Approximately one-half of the penis is located inside the body. It is attached to the pubic bone by what is known as the suspensory ligament. Lengthening is achieved by a procedure that releases the suspensory ligament where it's attached to the pubic bone, thereby allowing the penis to be advanced toward the outside of the body. The procedure is performed through a discreet horizontal incision located in the pubic region where the pubic hair will help conceal the incision site. No incision is made on the penis itself.

A patient can anticipate a typical gain of between 1 to 2 inches. The amount one can expect to gain depends on several factors. First, length gain is dependent on the size of the penis. A larger penis will typically result in a bigger gain than a smaller penis since there is usually more inside the body that can be advanced. Secondly, the body build of the patient is important. If there is excessive fat located in the pubic region, this can conceal part of the penis and thereby affect the length gain that is achieved.

It is often helpful in these cases to also perform pubic liposuction or a pubic lift to expose more of the penis. Also, a peno-scrotal web (turkey-neck deformity) can decrease the 'usable' penis length. Correction of the peno-scrotal web can usually be performed in conjunction with penis lengthening. Lastly, the use of a penis stretching device following the surgery is necessary to achieve the best possible results from penis lengthening surgery.