In order to answer this question, you first need to know about the anatomy of the penis. Scientific studies have concluded that the penis will stop developing by the age of 20 at the latest, and its length and circumference will not change again. The principle of the current penis lengthening surgery is to increase the length of the visible part of the penis as much as possible to achieve the lengthening effect. It is easy to see from the picture above that under normal circumstances only part of the penis body is exposed outside the body, while the other part is “buried” under the skin. In order to maximize the exposure of the corporal tissues, we can either cut off part of the penile suspensory ligament (the part marked by the purple dotted line) or reduce the thickness of the lower abdominal fat by liposuction (the part marked by the green dotted line). The above is a diagram of the procedure, in which an incision is made at the root of the penis to expose the suspensory ligaments of the penis, and a portion of the suspensory ligaments is cut to increase the exposed length of the penis. In order to achieve better results, some surgeons place wedges of medical silicone material in the area of the severed suspensory ligament, the purpose of which is to prevent post-operative tissue adhesions from retracting and to maintain post-operative results. This diagram is even more intuitive, as the fat from the lower abdomen is aspirated, allowing the previously buried penile body to “reappear”, objectively achieving the effect of penile lengthening. With surgical indications, the length of the penis can be improved to a certain extent, both in a weak and erect state. Does penis lengthening surgery cause erectile dysfunction? The erectile tissue of the penis is the blood sinus tissue located within the white membrane of the penis, and the corpus cavernosum as it is known to the little ones. The penile lengthening procedure, whether it is suspension ligamentotomy or fat aspiration, is done in the space outside the white membrane of the penis and does not cause damage to the corpus cavernosum, so erectile dysfunction complications rarely occur.