Predictive Factors for Successful Penile Augmentation via Suspensory Ligament Release

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Abstract

BACKGROUND: Modifying the shape and size of the genitalia has been a relevant concern since ancient times. Surgical penile augmentation may improve quality of life in appropriately selected patients. Identifying predictors of success in penile augmentation surgery is an important and practically relevant task in surgical andrology.

AIM: To identify predictive factors for successful penile augmentation to support the selection and optimization of surgical approach.

METHODS: We analyzed anatomical and topographic data from 66 patients who underwent penile augmentation at the National Medical Research Center for Obstetrics, Gynecology and Perinatology named after academician V.I. Kulakov between 2022 and 2025. The procedure involved suspensory ligament release with V–Y skin plasty, Heineke–Mikulicz plasty, and lipectomy.

RESULTS: Based on the obtained data, it was determined that the effectiveness of penile augmentation surgery was significantly influenced by the thickness of the subcutaneous fat in the pubic area and the length of the penile suspensory ligament.

CONCLUSION: Preoperative assessment of anatomical structures may support the selection of the optimal surgical technique and help form adequate and realistic expectations in patients regarding surgical outcomes.

About the authors

Kyanan S. Guluzade

The First Sechenov Moscow State Medical University

Author for correspondence.
Email: kanansafarovich@gmail.com
ORCID iD: 0000-0002-8814-4361
Russian Federation, Moscow

Safar I. Gamidov

The First Sechenov Moscow State Medical University; Research Center for Obstetrics, Gynecology and Perinatology

Email: safargamidov@yandex.ru
ORCID iD: 0000-0002-9128-2714

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Moscow; Moscow

Taras V. Shatylko

Research Center for Obstetrics, Gynecology and Perinatology

Email: dialectic.law@gmail.com
ORCID iD: 0000-0002-3902-9236
SPIN-code: 4129-3649

MD, Cand. Sci. (Medicine)

Russian Federation, Moscow

Nikita P. Naumov

Orekhovo-Zuyevskaya Hospital

Email: naumovuro@mail.ru
ORCID iD: 0000-0003-1854-368X
SPIN-code: 2518-1433

MD, Cand. Sci. (Medicine)

Russian Federation, Moscow

Natig G. Gasanov

Research Center for Obstetrics, Gynecology and Perinatology

Email: natiqhasan@gmail.com
ORCID iD: 0000-0003-4695-9789
SPIN-code: 7080-4880

MD, Cand. Sci. (Medicine)

Russian Federation, Moscow

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Supplementary files

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2. Fig. 6. Penis length increase after surgery.

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3. Fig. 1. Length of the penile suspensory ligament.

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4. Fig. 2. Width of the penile suspensory ligament.

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5. Fig. 3. Thickness of the subcutaneous fat.

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6. Fig. 4. Divergence angle of the ligament fibers.

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7. Fig. 5. Angle between the corpora cavernosa and the pubic symphysis.

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