Penile Lengthening Surgery – Ligamentolysis with Laser

Laser ligamentolysis is the most advanced surgical option for permanent penile lengthening. The procedure involves cutting the suspensory ligament, allowing more of the penile shaft to extend outside the body.

• Procedure performed under general anesthesia

• Day-care surgery – no overnight hospital stay required

• Gain of 2–5 cm in visible flaccid length

• No incision on the penis itself

Additional supporting techniques:​

• Suprapubic lipectomy (vibroliposculpture)

• Penoscrotal webbing release

Results become more refined within 3–6 months. Scar contracture may reduce some gains if post-op instructions are not followed.

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Liposuction for Penile Visibility Enhancement

For men with excess fat in the lower abdominal area, liposuction can dramatically improve the visual length of the penis. By removing fat from the suprapubic region, the penis—especially in flaccid state—appears longer and more prominent. While the procedure boosts self-confidence, long-term benefits are best sustained through lifestyle changes, such as diet and exercise.

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Full Penis Enlargement – Length + Girth Combination

This day-care surgical procedure targets both dimensions:

• Length gain: 2–5 cm

• Girth gain: 30–40%

• Permanent results

This combined approach reshapes the penis through ligament release and volume augmentation techniques. There is no need for skin grafts as the existing penile skin allows full coverage.

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Girth Enlargement – Fat Grafting and Filler vs. Grafts

Autologous Fat Injection

Fat is harvested via liposuction, processed, and injected around the penis:

• Natural, safe, and biocompatible

• Enriched with stem cells to reduce resorption

• Long-term results with natural tissue integration

• May require touch-up procedures in some cases

Hyaluronic Acid-Based Fillers (SafeFill®)

One of the safest and most popular methods for girth enhancement:

• Non-surgical, minimally invasive

• Immediate results with no downtime

• Can be adjusted or reversed

• Does not interfere with penile function or sensation

• Ideal for patients who want quick, safe, and flexible outcomes

At our clinic, SafeFill® and fat grafting are considered the first-line options for girth enlargement due to their safety profile, reversibility, and natural aesthetic outcomes.

Acellular Dermal Grafts (e.g. AlloDerm, BellaDerm)

• No need for harvesting tissue from the patient's own body

• Reduces operative time and donor-site complications

• 30–40% permanent girth enhancement

Modern grafts provide better consistency than fat injections, but they still carry higher risk profiles compared to fillers and autologous fat.

Risks of Xenografts – SurgiMend, SureDerm, Tutopatch

These materials, derived from bovine pericardium, are marketed as thick and strong dermal matrices. Although FDA- and KFDA-cleared for general surgical use, they are not approved for penile enhancement.

Common Complications:

• Chronic fibrosis, pain, and swelling

• Scar contracture and penile shortening (2–3 cm reported)

• Subcutaneous masses and disfigurement

• Hardening and loss of natural flexibility

• Irreversible outcomes requiring complex revision surgery

These techniques are discouraged due to high risk of complications, long-term dissatisfaction, and structural damage to penile tissues.

Conclusion: Filler and autologous fat injection remain the safest and most effective options for penile girth enhancement. Graft-based or xenograft techniques, despite being used in some centers, are associated with serious risks and should be avoided whenever possible.

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SurgiMend: A Cautionary Note

SurgiMend is marketed as a thick, collagen-rich acellular dermal matrix derived from fetal and neonatal bovine dermis. Although FDA- and KFDA-cleared for general surgical use, it is not approved for penile enhancement and carries significant risks when used in such procedures.

Claims and Theoretical Advantages:

• High collagen density and mechanical strength

• Rapid tissue integration and vascularization

• Regular 4.0 mm thickness

• Claimed high patient satisfaction after full engraftment

Documented Disadvantages and Complications:

• Performed under anesthesia with poor cosmetic outcomes

• High risk of chronic pain and swelling due to fibrosis (scarring)

• Penile shortening of 2–3 cm has been commonly reported

• Loss of natural flexibility and hardness

• Irreversible changes; revision surgery may not restore normal function

Conclusion: While SurgiMend is structurally strong, it is not suited for penile enlargement. The risks outweigh the proposed benefits.

SureDerm: Associated Risks in Penile Enhancement

SureDerm is a widely used acellular dermal matrix claimed to provide a human skin-like texture. Though FDA-approved for general medical applications, it is not approved or recommended for use in penile augmentation.

Marketed Advantages:

• No antigens, no skin testing required

• Integrates with host tissue

• No post-implant cysts or blisters

• Lower cost than AlloDerm, higher accessibility

Critical Disadvantages and Warnings:

• Used under anesthesia, but often fails to deliver desired aesthetic results

• High rate of fibrosis, leading to chronic pain

• Significant risk of penile shortening (2–3 cm)

• Irreversible effects that may leave patients with permanent deformity or dysfunction

Conclusion: Despite being affordable and biologically compatible in other areas of surgery, SureDerm is not a safe or effective option for girth enhancement procedures in men.

Important Reminder: At our clinic, we strictly avoid using SurgiMend, SureDerm, and other xenograft materials for penile enhancement due to the unacceptable rate of complications and permanent damage. Safer alternatives like SafeFill® fillers and autologous fat injection are strongly recommended.

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Silicone Implant Girth Enlargement – Penuma® and Peniflex®

Penuma® is the first FDA-cleared silicone penile implant developed for cosmetic girth enhancement in men. It is designed to provide both permanent and reversible results, and is recommended only for select patients. Since 2004, Penuma® has been successfully implanted in thousands of men worldwide. A comparable alternative, Peniflex®, is also available and shares similar procedural outcomes and patient satisfaction rates.

Who Is a Candidate?

• Must be over 21 years old

• Must be circumcised (or willing to undergo circumcision prior to implantation)

• Must not have had prior filler, fat, or silicone enhancement procedures

• Must undergo a thorough consultation and physical evaluation

If a candidate is declined, it is typically due to previous penile enhancement procedures, which may compromise the success and safety of the implant.

Surgical Details and Approach:

• Implant is placed via a lateral, scarless scrotal incision

• Performed under general anesthesia

• Recovery time is generally short with appropriate post-op care

Clinical Standing at Our Clinic:

Penuma® and Peniflex® are considered third-line options at our clinic, used only after fillers and fat grafting when those are not indicated or preferred. The technique can offer long-term volume and length gain in select patients, but must be approached with informed caution.

Disadvantages and Risks:

• Although rare, complications can occur

• Reported issues include:

  • Severe swelling (edema)

  • Subcutaneous masses

  • Penile curvature or deformity

  • Infection and non-healing wounds

  • Scar tissue formation

• Revision surgery may be needed in some cases

Important Note: All potential risks and complications will be discussed in detail during your consultation. The implant procedure should only be considered by patients who are fully informed and have realistic expectations.

We emphasize that Penuma® and Peniflex® are not first-line treatments. For most patients, SafeFill® fillers or autologous fat grafting provide safer, effective, and less invasive options for penile girth enhancement.

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