When the fatty upper pubic area (FUPA) or escutcheon becomes large, the penis can be hidden. The skin and fat above the penis can overhang the corporal length, often resulting in discomfort and embarrassment for patients. In the world of plastic and reconstructive surgery, this effect is referred to as the “pannus,” “buried,” “hidden,” or “FUPA” penis.
The “buried penis” can have a number of causes, including:
- Congenital fatty deposits
- Excess weight gain or loss
- Extra skin following weight loss
- Aggressive circumcision
- Release of the dartos fascia during an abdominoplasty
Many men who experience a “hidden penis” do not seek treatment for this issue or are told that it is a solely cosmetic problem. In reality, however, this phenomenon can also create functional and emotional issues. Worse yet, hygiene and difficulty with urination can result in further penile shorting and tethering.
At Chrysalis Cosmetics, our compassionate Sacramento plastic surgeon offers several different treatments for the “buried penis.” Depending upon your personal goals and the severity of the concern, correction of the issue can involve uncovering, releasing, and otherwise altering the position of the penis.
In younger men, liposuction is often all that is necessary to uncover the penis and make the FUPA less bulky. In other cases, the escutcheon must be defatted, reduced, and elevated, and the penopubic junction redefined. Elevation of the FUPA can produce a more youthful appearance and allow for the penis to be more visible. Usually done with skin excision and quilting sutures and performed under general anesthesia, this procedure includes release of the suspensory ligament of the penis, which can allow for a slight lengthening. This is usually performed with dorsal subdermal penile skin tacking to the rectus fascia to define the junction of the penopubic border; the tacking of the ventral dartos fascia to the periurethral tunica albuginea of the penoscrotal junction; and a “z-plasty” to release the penoscrotal webbing, if present.
Surgery to address the “buried penis” is similar to monsplasty, which can combat an enlarged FUPA in female patients. Drains are often unnecessary in this procedure, but they may be placed to decrease initial swelling (which can last for about three months). The sutures used are absorbable and generally do not require removal. Following the surgery, most patients can return to work in two to four weeks. In general, we like to see our patients following surgery at one week, one month, and one year, but we welcome visits between these appointments as well.
Our caring team at Chrysialis Cosmetics is always grateful to help whenever needed. We look forward to discussing this matter further with you. To learn more about treating a “FUPA penis,” get in touch with our team today.
