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The original methods, which haven't changed much since then, involved attempts to lengthen the penis, increase the girth, or both. Here's how it works: to add the appearance of length, the surgeon cuts the suspensory ligament that anchors the penis to the body, allowing it to drop down and forward; in this way, it is hoped that the portion of the penis that is normally held inside the body cavity will stretch outward and appear as more length. The penis isn't technically "lengthened" so much as it is uncovered or released from the body.
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