Intraoperative procedures during the division of the suspensory ligament system of the penis to correct a buried penis. (A) Extending the SPL by the palmaris longus tendon. The palmaris longus tendon (arrow) is tunneled beneath a symphysis pubis periosteum and through a hole in the stump of the suspensory ligament of the penis. (B) The development of the pubic symphysis flap (arrow) before division of the superior attachment to the perichondrium of the pubic symphysis to create an inferiorly pedicled flap. (C) The deep median bundle of the fundiform ligament (arrows) spared to provide the residual support for anterior movement of the penis required for an effective erection after fixation of the flap to the SPL. SPL, suspensory penile ligament.