What is my best course of action for the result I want? Explained more below

Question

Background: Male, 20, 200 pounds, 5’10. I have a large pubic fat pad, as well as lax skin in that area. Due to this, a good amount of my penis length is hidden, causing “buried penis” especially when I sit down or kneel over. When I push said fat down when my penis is erect, my penis looks considerably bigger. I want to get rid of this fat surrounding my penis, in order to get that increased visual length. What is the best procedure for me based on my goals? I appreciate any advice.

Nathan Molina, MD · Answer

Hi, thanks for sharing. Most people need a combination of liposuction and skin removal, but everybody is unique! People with really good skin elasticity may be able to get away with liposuction alone. I recommend an in-person evaluation to get your answer. Best of luck!

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question about addressing excess skin and fat in the pubic region, particularly regarding a hidden penis condition. Your choice of treatment will depend on various factors, including whether you have a history of significant weight loss.
For excess fat in the pubic area, liposuction is a common option. VASER liposuction, in particular, can be effective for this purpose. It involves making one or two small incisions, injecting a tumescent solution to help break up the fat, and then using cannulas (thin tubes) to suction out the fat. VASER liposuction is known for its ability to more effectively target fat while preserving surrounding tissues, and it also aids in better skin retraction post-procedure.
If you have a history of massive weight loss, the skin's elasticity and ability to recoil might be compromised. In such cases, simply removing fat may not yield the desired skin tightening. Surgical excision of excess skin, also known as a pubic lift, might be necessary. This involves making an incision in the pubic hair area or slightly above it and removing an ellipse of excess skin and fat, effectively reducing and lifting the pubic area.

In cases where there is no significant history of weight loss, and the skin's elasticity is presumed to be intact, VASER liposuction alone might be sufficient. To enhance skin contraction after VASER liposuction, you might consider adjunctive treatments like J-Plasma, which can help tighten the skin further.
Each person's situation is unique, so it's important to consult with a board-certified plastic surgeon who can evaluate your specific needs and recommend the best approach for your condition. They can assess factors like skin quality, the amount of excess fat, and your overall health to determine the most suitable treatment plan.
I hope this information provides a clear understanding of the options available for addressing excess skin and fat in the pubic region and helps guide you in making an informed decision.
Good luck with your journey to achieving the results you desire.

Daniel Barrett, MD · Answer

Dear Diligent53905,
it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

I suggest going for consultation and seeing if liposuction would work well for you. Other men have been treated in that area with liposuction and did well.

Camille Cash, MD · Answer

Depending on the amount of skin laxity you have you may need both skin excision as well as liposuction.  If you have good skin elasticity then liposuction alone may be adequate to get you the results you are looking for.  See a board certified plastic surgeon near you to learn more.

Mats Hagstrom, MD (license on probation) · Answer

Liposuction in this area for what you’re hoping to achieve tends to leave disappointment. Most men who request this treatment have had weight fluctuations and the skin laxity is the issue. Liposuction will not create the effect of you pushing on the skin. It’s not a good procedure. 
If anyone says they can do this with good outcome insist they slow you before and after pictures!!!
MH

John E. Nees, MD - Account Suspended · Answer

Given your background and description of a large pubic fat pad leading to "buried penis" syndrome, the most common and effective procedure to consider is pubic liposuction. This technique focuses on removing the excess fat from the pubic area to reveal more of the penile shaft. In cases with lax skin, a surgical lift might be necessary to remove and tighten the excess skin for better aesthetic results. However, every individual's situation is unique, and it's important to consult with a qualified plastic surgeon who can assess your specific needs and recommend the best approach. They will consider factors like your overall health, weight, skin elasticity, and goals to suggest the most suitable procedure(s) for you.

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