natural and there are fewer complications, as well as being able to perform the procedure through 2 types of approaches:
Filling techniques using hyaluronic acid, which achieves results of 2-3 cm increase in the circumference of the penis both at rest and in erection and with a duration of more than 1 year, and with a certain permanent residual effect due to the endogenous production of collagen and that allows repeating the procedure as many times as desired.
To perform this procedure, the ideal is to be previously circumcised, however, said intervention can be performed in the same act, or the possibility of performing it without performing circumcision can be evaluated.
As an alternative, to surgery and fillers, we have recently incorporated penile enlargement through growth factors obtained through platelet-rich plasma into our portfolio of treatments.
This novel treatment increases the volume, both length and thickness, by stimulating the formation of new blood vessels at the level of the corpora cavernosa of the penis, managing to increase the blood flow of the erect penis and therefore, as more blood arrives, increases the penis size.
Additionally, an improvement in the quality of erections and sexual intercourse is achieved.
As an additional or isolated procedure, hyaluronic acid and / or Platelet Rich Plasma can be filled in the glans to achieve an increase in its thickness, and at the same time to prolong ejaculation time.
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We are urologists, so we approach this type of procedure with a complete aesthetic and functional vision. We are experts in male genitalia, with extensive experience in the field of genital surgery, using the latest techniques that offer the best results.
We offer total transparency and honesty, without false expectations. We carry out an individualized study in each case to be able to advise you and offer you the most appropriate treatment to seek the best aesthetic result without loss of functionality (including the advice not to need surgery). If you are interested, contact us, we will send you an explanatory document and we will clarify any doubts.
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