Approximately one-third to one-half of the penis is inside the body, and is internally attached to the undersurface of the pubic bone. Penis enlargement involves the release of the fundiform ligament and the suspensory ligament that attaches the two erectile bodies to the pubic bone (ligamentolysis). The suspensory ligament makes the penis arch under the pubic bone. Release of this ligament allows the penis to protrude on a straighter path, further outward to give a longer physical appearance]With the penis on stretch, the ligament is divided close to the pubic bone until all midline attachments have been freed. Once these ligaments have been cut, part of the penile shaft (usually held within the body) drops forward and extends out, enlarging the penis by 2-3cm (0.78-1.18 in.). After surgery, part of the postoperative treatment includes stretching of the penis to prevent the severed suspensory ligament from healing shorter than it was previously. The article “Penile Suspensory Ligament Division for Penile Augmentation: Indications and Results” discussed the subject. According to Nim Christopher, a urologist at St. Peter’s Andrology Center in London, among men who have had the surgery, “the dissatisfaction rate was in excess of 70 percent”.
Real penile lengthening (i.e., lengthening of corporal bodies vs. ligamentolysis) is not a routine and safe procedure because of high risk of losing the ability to have an erection. It can be done safely only in patients with erectile dysfunction or Mb Peyronies concomitantly with implantation of penile prosthesis.