Ligamentolysis: What Suspensory Ligament Release Can and Cannot Do
Ligamentolysis releases the suspensory ligament, which anchors the penis to the pubic bone, so more of the shaft sits outside the body. It can make the penis look longer at rest. However, it does not grow new tissue, and the gain during an erection stays modest.
Medically reviewed by Assoc. Prof. Dr. Tuncay Taş, urologist. Updated November 2026.
That difference between resting length and erect length decides whether this surgery suits you. This guide explains what the operation changes, what it leaves alone and why the weeks after surgery matter so much.
What is ligamentolysis?
Part of the penis sits inside the body, hidden below the pubic bone. Two bands of tissue hold that shaft in place: the fundiform ligament, which lies closer to the skin, and the deeper suspensory ligament, which attaches to the bone itself.
During ligamentolysis, the surgeon divides part of the suspensory ligament through a small incision above the penis. As a result, the shaft can move forward and hang lower. So the operation reveals length you already have, rather than creating more.
The names you will see
Clinics use several names for this operation, and most of them mean the same thing. The table below can help you read an offer.
Term | What it usually means | What to ask |
Ligamentolysis | Release of the suspensory ligament | How much of it will you divide? |
Ligamentotomy | A cut through the same ligament | Is this the same operation? |
Suspensory ligament release | The plain English name | What happens to the gap afterwards? |
Penis lengthening surgery | Often a release, sometimes with more steps | Which steps does the plan include? |
What suspensory ligament release can do
Assoc. Prof. Taş describes this as an operation for visible length. In the right man, it can bring real and useful changes.
A longer look at rest: the penis hangs lower because the ligament no longer holds it upward.
More visible shaft: hidden shaft moves forward, which also helps when a man feels the base looks short.
A base for other steps: the surgeon can combine it with fat pad contouring or a skin repair in one plan.
A clearer outline: the area above the penis can look more defined when the plan includes contouring.
How much you gain depends on your anatomy. Specifically, the amount of hidden shaft, the elasticity of your skin and the thickness of your pubic fat pad all play a part. For that reason, we do not promise a set number of centimetres in this guide.
What it cannot do
Honest limits matter here, because most disappointment comes from a mismatch between the goal and the method.
Your goal | What release offers | A better question |
Longer look at rest | A realistic goal for many men | How much shaft sits hidden? |
Longer erection | Only a modest gain | Is your erect size already normal? |
More girth | No change in width | Which girth method fits you? |
Firmer erections | No effect on firmness | What causes the weak erections? |
Straighter penis | No correction of a bend | Do you need curvature surgery? |
Why the erect gain stays modest
An erection depends on the erectile bodies, two long chambers that fill with blood. The operation does not lengthen these chambers. Consequently, the penis keeps essentially the same erect size, although a little more of it can show at the base.
Many men only learn this after they have booked. So if your main goal is a longer erection, ask your surgeon about it directly. Assoc. Prof. Taş raises this point before any plan, because a clear answer can save you an unnecessary operation.
Why it does not treat erection problems
Weak erections need their own assessment, since they can point to blood vessel, nerve or hormone problems. In addition, the NHS advises men to get persistent erection problems checked by a doctor. Treatment comes first, and a cosmetic decision can follow later.
Our erectile dysfunction treatment page sets out the options. Assoc. Prof. Taş has also published early results on platelet-rich plasma for erectile dysfunction, listed in the sources below.
Who may benefit, and who should wait
The best candidates have a clear goal and healthy erections. A careful examination then shows whether enough hidden shaft exists to make surgery worthwhile.
May suit: healthy adults who mainly want a longer look at rest and accept the limits above.
May suit: men whose fat pad or skin hides part of the shaft, because contouring can reveal it.
Needs extra care: men with earlier penile or pubic surgery, since scar tissue makes the operation harder.
Should wait: men with uncontrolled diabetes, a bleeding disorder or an active infection.
Should think again: men who expect a large erect gain or whose goal is mainly about girth.
Most men who worry about size fall within the normal range. In that situation, Assoc. Prof. Taş says so plainly. Similarly, the NHS describes body dysmorphic disorder as a treatable condition, and surgery does not solve it, so see your doctor first if size worries fill your day.
