How does Penis Enlargement Surgery work?

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Want to know what to expect if you opt for penis enlargement surgery?

Some of the main things we’re asked are:

  • How exactly how does penis enlargement surgery work?

Penis enlargement surgery can increase the flaccid length and the flaccid and erect girth of a penis. The lengthening process is completed by dividing a ligament called s suspensory ligament from its attachments to the pubic bone. This helps to push the penis forward and reveal an additional 2.5cm to 5cm of flaccid length. After this manoeuvre, native tissues are used as a barrier to prevent ligament reattachment. This procedure cannot increase the erect length of the penis. The erect penis length can be increased by using a penis extender after the surgery for one year starting at six weeks post-op.

The penis girth can be increased with a fat transfer. Fat is harvested from the belly and inner thighs where the best quality fat is, and then it is out through a purification process. The remaining fat is then injected into the shaft to increase the thickness. In most cases, this will thicken the penis between 2.5 to 5cm in the flaccid and erect girth.

In both the lengthening and thickening processes, both are permanent.

  • Are there different types of surgery?

The gold standard way to increase the penis length and girth is with the ligamentolysis surgery together with a fat transfer. Some men choose to have just the length or girth increased, but over 80 % of patients choose both options at the same time for the best result.

Silicone implants are used in the USA and in South Korea to increase penis size, but at the time of writing, these are not available in Europe. Concerns over infection risks with such devices may explain why European providers of penis enlargement surgery have yet to use such devices.

  • Which type of surgery is best?

Ligamentosis surgery and fat transfer surgery have been around for many years. Improvements in the quality of the fat transfer with the use of purification systems have dramatically improved the survival rates of the transferred fat. Furthermore, techniques developed by Moorgate Andrology Urologists have improved results in penis lengthening to the point where the use of silicone implants to prevent penis retraction are no longer needed. 

Does penis enlargement surgery only increase length?

At Moorgate Andrology, we are able to increase both the length and thickness of the penis at the same time, such is our level of expertise. Of course, if you would like to increase just the length or thickness without affecting the other, we can also perform this with ease.

About 80 % of all penis enlargement patients will choose to have their penis lengthened and thickened at the same time.

The procedure is performed under general anaesthetic and takes about one hour. It is performed by one of our Specialist Urologists, and in a private care quality commission registered hospital.

You will be able to go home on the same day as the surgery, which we’re sure you’ll be thankful to find out!

Penis enlargement surgery, how does it work?

Penis enlargement for length

To increase the length of the penis, an incision is made at its base, where there is is a natural fold that all men have. This hides any residual scar. The Urologist will then find the suspensory ligament and divide it from its attachments to the pubic bone. This manoeuvre will enable the penis to slide forward and drop down to a lower position. This results in a typical length gain of the penis of between one and two inches. 95% of men gain an extra one to two inches and 5% of men gain either a bit less than one inch or a bit more than two inches. Either way, we’re sure you’ll be very happy with the results of penis enlargement surgery!

It should be remembered that this extra length gain is only visible in the flaccid state, not the erect state. Most men complain that their penis looks very small when it is flaccid, so this procedures helps to improve the length and flaccid look of the penis.

Six weeks after the penis extension surgery when everything has settled down, the Urologist will give the Patient a penile extender. This device helps to increase erect length over the course of the following 12 months when worn on a daily basis for about one to two hours.

It is possible to gain up to one inch more on the erect length with regular use after the surgery.

Penis enlargement for girth

As for the girth, this is performed by extracting fat from the abdomen or inner thighs (where we have the best quality fat for this procedure). This is done in a small liposuction procedure. This extracted fat is purified to remove dead cells, blood, and other debris from fat before it is injected into the penis shaft to thicken it.

This will thicken the penis in both the flaccid and erect states by one to two inches.

The extra girth will depend on the initial absorption rate. In the first six to eight weeks it is normal to lose 30 to 50% of the transferred fat. This is a normal physiological process than cannot be prevented. In any case, the Urologist will transfer the maximum amount of fat that your penis can safely take. Even allowing for the absorption rate, girth gains of around one inch are possible in most cases. In some cases Patients retain most of the transplanted fat and in these cases the girth gains are even more.

How do different penis enlargement procedures work?

