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Penis
Enlargement

Penis Enlargement: Surgical Lengthening through Ligamentotomy

Many men think about this topic for a long time before seeking their first consultation. Surgical penis enlargement is not a niche topic: At the Praxisklinik am Rosengarten alone, many come each week for such a procedure. The desire for more length and thickness is widespread — and, in experienced hands, it can be achieved safely from a medical standpoint. Erectile function also plays a role in an increasing number of consultations, as many men also suffer from declining erections and would like to have this treated at the same time.

The most effective and most frequently applied method for permanent surgical penis lengthening is ligamentotomy — the surgical severing of the ligamentum suspensorium penis. Dr. med. Timo A. Spanholtz has been performing this procedure for years. What you can expect on this page: honest information about results, procedure, risks, and the aftercare that permanently secures the result.

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The Principle: Why Lengthening Is Possible

What most men do not know: The visible part of the penis is not the entire penis. A considerable portion of the penile shaft lies within the body and is attached to the pubic bone via a ligamentous apparatus — the ligamentum suspensorium penis. This ligament holds the penis in its position and determines its angle - however, this ligament also holds the penis back inside the body and can therefore be used to "pull" more length to the "outside".

During ligamentotomy, this ligament is surgically severed through a small incision at the root of the penis. The penis, which describes an upward curve due to this suspension, thereby moves outward — the hidden portion becomes visible. This is the anatomical basis of penis enlargement.

Quick Overview: Surgical Penis Enlargement

  • Method:
    Ligamentotomy — severing of the ligamentum suspensorium penis
  • Anaesthesia:
    General anaesthesia required
  • Procedure duration:
    Approx. 1 hour
  • Result:
    Typically 3-4 cm length result
  • Erection angle:
    May change somewhat — slightly flatter during erection (this, however, does not bother most men at all after the surgery).
  • Downtime:
    Office work: possible after a few days · physical work: several weeks
  • Aftercare:
    Phallosan Forte stretching therapy from day 5–7 — crucial for a permanent result
  • Combination:
    Often combined with penis thickening (autologous fat) for a harmonious overall appearance

What You Can Really Expect — and Why We State the Final Length

Here is an important difference between the Androklinik of the Praxisklinik am Rosengarten and some other providers: We always also communicate the final length — not the initial length directly after the surgery.

What this means: Immediately after ligamentotomy, the visible lengthening may appear greater than the final result. In the weeks after the surgery, scar formation can partially pull the ligament back together. This is why some colleagues like to state impressive figures — which, however, refer to the initial and not to the permanent result. This creates unrealistic expectations.

Criterion

Initial surgical result

Permanent final result

Typical length increase

4–5.5 cm (directly after surgery)

+1.5 to +2.5 cm (permanent)

Significance

Misleading without explanation of the reduction

Realistic and relevant for you

Influenced by

Anatomy, surgical technique

Anatomy + scar formation + aftercare

With consistent aftercare

Partially retainable

Optimally secured through Phallosan Forte

Clear note from the Praxisklinik am Rosengarten

Expect to gain about 1.5 to 3 cm in length permanently.

If this is not enough for you, it is better to forgo the surgery than to be disappointed afterwards.

More length may also be possible — but before the surgery no reliable statement can be made, as the hidden penile length is individually different and predetermined for every man.

This is the honest information you can expect from us.

Realistic Expectations — in a Personal Consultation

Dr. Spanholtz explains to you what is realistic in your individual situation.
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Who Benefits — and for Whom Is the Surgery Not Suitable?

Particularly good candidates:
  • Men for whom +1.5 to +3 cm of permanent length gain would mean a genuine improvement in their satisfaction and self-confidence
  • Men whose erectile length is already over 12 cm — here a proportionally very nice result is possible
  • Men who wish for a combination of length and girth and are also considering a penis thickening
Realistic assessment with a shorter starting measurement:

If the flaccid length is, for example, only 4 or 5 cm or the erectile length before the surgery is below 12 cm, the penis enlargement can help achieve a satisfactory result — the gain here is also approx. 1.5–3 cm, which, however, is very noticeable in percentage terms. In the consultation, Dr. Spanholtz will discuss with you honestly whether the surgery can meet your expectations.

The Procedure of the Penis Enlargement Surgery

Consultation & Preparation

Detailed consultation (also via video) · individual measurement and assessment · information about results and risks · cost plan · blood tests beforehand

The Procedure (approx. 1 hr.)