Hidden length that needs a different repair
Sometimes the ligament is not the main problem. A thick pubic fat pad can hide shaft, and a skin web between the penis and scrotum can make the underside look short. Then a surgeon may treat the fat or the web first, with or without a release.
Weight loss also helps some men, because it reduces the pad at no surgical risk. So a good assessment looks at the whole area, not just the ligament.
How a urologist decides whether it makes sense
A good decision starts with measurement, not with a price list. Assoc. Prof. Taş measures the penis at rest and on gentle stretch, and he asks about your erect length. The gap between those numbers shows how much hidden shaft a release could bring into view.
He also checks several things that can change the plan:
Erection angle: a high angle today gives you more to lose afterwards.
Pubic fat pad: a thick pad may hide more shaft than the ligament does.
Skin: tight or webbed skin can limit how far the shaft moves.
Earlier surgery: old scars make the release slower and harder.
Erections: weak erections need attention before any cosmetic step.
Sometimes the honest result of this visit is advice against surgery. If little shaft sits hidden, the operation has little to offer. You should also feel free to leave without booking anything.
Partial or complete release?
Surgeons do not all divide the same amount of ligament. Dividing more can free more shaft, yet the erect penis also loses more support. So the surgeon has to balance visible length against stability.
Assoc. Prof. Taş releases part of the ligament and keeps this balance in view. Ask any surgeon to explain their own approach in plain terms. A vague answer here should make you pause.
What happens during the operation
You will usually have sedation or general anaesthesia, and the operation takes about 60 to 90 minutes when no other procedure joins it. Most men go home the same day or the next morning.
Assessment: the surgeon examines the penis at rest and on gentle stretch, then checks your blood tests.
Incision: a small cut above the penis gives access to the ligament.
Release: the surgeon divides part of the ligament under magnification, away from the nerves and vessels.
Protecting the gap: the surgeon can place a small tissue barrier where the ligament used to be.
Closure: the wound closes in layers, sometimes with a skin technique that resists scar pull.
Why traction decides how much you keep
After the release, the body fills the gap with scar tissue. Scar tissue contracts over time, so it can pull the shaft back toward the pubic bone. This retraction is the main reason a man can lose part of his early gain.
Therefore, traction forms part of the treatment rather than an optional extra. You usually start once the incision has healed, often in the second or third week. Then you wear a medical extender for a few hours a day over several weeks, and the team adjusts your schedule at each follow-up.
Our penile extender and traction guide explains how the devices work and what the evidence shows. If a clinic never mentions aftercare, treat that as a warning sign.
Recovery after ligament release
Recovery is usually steady, and most men return to desk work within about a week. As a general guide:
Days 1 to 3: swelling and soreness above the penis, eased by simple pain relief.
Weeks 1 to 2: bruising fades, and you keep the wound clean and dry.
Weeks 2 to 3: traction often begins once the wound has healed.
Weeks 4 to 6: everyday activity returns, while sex and heavy exercise wait for your surgeon's approval.
Months that follow: the scar matures, and your final look gradually settles.
A few habits help during this time. For example, avoid smoking because it slows wound healing, and report fever, spreading redness or growing pain the same day.
What are the risks of ligamentolysis?
Like any operation, this one carries risk, and a calm conversation about it belongs in your first visit. Most problems stay minor and temporary, yet a few can change the result.
Retraction: scar contraction pulls the shaft back, and the gain shrinks.
Lower erection angle: the penis may point less upward, because the ligament no longer lifts it.
Less stability: some men notice a slightly less steady erection during sex.
Numbness: feeling can change around the incision, usually for a while.
Wound problems: infection, bleeding or a visible scar above the penis can occur.
Disappointment: the result may fall short of what you pictured.
Because of these trade-offs, men with a strong upward erection angle should discuss the likely change first. Our post on whether enlargement surgery is safe covers wider safety questions.
Sex after a ligament release
Once your surgeon clears you, most positions should still be possible. However, a lower angle or a less steady shaft can change what feels comfortable. For that reason, start gently and stop if you feel pain.
Your traction routine continues alongside this stage. So keep your follow-up visits, even when everything feels fine. Report any new bend or sudden pain during sex promptly.
If you already have a penile implant
A release does not make a prosthesis longer. It also removes support that helps a firm implant stay steady. Our post on whether a penile implant makes you bigger explains what to expect from these devices.
