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Modified Penile Augmentation by Dermal-Fat Graft in Post-Hypospadias Adults

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Abstract

Background

Although a considerable part of patients desire further improvement in penile size after hypospadias repairs, penile augmentation is only considered in patients with congenital penile hypoplasia or acquired penile retraction. Modified penile augmentation by free dermal-fat graft is introduced to satisfy these patients and improve surgical safety.

Methods

From April 2012 to December 2014, a total of 15 male adults after hypospadias repairs, aged 18–24 years, underwent modified penile augmentation which involved girth enhancement by a free dermal-fat graft and penile elongation (suprapubic skin advancement–ligamentolysis). A specially designed tunneling instrument was introduced to facilitate pericavernous thickening without degloving. Outcome evaluation was mainly based on objective penile measurements and results of the Male Genital Image Scale.

Results

With 6 months’ follow-up, all patients had achieved excellent cosmetic results, with a significant average dimensional increase of 1.53 ± 0.23 cm in flaccid girth and 1.67 ± 0.24 cm in flaccid length. No erection deficiencies or urinary fistula occurred. Patients’ perception of male genitalia improved postoperatively, with the average MGIS score rising from 31.73 ± 4.86 to 40.20 ± 4.54.

Conclusions

This modified technique is safe and effective in enlarging penile size. The use of the specially designed tunneling instrument simplifies penile girth enhancement, avoiding unnecessary trauma to the neo-urethra and neurovascular bundle. It is confirmed that physical dimensional enhancement does contribute to improving their underestimation of penile size.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

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Authors and Affiliations

  1. The 2nd Department of Plastic Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 33, Ba-da-chu Road, Shijingshan District, Beijing, 100144, China

    Lisi Xu, Muxin Zhao, Zhe Yang, Wen Chen, Yangqun Li, Ning Ma, Weixin Wang, Jun Feng, Qiyu Liu & Tong Ma

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  1. Lisi Xu
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  2. Muxin Zhao
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  3. Zhe Yang
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  4. Wen Chen
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  5. Yangqun Li
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  6. Ning Ma
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  7. Weixin Wang
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  8. Jun Feng
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  9. Qiyu Liu
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  10. Tong Ma
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Correspondence to Yangqun Li.

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The authors declare that they have no conflict of interest. None of the authors has a financial interest in any of the productions, devices, or drugs mentioned in this manuscript.

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Xu, L., Zhao, M., Yang, Z. et al. Modified Penile Augmentation by Dermal-Fat Graft in Post-Hypospadias Adults. Aesth Plast Surg 40, 120–129 (2016). https://doi.org/10.1007/s00266-015-0593-6

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  • DOI: https://doi.org/10.1007/s00266-015-0593-6

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