General anaesthesia · small incision at the root of the penis · severing of the ligamentum suspensorium · professional internal fixation for stabilisation · wound closure · afterwards outpatient or a short inpatient stay

Immediate Aftercare

Swelling and mild pain in the first days are normal and subside · office work possible after a few days · physical work: several weeks of rest

Phallosan Forte Aftercare (from day 5–7)

The stretching device is applied and prevents reduction due to scar formation · daily wear times according to instructions · this step is crucial for the permanent result

Result Check & Follow-up Planning

Check-up appointment with the doctor · assessment of the healing process · if applicable, planning of the penis thickening as a second step · sexual activity after complete wound healing
The Aftercare: Phallosan Forte

The decisive factor for the permanent result is not the surgery alone — it is the consistent aftercare. After ligamentotomy, the severed ligament must be prevented, through continuous traction, from pulling back together and reversing the lengthening.

For the aftercare, the Androklinik team uses the Phallosan Forte — an established stretching device, for which the company specially developed a dedicated wearing strap for the Androklinik.

  • Application:
    Possible from day 5–7 after the surgery
  • Wear time:
    Daily according to Dr. Spanholtz's individual instructions
  • Effect:
    Prevents reduction — permanently secures the lengthening result
  • Comfort:
    Fixation only at the glans — no pressure on the shaft

Penis Enlargement and Penis Thickening: The Harmonious Overall Appearance

A penis enlargement alone changes only the length — not the girth. Many men therefore decide on a combination: lengthening first, thickening with autologous fat as a second step. The result is proportionally balanced — more length and more girth in a coordinated treatment plan. When penis lengthening and penis thickening are combined, this is then referred to as penis enlargement.

This combination is the core of the PHALLOMAX® treatment concept of the Praxisklinik am Rosengarten, the complete overall package consisting of lengthening, erection improvement, and thickening.

Lengthening + thickening: the most common combination

  • Step 1:
    Penis enlargement (ligamentotomy) + optionally Penitox/P-Shot for erection improvement
  • Step 2:
    Approx. 12 weeks later: penis thickening with autologous fat (+1.5–2.5 cm girth, permanent)
More about penis thickening with autologous fat
More about the overall package

Risks and Possible Complications

In experienced hands, penis enlargement is to be classified as low-risk. Unsatisfactory results often arise from a lack of experience on the part of the surgeon and insufficient aftercare — not from the procedure itself. The structured aftercare also plays a decisive role.

Possible risks — complete information before the procedure

General anaesthesia risks — minimised in coordination with anaesthesiology

Swelling and minor secondary bleeding — normal, usually subside quickly

Scar formation in the fold between the penis and the body — minimal with correct technique and scar care

Change in the erection angle — the penis may point somewhat flatter during erection

Reduction of the lengthening — possible with insufficient aftercare or very strong scar formation; minimised through correct aftercare

Changes in sensitivity — rare, usually temporary

Our team informs you in detail about all risks before the procedure. Please state all medications, pre-existing conditions, and allergies in the consultation.

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Frequently Asked Questions about Penis Enlargement

Why do some providers state higher lengthening results?
Many providers state the initial length directly after the surgery — this can be 4–5 cm. However, over the course of the healing phase, scar tissue forms, which partially pulls the ligament back together. The permanent final result is usually 1.5–2.5 cm. Dr. Spanholtz always communicates the final length — from his perspective, this is the only relevant figure for you.
How long do I have to wear the Phallosan Forte?
This depends on the individual healing process and is determined personally by Dr. Spanholtz. As a rule, application begins from day 5–7 after the surgery. The daily wear times are gradually increased. The exact period of the overall application is discussed in the aftercare consultation.
Does the erection angle change after the surgery?
Possibly yes. The ligamentum suspensorium holds the penis at a certain upward angle. After severing, the penis may point somewhat flatter downward during erection than before. This change is minor in most patients — but it should be discussed in the consultation so that you can decide in an informed manner.
When is sex possible again after the surgery?
Sexual activity is possible again after complete wound healing. After the procedure, Dr. Spanholtz will give you specific recommendations for your individual healing phase.
Should I have a penis thickening done at the same time?
This is a very common and sensible combination. Lengthening and thickening planned together result in a harmonious result in all dimensions. The thickening with autologous fat takes place approx. 4 weeks after the lengthening procedure — as part of the PHALLOMAX® overall plan or as a separate measure.
Further Treatments

Honest advice. Experienced surgeon.

Dr. Spanholtz — several penis enlargements weekly, many years of experience, clear communication.

About the Author

Dr. med. Timo A. Spanholtz
Specialist in Urology & Andrology

Dr. med. Timo A. Spanholtz
Dr. Spanholtz is the founder and chief physician of the AndroKlinik. With many years of clinical experience in men's health, andrology, and reconstructive urology, he accompanies patients from throughout the German-speaking region.
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