Surgical · Length · Not AUA endorsed · Modest results
Suspensory Ligament
Release — penile
lengthening surgery
Suspensory ligament release involves cutting the ligament that anchors the penis to the pubic bone, allowing more of the penile shaft to extend visibly beyond the body. It is the only surgical procedure targeting length — but the AUA does not recommend it, results are typically modest and limited to flaccid length, and the procedure carries real risks.
PhallusMD covers this procedure because men search for it — not because we recommend it. The honest picture is important to have before making any decision. We also cover the P-Long Protocol as a non-surgical alternative with published evidence that most urologists consider more appropriate.
Overview
What is suspensory ligament release?
The suspensory ligament is a fibrous structure that attaches the base of the penis to the pubic symphysis — helping to anchor the penis in its normal position and provide support during erections. Suspensory ligament release involves surgically cutting this ligament to allow more of the internal portion of the penile shaft to extend outward from the body, increasing visible flaccid length.
The procedure is typically performed under general anesthesia through a small incision at the pubic area. Recovery involves several weeks of restricted activity and often the use of penile traction devices post-operatively to help maintain the length gain as healing occurs.
The critical point to understand before considering this procedure: gains are primarily flaccid. Erect length improvement is minimal to none in most cases — because erect length is determined by the size of the erectile cylinders (corpora cavernosa), not by the ligament position.
The American Urological Association does not recommend suspensory ligament release for penile lengthening. The AUA’s position reflects the limited and inconsistent evidence for meaningful erect length improvement, the risk of complications, and the availability of better non-surgical alternatives for men concerned about penile length.
This is the most important thing to understand: suspensory ligament release primarily affects flaccid length — not erect length. Erect length is determined by the capacity of the corpora cavernosa, which this surgery does not change. Published results consistently show 1–2cm average gain in flaccid length with minimal to no reliable improvement in erect length. Many men who undergo this surgery expecting erect length improvement are disappointed.
The suspensory ligament plays a functional role — it provides support and angular stability during erections. Some men who have this ligament cut report that erections are less stable, pointing downward at an angle that is different from their pre-surgical baseline. This can be uncomfortable or functionally limiting.
This is not a universal outcome — but it is a documented complication that results directly from removing the structural support the ligament provides. Men who value their current erection angle and stability should carefully weigh this risk.
Risks and complications
What can go wrong
Erection instability — downward pointing or “floppy” erection from loss of ligament support
Scar tissue formation pulling the penis back — negating length gain or worsening appearance
Infection at the surgical site
Hematoma — bleeding and bruising at the incision site
Disappointing results — flaccid gain less than expected; no erect gain
Pubic hair migration — incision in pubic area can pull hair onto penile shaft
A better alternative for most men
The P-Long Protocol — non-surgical length enhancement
Before considering suspensory ligament release, the P-Long Protocol is worth understanding. The P-Long Protocol uses penile traction therapy — a medically supervised approach using a traction device — combined with PRP injections and, in some protocols, vacuum erection devices.
Penile traction therapy has published evidence including randomized controlled data supporting modest but real improvements in both flaccid and erect penile length. Unlike ligament release, traction therapy acts on the corpora cavernosa themselves — meaning gains can include erect length, which surgery cannot reliably deliver.
The comparison is significant: traction therapy provides comparable or better evidence for length improvement with no surgical risks, no recovery time, and no permanent anatomical alteration. Most urologists who are honest about the evidence consider traction therapy a more appropriate first approach than surgery.
P-Long Protocol: Non-surgical. Published RCT evidence. Can improve both flaccid and erect length. No permanent anatomical change. No recovery time.
Ligament Release: Surgical. Limited evidence. Flaccid length only. Permanent anatomical change. Risk of erection instability.
Unless you have specifically tried supervised penile traction therapy and found it insufficient, surgical ligament release is not the appropriate starting point for length concerns.
Common questions
Frequently asked questions
Will this surgery make my erect penis longer?
Probably not significantly. Published data consistently shows that gains are primarily in flaccid length — typically 1–2cm on average — with minimal to no reliable improvement in erect length. This is because erect length is determined by the size of the corpora cavernosa, which this surgery does not affect. Men seeking erect length improvement are not good candidates for this procedure.
Why do surgeons still offer it if the AUA doesn’t recommend it?
The AUA represents the mainstream medical consensus — which requires a higher level of consistent evidence than individual surgeons may need to offer a procedure. Some surgeons report good outcomes in selected patients with specific techniques. The AUA position reflects the overall evidence base and complication profile, not a universal condemnation of every surgeon who performs the procedure. However, the lack of endorsement is meaningful and should factor into your decision.
Is the P-Long Protocol effective enough to skip surgery?
For most men, yes — the P-Long Protocol should be tried before surgery. Penile traction therapy has randomized controlled trial evidence supporting real, if modest, length improvement in both flaccid and erect dimensions. It carries no surgical risks. A supervised 3–6 month traction protocol is a reasonable first step for any man concerned about penile length before considering any surgical option.
Can I combine suspensory ligament release with other procedures?
Some surgeons combine ligament release with fat grafting or dermal grafts for simultaneous length and girth enhancement. Combining procedures increases surgical complexity, recovery time, and the potential for complications. If you’re considering combination surgical procedures, thorough consultation with an experienced urological surgeon — and a second opinion — is particularly important.
Consider first
Non-surgical length options
Get a specialist opinion first
Before considering ligament release, consult a board-certified urologist with sexual medicine experience. Most will recommend non-surgical options first. Join the forum to hear from men who have explored length enhancement.
This page is for informational purposes only. Suspensory ligament release is not recommended by the AUA for penile lengthening. Always consult a board-certified urologist before any surgical procedure. PhallusMD does not endorse this procedure. Results vary significantly and satisfactory outcomes are not guaranteed.