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How Do I Know If I Need a Scrotoplasty?

A scrotoplasty procedure is a surgery that helps patients alter the distance between the skin of the scrotal sac and the penis. It can be performed on patients looking to “tighten things up” for cosmetic reasons, or to address an anatomical irregularity that is causing discomfort. A scrotoplasty is also performed in the case of scrotal webbing. This is where the scrotal skin attaches too far up the shaft of the penis, causing a perceived feeling of loss of penile length particularly when the penis is erect as well as an unaesthetic “sail” appearance of the scrotal attachment to the penis. Being dissatisfied with the aesthetic aspects of the area can impact a man’s day to day life. This may include decreased self-confidence and feelings of embarrassment. Moreover, if there is an aspect of your anatomy that is not allowing you to do certain things as expected, it may be time to consider a lasting solution. The issue for many of my patients is whether or not to opt for the surgery. So in what circumstances would a person require a scrotoplasty procedure? And what does a scrotoplasty involve?

Dr. Mo Bidair is one of Southern California’s leading urogynecologists, specializing in adult circumcision, scrotoplasty, and other men’s health issues. At Alvarado La Mesa Medical Center, Dr. Bidair can perform scrotoplasty surgery to help you achieve aesthetic goals, functionality goals, or a combination of the two. For further details, and to book a personal consultation with Dr. Bidair, please get in touch with California Adult Circumcision at (619) 486-5005, or fill out our confidential inquiry form.

Before and After Photos

Scrotal Anatomy

The scrotum is the sac of skin that holds and protects the testicles. The temperature of the testicles must be lower than the rest of the body for the production and conservation of sperm. Scrotal anatomy therefore serves a vital function, in that it allows the testicles to maintain the correct temperature for sperm. The amount of scrotal skin present varies from person to person. Moreover, with age, loose skin (skin laxity) can cause the testicles to hang significantly lower than before.

Why Get a Scrotoplasty?

Scrotoplasty procedures can be split into two categories: aesthetic and medically necessary. In some cases, a person may seek to address both issues simultaneously with one surgery.

Skin Laxity

Skin laxity happens throughout the body with age. We may find our jowls become more prominent, we may develop looser skin in the neck, and we may see less definition in the chest and abdomen as gravity takes its toll over time. This is mainly due to less collagen production.

It’s usually more noticeable from around age 50 onwards but can occur earlier

Unfortunately, increased scrotal laxity is not particularly well-studied in medical literature. However, those who have examined it have found a number of difficulties faced by patients. These include discomfort in the following circumstances:

  • While wearing loose clothes
  • Walking and running 
  • Doing sports
  • During intercourse (1) 

Scrotal Rejuvenation

In some cases, skin laxity can be a bothersome physical problem that may require scrotal rejuvenation in the form of scrotoplasty. In fact, one study has identified the extent of scrotal skin laxity that would cause problems. An enlarged scrotal sac hanging more than 1–2 cm (0.4 – 0.8 in) below the tip of the penis can be associated with persistent penoscrotal webbing. (1)

But when should you consider getting a scrotoplasty?

Scrotal Webbing

Penoscrotal webbing, webbed penis, or simply scrotal webbing, is a rare condition that can be present at birth. In very young children and babies, it’s diagnosed by physical symptoms such as an abnormal urine stream, undirected voiding, and infection. (2)  This may warrant further examination to rule out scrotal webbing. It can also occur as the result of a poorly performed circumcision or inadequate healing following injury. 

Where scrotal webbing is present, the skin that connects the penis to the scrotum is located unusually high in the shaft of the penis. It may appear taught and band-like. It may hinder or prevent an erection by reducing the angle between the penis and scrotum. As well as affecting the function of the organ, this skin can also give the appearance of a smaller penis, which can cause both physical and mental hardships.

Left untreated, scrotal webbing can cause a number of physical problems, including:

  • Abnormal urine stream
  • Pain during erection
  • The appearance of a smaller penis
  • Uncomfortable intercourse
  • Difficulty wearing condoms
  • Sexual function problems

The condition can also cause embarrassment, and may even lead to feelings of inadequacy, sexual performance anxiety, and even depression.

