Introduction. Penile augmentation surgery remains a relevant area in andrology aimed at correcting the aesthetic and functional parameters of the organ. One of the key stages of such interventions is the choice of adequate surgical access and skin plasty that allows to achieve the desired aesthetic result while minimizing complications. Despite the variety of surgical techniques, there is still no unified approach to assessing their aesthetical effectiveness.

Materials and methods. The study included 66 patients who underwent dissection of the suspensory ligament of the penis using various skin grafting techniques. A comparative analysis was performed between the groups of patients depending on the technique used (V-Y-shaped skin grafting – 24 patients, Heineke-Mikulich skin grafting – 36 patients, scrotal access – 5 patients, lipectomy – 37 patients). A logistic model was constructed for identify factors that significantly affect the level of aesthetic satisfaction with the results of the operation.

Results. The most significant predictor of aesthetic satisfaction within the framework of the constructed model was skin grafting according to the Heineke-Mikulich principle (logistic regression coefficient (β) = 2.62, significance level p = 0.03). For V-Y skin grafting β = 0.7, however, the p-value (p = 0.56) did not reach statistical significance, and the V-Y skin grafting technique did not demonstrate statistically significant advantage over alternative approaches. Evaluation of the contribution of lipectomy to patient satisfaction with the aesthetic result showed less pronounced, but still clinically significant trends. The logistic regression coefficient was β = 0.67, with p = 0.28, which does not allow us to speak about the presence of a statistically significant relationship.

Conclusion. The Heineke-Mikulich skin grafting technique demonstrated the greatest clinical effectiveness in achieving aesthetic satisfaction of patients in combination with ligamentotomy and can be recommended as a standard of skin grafting in aesthetically oriented penile lengthening surgeries.