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Hidden Penis Release:
Adjunctive Suprapubic
Lipectomy

Charles E. Horton, M.D.*
Bert Vorstman, M.D.†
David Teasley, M.D.*
Boyd Winslow, M.D.*

We believe the hidden penis may be caused and concealed by a prominent suprapubic fat pad in addition to the restrictive fibrous bands of the dartos fascia fixing the shaft of the penis proximally while loose skin folds prolapse distally over the phallus. A penis of inadequate length or appearance may affect body image. Patients with this problem often require psychological support. Hidden penis may be distinguished from micropenis by palpating adequate corpera and showing a stretched penile length within 2 SD of normal. Excision of suprapubic fat with sectioning of the tethering dartos bands will release and increase the length of the penis. Suprapubic fat resection may also be helpful to elongate a short penis in cases of adult microphallus, or after partial penectomy because of trauma or cancer. Circumcision is contraindicated.

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From the *Departments of Plastic Surgery and Urology, Eastern Virginia Medical School, Norfolk, VA, and the †Department of Urology, University of Miami School of Medicine, Miami, FL.

Address reprints to Dr. Horton, 400 West Brambleton Ave., Suite 300, Norfolk, VA 23510.