Liposuction and Abdominal Panniculectomy – Unearthing the Buried Penis
August 6, 2009
Plastic surgery treats a wide variety of problems that literally knows no bounds. Some of these problems are more obscure than others…and the buried penis falls into this category. Not having visible penile show seems like a near comical problem, or at least unheard of, unless you are the male so afflicted. Besides the adverse psychological impact of lack of an organ, interference with the urinary stream and hygiene issues becomes an even more significant medical problem.
The buried penis is a not rare condition that actually occurs from a variety of medical conditions. In my Indianapolis plastic surgery practice I have seen and treated such problems from children to adults over the years. In children it occurs from penile conditions such as a poorly performed circumcision or hypospadius repair where valuable penile skin is lost. This results in scar contracture and retraction often with no visible penile show at all. The ‘loss’ of the penis is further magnified if a significant suprapubic mound of fat exists. In working with the many fine pediatric urologists at Riley Hospital for Children in Indianapolis, we have developed a combined procedure of suprapubic liposuction and penile lengthening (penoplasty) for this condition. This ‘ying and yang’ approach (one come outs, the other goes back) works well for this buried penis.
The buried penis in adults is a completely different problem. This is rarely a function of penile retraction, it is usually a matter of obstruction. The overhanging stomach or abdomen, known affectionately in plastic surgery lingo as a pannus or apron, may hang low enough that it sits in front of the penis thus burying it. When the pannus is this big, it also pushes the suprapubic mound forward also helping to obscure penile shaft length. The treatment for this adult buried penis problem is a traditional abdominal panniculectomy or the cutting off of the overhang. This produces an instant and dramatic improvement. Fortunately, the emergence of bariatric surgery has reduced the incidence of these large weight issues as they are not nearly as common today as they were a decade ago. But the incidence of obesity is not lessening and the economics of bariatric surgery preclude many from having the operation, so plastic surgeons have not seen the last of these medically necessary abdominal amputations.
The use of common plastic surgery techniques, such as liposuction, abdominal panniculectomies, and even an occasional need for skin grafting, offers help for the lost and vanishing penis.
Dr. Barry Eppley