List the different types of procedures a patient could use for penis enlargement:

  • Ligamentosis

Ligamentosis surgery is the gold standard way to increase the flaccid length of the penis. It is performed by a urologist and involves the division of a ligament called the suspensory ligament from its attachments to the pubic bone. This will increase the flaccid length of the penis by one to two inches for most men. It is permanent because native tissues are used to help prevent the ligament reattaching to the pubic bone again. It should be noted that the erect penis length remains unchanged with this procedure. The penis is bigger when it is on show.

  • Using dermal fillers

Dermal fillers have been used to enhance penis girth for around ten years when Moorgate Andrology first introduced them to the UK.

They are a non-surgical option to increase penis girth both in the flaccid and erect state.

They are an easier option than surgery with no general anaesthetic required, and a faster recovery, but they are a temporary fix. This is because hyaluronic acid breaks down in the body over time and requires topping up. Providing that the top ups are maintained they can be an easy way to get a bigger penis with little downtime.

  • Using autologous fat

An autologous fat transfer is considered by many Urologists to be the gold standard way to increase a penis girth. A penis fat transfer will yield permanent results with a 2.5 to 5cm increase in penis thickness. As the fat is thicker than the other option, penis filler, a fat transfer provides maximum penis girth gains. A fat transfer to the penis will cost more than penis fillers in the short term, but in the medium to long term they are much cheaper because you do not need to top up with more every 12 to 18 months as is required with penis fillers. A penis girth fat transfer is a surgical procedure however and as such the recovery period is longer than the option with penis fillers. For example, sexual activity should be avoided for up to six weeks with a fat transfer but only two weeks with dermal filler. It should be noted that about 30 % of all patients who start with penis fillers at Moorgate Andrology will go on to have a penis girth fat transfer at some point.

Penis enlargement surgery is considered a permanent procedure. When dividing the suspensory ligaments, the Urologist will use native tissues to act as a barrier to prevent ligament re-attachment. Our Urologists have developed this technique to avoid the need to use a silicone implant, which would be in situ for the rest of your life. You can be reassured that you will always have the benefit of this extra penis length.

In terms of the girth, after the initial absorption of the fat the remaining fat becomes living tissue with its own blood supply, just like fat elsewhere on the body.

Are there any non-surgical penis enlargement options?

Where surgery is not an option because of budgetary constraints, or perhaps because of pre-existing medical conditions making it an unwise choice, penis filler using hyaluronic acid can be used to increase penis girth. These are a temporary solution though because hyaluronic acid absorbs naturally in the body. Regular top ups between one and two years will be required to maintain the new penis size. 


Testosterone replacement therapy can be used where testosterone levels are found to be low. A simple blood test arranged by Moorgate Andrology can determine your testosterone levels and treatment can be put in place quickly to bring your levels back to normal. We do not prescribe TRT therapy routinely to increase penis size. We also advise against taking testosterone supplements without medical support and advice as too little or too much testosterone can have unwanted side effects.

Creams or lotions

We see many men at Moorgate Andrology who have tried various lotions and potions to try and increase their penis size. They are readily available online and all have amazing claims to increase penis length and girth. Of course, they do not work but it does not stop many men trying them, lured in by the sensational claims. We also see men who have injected various substances into their penis to increase the size. In worst cases they have caused deformity of the penis, erectile dysfunction, and infection. They are mostly self-injected, but not always. It is very important not to self-inject anything into the penis to increase the size. Increasing the size of a penis should be something performed by a qualified Doctor, such as a Urologist, with experience in penis enlargement.


Many supplements are available to help boost sexual performance. Some seem to work better than others, but none have any scientific proof that they can increase the size of a penis. There is nothing wrong in taking supplements to improve your sexual health, but we always advise seeing your family Doctor, or a Urologist before you start taking them. Even though these substances may be herbal based, they can sometimes interact with medications that you may be taking already.

Penis enlargement surgery is best for long lasting results

There are some non-surgical options for penis enlargement but the best, long lasting results, penis enlargement surgery is the best option. Most men who come to Moorgate Andrology for penis enlargement want permanent results. Even those who start with filler injections eventually choose to have a fat transfer because they get tired of paying for regular top ups. Of course, if you do not have the budget and /or time for penis enlargement surgery then penis fillers can be an option. Bear in mind that there will come a time when you will have paid the same amount as a penis enlargement surgery, and you will still have temporary results. Also, the best visual result comes from both the lengthening of the penis and a fat transfer.  The fat is thicker than the hyaluronic acid filler, therefore girth gains of 2.5cm to 5cm are easier to achieve with a fat transfer. It is possible with penis filler, but it takes a lot of filler to reach these levels. 

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