Buried Hidden Penis Reconstruction Surgery
Hello, I’m Dr. Gary Alter. I’m a board certified plastic surgeon and a board certified urologist. Today we’re going to talk about a very mis and underdiagnosed problem called hidden or buried penis. Basically what that means is when the man stands up, the penis is partially visible or totally invisible, and there are many causes for this.
The causes in a child are various. It could be a congenital buried penis in which the child is born kind of chubby. It could be because the child gains weight and becomes somewhat overweight. It can be also caused by an over removal of penile skin from a circumcision. A lot of times these kids have penises that are really not very visible, and they’ll go to the urologist and the urologist will say, “Oh, don’t worry about it. He’ll grow out of it.” But I can tell you that if it’s a severely buried penis, in many, many cases, the child will not grow out of it. And this causes a severe loss of self-esteem, it causes them to get isolated socially, and in many cases, they won’t go out for sports and they don’t date because they’re afraid of being ridiculed. It’s a terrible problem.
Despite the fact that the child with a severe buried penis may be ridiculed, there are other issues involved. He may get infections at the head of the penis, he may have to sit down to urinate, so he’s in the grammar school or he goes to school and he can’t urinate in a urinal and therefore has to go into a stall, makes him feel very inferior. So this all adds to discomfort and psychological distress.
The surgery to correct this is not dangerous surgery. Unfortunately, there are very few doctors that really know how to do the surgery correctly. I see patients that come to see me who have had failed surgeries for buried or hidden penis, and that’s because the surgeon really did not understand the underlying problem.
My determining factor of whether the man really has a buried penis is when he sits down, does it disappear or does it almost completely disappear? If it does, in my definition, he’s got a buried penis and that can be resolved surgically without a very painful or without a dangerous operation. The key is reattachment of the skin to the shaft of the penis.
So I have a four point attachment from the skin to the penis, and I do this with the penis erect so that I make sure that I don’t shorten the penis. If the patient has droopy skin, either from weight loss or excess fat in the area, or if the patient has a large fat pad, then I have to eliminate the fat in the pubic area. I’ve got to make it real flat, and then if there’s extra skin, I will cut away some of that extra skin. And the incision for this operation is above the pubic area, but below the abdominal area. So I make that incision, I usually get rid of most of the fat through liposuction. Then I give the patient an erection through an injection of medicine into the penis. I can determine adequacy of the skin. And then I put stitches from the abdominal skin down to the muscles of the lower pelvic area so that it’s flat, the whole pubic area is flat. So now the penile skin is well stabilized by stabilizing the skin at the base of the penis.