Scrotal Webbing vs. Buried Penis

A condition known as buried penis is sometimes confused with scrotal webbing, as the two conditions can look similar. Buried penis may also cause the penis to appear shorter than its true length, though this is often due to an excess of fatty tissue surrounding the organ. Get an expert opinion and conclusive diagnosis from leading Southern California urogynecologist Dr Mo Bidair by booking your personal consultation at California Adult Circumcision.

Candidates for Scrotoplasty

A scrotoplasty or modified scrotoplasty can address problems with excess skin, or conditions where insufficient skin is present, as with penoscrotal webbing. If you are considering scrotoplasty, but aren’t sure if it’s the right surgery for you, take a look at the questions below to make a more informed choice.

  • Are you embarrassed or self-conscious about the appearance or function of your penis because of excess scrotal skin?
  • Does your scrotal skin impede your ability to urinate?
  • Do you feel that the true size of your penis is obscured by scrotal skin?
  • Are your concerns about excess scrotal skin affecting your ability to perform during intercourse?
  • Do you experience frequent discomfort in the groin area due to skin laxity or skin tightness?
  • Is discomfort in the scrotum preventing you from completing daily tasks like walking and exercising?
  • Is excess scrotal skin causing you to change the way you do things or stop doing them entirely (e.g. riding a bicycle)?

Revision of Circumcision

Oftentimes, the physical problem present is not related to the scrotum, but to the penis itself following a prior mismanaged surgery. It can be difficult for patients to distinguish without a medical assessment of the condition. Many men live with the shame of such conditions for many years without seeking the necessary medical attention. But thankfully, there are ways to improve the situation considerably through surgical intervention.

Was your circumcision performed inadequately? Is it stopping you from getting on with living your best life? Speak to Dr. Bidair about revision circumcision at your personal consultation to see how he can help.

Personal Consultation

Dr. Bidair will take some time to get to know your issues in a private environment at our San Diego facility. We will ask you to disclose some information about your medical history, and whether you have undergone any prior surgeries in the area. Dr. Bidair will examine the scrotum and penis to note the extent of scrotal webbing, if present, or the extent of skin laxity. He will then determine the best course of action for your treatment. Once you have given us the relevant information, we will schedule your procedure and you can prepare for change.

Life can be hectic for many of us. If you cannot make it to our office, Dr. Bidair offers tailored phone consultations to align with busy schedules and out-of-town patients.

Scrotoplasty Procedure

The exact techniques Dr. Bidair will use to complete your scrotoplasty depend on your reason for the surgery. The aim of any scrotoplasty is to help the patient achieve greater confidence and normal functionality. Where there is scrotal webbing, Dr. Bidair will release the skin from the shaft of the penis for a truer representation of penis size and increased functionality. Where there is increased skin laxity, and lower-hanging testicles, Dr. Bidair will make adjustments to the scrotal area and may remove excess skin for a tighter, more compact aesthetic. 

Once your initial meeting with Dr. Bidair has taken place, he will draw up a personalized treatment plan for you and explain the details of his approach in more depth. Before this, please feel free to ask any general questions you may have about the procedure you seek.

Cost of Scrotoplasty in San Diego, CA

Scrotoplasty cost depends on the specifics of the surgery and the patient’s reason for treatment. Dr. Bidair will discuss this, and many more aspects of your procedure at your personal consultation. To set up your first meeting with him, please call our San Diego office at (619) 486-5005 or use this form to make an inquiry regarding scrotoplasty treatment.

Get more information about scrotoplasty, types of circumcision available, aesthetic surgery, and recovery guidance for men by reading Dr. Bidair’s blog. You can also find out more by taking a look at our Frequently Asked Questions.

References

  1. Thomas C, Navia A. Aesthetic Scrotoplasty: Systematic Review and a Proposed Treatment Algorithm for the Management of Bothersome Scrotum in Adults. Aesthetic Plastic Surgery. 2021;45(2):769-776. https://link.springer.com/article/10.1007/s00266-020-01998-3 
  2. Erikci, V. S., Öney, M. D., & Köylüoglu, G. (2017). Surgical Correction of a Penoscrotal Web:A Report of a Case with Literature Review. SOJ Surgery, 4(2). https://symbiosisonlinepublishing.com/surgery/surgery43.php