Nowadays, men with the correct penis size can undergo PDD or spine surgery.
An ethical review of penis extension procedures has shown that most men with normal penis size lose weight after clearly hearing and understanding the risks and complications associated with each procedure.
All men undergoing penile stretching at a sound pressure level within the normal range should undergo a psychiatric examination (21).

Until the end of the last century, penis removal and skin rejuvenation were considered the most important approach to penis twist correction.
Shortening of the penis and weakness of sensation have been reported as a complication in some cases.
The modified Nesbit technique can be considered in complex cases in older men.
A peer group of 6 boys with penile twists received the art of sticking penis and skin attachment.

During the incision and suspension of the band, the silicone sheath of the penile prosthesis was inserted into the soft tissue defect formed between the base of the penis and the pubic symphysis.
Paradoxically, the main side effects of this procedure are relapse, shortening of the penis and lack of penis support during erection, which leads to difficulties in intercourse and penetration (36).
Due to low satisfaction, this surgical technique is unfavorable for many patients.

A suprapubic lipectomy was performed to increase the perceived length of the penis, especially in patients with a buried penis.
In these patients, weight loss does not always reduce the problem of large dangling fold or mons pannus.
Skin and fat removal that obstructs the penis can be done as suprapubic lipodomy or limited panniculectomy.
The lower part of the incision is marked 2 cm above the penis to allow the penis base to close from the periosteal pubic hair, and the upper part should not disturb the waist furrow (50).

To fully understand the limitations of small penis size and surgical correction options, we need to review the appropriate basic penis anatomy.
The main components of the penis are surrounded by enveloped tissue and surrounded by skin.
Each layer of the penis plays an important role in the functioning and dynamics of the penis during sexual activity and emptying (1).
The skin plays an important role in protecting penile tissue from damage during intercourse and as a barrier to bacterial infections.

The penis is an external male genital organ that also acts as part of the urinary tract.
It consists of skin, nerves, smooth muscles and blood vessels.
The penis consists of various parts, such as acorns, stem, corpus cavernosum, spongy body, muscle and urethra.
Acorns, also known as the head of the penis, are the tip of the penis that is covered with skin called the mucosa.

Embryological anomaly is often an isolated skin defect and dartos defect that can be resolved simply by releasing the penis shaft from surrounding tissue.
The urethral muscle is in an oblique position, and the middle of the curve forms a spiral curvature from the base of the penis to the digestive tract.
However, in some cases, penile twist is associated with benign hypospadias or foreskin on the hood.

Penisverdrehung, also known as wandering raphe, is characterized by counterclockwise rotation of the penis.
Sometimes this is called a walking chart because the penis’s middle penis surrounds the penis counterclockwise.
When approaching 90 degrees, it can cause the penis to twist under the foreskin.

Penile cancer usually occurs as a lump, mass or ulcer on the penis.
Penile changes can be sore and inflammatory, as well as itching and burning in the area.
In general, penis shrimp tend to affect the head of the penis or foreskin more often than the body of the penis.

Circumcision shortly after birth, it seems that the procedure for removing the skin covering the tip of the penis protects men from developing the disease.
Phimosis or seizure is also associated with an increased risk of penile cancer.
It is believed that the reasons for circumcision reduce penile cancer incidence, avoiding phimosis and preventing smegma (skin that has been shed from the skin with moisture and oil).

To perform the lobe technique after subcortical incision in the periphery of the mucosa and removal of the penile skin, we separated the arrow lobe from the surface under the skin of the dorsal penis.
The petal was twisted around the opposite torsional side of the penis and stitched with low resorbable sutures on the abdominal side of the shaft.
The extent of lobe rotation was regulated by the degree of penile twisting, which had to be corrected, and minor corrections were made when the circumcision sutures were applied.

As already mentioned, the suspension strap anchors the penis in the pubic hair and acts as a penis movement point during the erection.
The suspending ligament consists of a real suspending ligament and an arcuate subjugular ligament that attaches the white sheath to the midline of the pubic symphysis.
The surgical release of this ligament changes the acute angle of the penis to the pubic hair at an obtuse angle, which allows the penis to be in a dependent position, thus mediating the perception of extension (44).

Recurrent Chordee (penis bending) is a rare problem after Chorden repair surgery.
If Chordee returns after surgery, another surgery may be required to smooth the penis.

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