Penile Lengthening is a relatively new technique in the plastic/cosmetic surgery field. It was first performed in China, in 1984, by Dr. Long Daochau. Dr. Daochau performed the surgery on a man who, as an infant, had his penis bitten off by a dog. The success of this procedure made it possible to offer it to adults who have a normal size penis, but who are unhappy with the length of their penis.
In the relatively safe environment of the doctor’s office, many men confide that they experience embarrassment and lowered self-confidence when in the locker room with other men or when in the bedroom with women. They report that they feel “less a man” because of the size of their penis. They believe that having a longer penis will improve their self-esteem and self-confidence, and decrease their constant frustration with the size of their penis. Before surgery, patients usually express excitement. After the surgery, most of them speak enthusiastically about their experience, express satisfaction with the results, and often report a positive sense of feeling "sexier". Of course, there are some patients who will never be satisfied with the surgeon and/or the surgery, no matter how surgically perfect the operation.
This surgery primarily increases the non-erect (flaccid) length of the penis and, to a lesser extent, the erect length. The average penis length that a patient gains as a result of this surgery varies from person to person, and may or may not fall into the normal range of one-half to one-and-one-half additional inches in the flaccid position. It is not possible to determine before surgery how much length the patient will gain from the surgery. Separation of the penis from the pubic bone, combined with suprapubic liposuction, enhances the length of the penis, and additional length can be gained by repositioning the scrotal pubic fold closer to the pubic area.
Achieving the desired result from the lengthening procedure depends equally on ligament detachment performed by the surgeon, and physiotherapy performed by the patient. Physiotherapy involves wearing weights after surgery (stretching exercises) for about up to one year after surgery. The patient must carefully follow the physiotherapy instructions given to him, in order to maintain the extra length gained during the operation, and to ensure that the gain will be long-term. In addition, sexual activity must be avoided for at least 3 weeks after surgery, and there should be no participation in sports for at least 4 weeks after surgery. Pain resulting from this surgery is minimal, and most men require just three to four days off work. This varies, depending on the individual and on the demands of the job.
Ligament detachment—release of the suspensory and fundiform ligaments and a few collateral ligaments—is required to increase penile length. When these ligaments are cut, the penis is freed, or disconnected, from its pubic bone attachments. This allows the part of the penis that was previously hidden inside the body to hang outside the body, thus increasing the visible length of the penis. In other words, by increasing the portion of the penile length outside the body, the penis appears longer, although it simply hangs lower from the body than it did when part of it was being held inside the body.
The surgery is performed under general anesthesia. The lengthening procedure is performed through a curvilinear incision, approximately two inches in length, in the infrapubic region at the base of the penis. Release of the internal part of the penis can occur only after excising all ligaments holding the penis.
It is important to note that many patients have unrealistic expectations of penile lengthening surgery. Despite what is written above, they think that after surgery their penis may increase two to three inches in length. This expectation is absolutely unrealistic and can create tremendous dissatisfaction for the patient. This dissatisfaction can, in turn, compromise the reputation of the surgeon and his techniques. Men have anatomical restrictions that prevent such a large increase in penis length. One of these restrictions is the length of that portion of the penis that exists inside the body and that can be freed up from its ligaments through surgical separation. This hidden portion of the penis varies in length from one-half inch to one inch. Another restriction is that the quantity of cells in every man’s cavernous bodies is fixed. These cells do not multiply as a result of lengthening surgery. Yet another restriction is the amount of compliance with the stretching exercise program following surgery. The patient must have realistic expectations when undergoing penile lengthening surgery.
Penile lengthening is a safe surgical procedure that provides excellent results when performed by a qualified, trained surgeon. Dr. Alexander Krakovsky is Vice President of the American Academy of Phalloplasty Surgeons. In 2002, the American Academy of Phalloplasty Surgeons issued a position statement regarding phalloplasty surgeries. This statement outlined standards and guidelines for the safety of phalloplasty surgeries. The statement specifies that phalloplasty surgeries are considered safe and effective under these standards and guidelines only if performed by a qualified surgeon who has completed special phalloplasty surgical training. Many plastic and cosmetic surgeons who have never undergone special phalloplasty training are performing phalloplasty surgeries. As a result, thousands of men are faced with injuries for which reconstruction is very difficult, or even impossible, to perform. Even when performed by a qualified surgeon, it is critically important that the patient learn about the possible complications of this type of surgery before making any decision regarding the surgery and, if the surgery is performed, the patient must precisely follow pre-operative and post-operative instructions.
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