(3a) Dr. Solomon, do you perform lengthening surgery (ligamentolysis)? If so, what can patients expect to gain on average? Are gains limited to flaccid length or will I see improvements in both flaccid and erect lengths? Also, will there be a change in the angle of my erection post-op?
Penis length surgery, sometimes called ligamentolysis is one of the most common procedures that I perform. It has a high degree of patient satisfaction and the questions here are good ones. I tell patients that the average increase in flaccid length is 1 inch (2.5 cm). The most I have ever seen is 2 inches (5cm). This is related to the amount of penis that is beneath the ligament. The increase in length that occurs is always in the flaccid state. Some men tell me that they are longer when erect, but there is no way to know in advance if there will be a gain in erect length. Moreover, I do not measure patients in the erect length, so I have no data to answer this question in any greater detail. To my knowledge, there is no large study that discusses this. There are some reports of about an average of one-half inch (1 cm) increase when erect after surgery. Many men think the angle of their erection will change after surgery, but I have not seen this in my patients. I do several things in the surgery itself to restore the angle. I also have my patients wear a weighted condom for 6 hours each day for 6 months after surgery to help prevent scar tissue from pulling the penis back.
(3b) Dr. Solomon, do you provide surgery to those who suffer from excessive scrotal webbing, sometimes called "turkey neck?" If so, can you detail some important things to expect like recovery time, whether it's an outpatient procedure, common techniques that are used, etc?
Scrotal webbing is an issue for many men. It can interfere with intercourse and be a source of irritation during exercise. There are several methods of correcting the web. The oldest method is known as z-plasty. Other methods include a U shaped skin excision and a V shaped skin excision. The decision about which pattern to use is based upon the extent of the problem, which varies with each patient. The surgery itself is not associated with much postoperative discomfort, but there is a large a mount of swelling. This takes the better part of a month to resolve and in that time men are restricted in terms of physical activity and sexual activity. Surgery is performed as an outpatient. Some patients require a drain to be used while others do not. This is a decision that I make at the time of surgery. The scars from these procedures are well hidden due to the nature of the skin of the scrotum. I use dissolving sutures that do not need to be removed.
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