How it compares with other options
Ligament release answers one narrow question: how much shaft shows at rest. Other methods answer different questions, so compare them by goal rather than by price alone.
Option | What it mainly changes | Main trade-off |
Ligament release | Visible length at rest | Surgery plus weeks of traction |
Extender alone | Stretched length, slightly | Hours of daily wear for months |
Fat pad contouring | Hidden shaft at the base | Needs a thick pad to help |
Filler or fat transfer | Girth, not length | Filler fades, and some fat is lost |
Soft silicone implant | Permanent girth, not length | A larger operation with its own risks |
Some men want more than one change. Our penis enlargement techniques and safety guide compares the methods in more depth, and our post on what penoplasty means explains how clinics combine them.
What does ligament release cost?
With Assoc. Prof. Taş in Istanbul, the guide price for ligament release runs from $3,500 to $6,000, and a written quote follows the consultation. His published list shows $10,000 to $20,000 in the United States and £8,000 to £13,000 in the United Kingdom.
Health insurers rarely pay for cosmetic length surgery, and the NHS does not routinely fund it either. For the full plan and hospital stay, see our penis lengthening surgery page.
Questions to ask before you book
These questions help you compare surgeons on facts rather than adverts.
How much shaft do you think sits hidden in my case, and how did you assess it?
What change should I expect at rest, and what during an erection?
Will my erection angle change, and by how much in your experience?
Which traction device do you recommend, and for how long?
Who follows my traction schedule once I am back home?
What will you do if the shaft retracts?
Be wary of guaranteed centimetres or pressure to decide quickly. To understand how results vary between men, you can also browse the results gallery.
Travelling from the US, Canada or the UK
This surgery needs follow-up long after the flight home, so plan the traction phase before you book. The NHS also advises checking your surgeon's training and the aftercare plan before any treatment abroad.
Time in Istanbul: plan up to about a week, so that a wound check happens before you fly.
The flight home: ask when you can travel, and walk around regularly on a long flight.
Back home: tell your own doctor about the operation, and keep your surgical records.
When to see a urologist
See a urologist before you decide on any length procedure, and sooner in these situations.
You had surgery elsewhere, and the shaft has pulled back or the scar feels tight.
You notice redness, fever, pus or growing pain after a procedure.
Your erections have become weaker or less reliable.
You have a new bend or a firm lump in the shaft.
To discuss your goal with Assoc. Prof. Taş, book a consultation or message the team on WhatsApp. He will examine you and explain what a release could change, and what it could not.
Frequently asked questions
What is ligamentolysis?
Ligamentolysis is surgery that releases the suspensory ligament, which anchors the penis to the pubic bone. As a result, more of the shaft can sit outside the body. It does not create new tissue.
Does ligamentolysis increase erect length?
Only modestly. The erectile bodies keep their size, so the main change appears at rest. For that reason, men whose only goal is a longer erection are often disappointed.
Is ligamentotomy the same as ligamentolysis?
Usually, yes. Most clinics use both words for dividing the suspensory ligament. Even so, ask how much of the ligament the surgeon will divide and which extra steps the plan includes.
Will my erection point lower after ligament release?
It can. The ligament helps lift the erect penis, so some men notice a lower angle or slightly less stability. Your surgeon should discuss this likely change with you before the operation.
Why do I need traction after surgery?
Scar tissue fills the gap after the release, and it contracts over time. Gentle traction works against that pull. Without it, the shaft can retract and part of the early gain can disappear.
How long is recovery after ligamentolysis?
Most men return to desk work within about a week. Traction often starts in the second or third week, and sex and heavy exercise usually wait for about 6 weeks.
Is the result of ligamentolysis permanent?
It can last, because the ligament stays released. However, the result depends on how the scar heals and on your traction routine. Retraction remains the main threat in the first months.
Sources
About the reviewer
Assoc. Prof. Dr. Tuncay Taş is a urologist in Istanbul with more than 20 years of experience and patients from over 60 countries. He graduated from Istanbul University in 2004, trained at Taksim Training and Research Hospital, completed a uro-oncology and laparoscopy fellowship at Heidelberg University and belongs to the EAU and the Endourological Society. Read his full profile.
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