Your Questions
Your Questions
Q: Dr. Eppley, I am interested suprapubic mound reduction surgery. I have grown up with a prominent suprapubic mound for a long time and did not know there was anything I could do.I have in the process of losing weight buteven growing up in high school when I was thin I always had it.
A: There are two approaches to reducing the size of a suprapubic mound for improving better show of penile length. Liposuction is part of any technique and may be adequate by itself if there is not a skin excess. However many suprapubic mounds do have excess skin, particularly in those patients who have lost weight, and may require a concomitant pubic lift (like a reverse mini-tummy tuck) with liposuction. I obviously do not know which one would be better for you based on your description alone. Ultimately I would need to see pictures or perform an actual examination to know whether suprapubic mound liposuction would be adequate.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, I am a 34 yrs old with a hidden penis problem I am uncircumcised too.. so I am getting a this surgery if suitable for me… please reply to me … I know below all that fat there a small but decent penis.
A: Thank you for your inquiry. Many buried penis problems are a combination of a suprapubic mound and a retracted penile length. Thus, suprapubic liposuction may not be completely effective for all buried penis patients as the penis may need to be released/lengthened as well. Do you develop a visible penis with an erection? Was the penis visible when you were younger before there was a significant suprapubic mound? To best answer your question I would need to see some pictures of the mound area, particularly from the side view to see what type of buried penis problem that it is you have.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, I am 57 years old and have just discovered that my hidden penis condition can be treated and improved. I have suffered through my teenage years and adulthood with the taunts in gym and the odd looks of women when I could of had something done about it! Doctors told me that I was OK and said that some men have an inee and others have an outee. I knew that something wasn”t right. My folks and the doctors back then could circumsize me, but they couldn’t fix this! While most of my sex life has passed me by at this point, I’d still like to look normal before I die.
A: While having either an inner or an outie may be normal for the appearance of the bellybutton, it definitely is not normal for penile exposure. The buried and hidden penis is often a developmental condition that can become apparent early as a child or in the teenager years. It is caused by a tethered or retracted penis that is often accompanied by a larger surrounding suprapubic mound. This combination can frequently result in partial or complete coverage of the penis. While a majority of buried penis cases do occur in males that are overweight, it is not exclusively so. This penile problem can be improved by a combination urologic and plastic surgery approach. The buried penis needs to be released while the suprapubic fat mound needs to be reduced by liposuction with or without a suprapubic lift. While there are some cases where suprapubic mound reduction alone is sufficient, most long-standing cases in adults benefits by dealing with both anatomic issues.
Dr. Barry Eppley
Indianapolis, Indiana
Q: I am 40 years old and I have a mound around my penis area. When fully erect I have 4 1/2 inchs but when I press down on the mound my penis measures about ¾ inch more. I have lost some weight and consider myself in good shape. But understandably I am a little embarrassed about my penis size. Plus my scrotal skin is high up on my penis making it smaller than it otherwise would be. Do you think liposuctioning of this mound would help? How long would the recovery be if I had the procedure?
A: Fullness of the suprapubic mound can definitely cause some concealment of the penis. There is no doubt that liposuction of the suprapubic mound can help with penile exposure but it is a question of how much. There are numerous factors that can contribute to camouflaging penile length besides a surrounding fat collection including scrotal skin position, overhanging suprapubic and lower abdominal skin and ligamentous attachments to the penile shaft. Whether liposuction alone would be beneficial or whether it should be combined with other penile lengthening procedures should be discussed with a Urologist.
When liposuction to the suprapubic mound is done, there is an immediate result that is apparent intraoperatively. However, because of swelling and gravity these early results can quickly be obscured. While compression after surgery with a garment is always provided, the low position of the suprapubic mound makes it difficult for any compression garment to be ideally effective. Therefore, one should anticipate a fairly long period of swelling and firmness around the penis. It may take as long as 6 to 8 weeks after before the results of the liposuction procedure can be fully seen.
Dr. Barry Eppley
Indianapolis, Indiana
Q: I had a tummy tuck about a year ago and I have been embarrassed about my pubic area since. Now it sticks out and it did not do this before the surgery. It is an embarrassing problem that makes me not want to show off my new figure. It is apparent in tight pants, underwear or a swim suit. I am so self-conscious about it. Is this normal after a tummy tuck and what can be done about it?
A: Because a tummy tuck has its greatest tightening effect around the waistline, it is not uncommon to have the suprapubic mound become more prominent. In reality, the suprapubic mound was always there and it has not gotten any bigger. It is just that what lies above it has now become less prominent, exposing what used to be an obscure and unobserved mound area. In my tummy tuck experience, this is not a rare development after surgery. The bigger the size of the tummy segment that is removed and the greater the waistline tightening is, the more likely a prominent suprapubic mound would be unmasked afterwards.
The suprapubic mound can be easily and very successfully reduced by liposuction. I have found it to be an area in which fat is easily extracted and the mound prominence reduced quite quickly. Because it is a small area, the liposuction procedure can even be done under local anesthesia with minimal recovery.
Dr. Barry Eppley
Indianapolis, Indiana