Ventral elongation

If through the dorsal elongation procedure the principle is to advance the internal portion of the corpora cavernosa, they will advance with them and the base of the scrotum. The penoscrotal junction is a specific region that brings together the connection between the skin of the scrotum and the skin at the base of the penis. The skin of the scrotum has a tendency for some patients to have a broad base and to rise quite high at the base of the penis, covering it in a rather serious manner.

The ideal candidates for ventral elongation of the penis

The ideal candidates for the ventral penis lengthening procedure are the ones that will practically benefit from the dorsal elongation, because when I perform the dorsal elongation of the penis, I also recommend the ventral one. They must be in good health, without serious comorbidities or decompensated and not be treated with anticoagulant, antiplatelet, immunosuppressive or antipsychotic medications. At the same time, those for whom this procedure would have a beneficial effect are those in which the insertion of the skin of the scrotum at the base of the penis is quite or very high.

Being a procedure that I recommend most of the time in conjunction with the dorsal elongation procedure, ventral elongation or penoscrotal webbing has the same preoperative regimen as the last one. Before 2 days of the procedure of ventral elongation of the penis, I recommend that patients do an epilation with a blade (fresh), cream or clipper so that there are no lesions or ulcerations in the epidermis that can promote a subsequent infection. 3-5 days before, I recommend using an antibacterial solution based on iodine (Betadine) or chlorhexidine (Dermobacter) in the shower, with the help of which we will reduce the amount of bacteria in the skin and thus we will reduce the risk of infection. The procedure must be performed as follows:

• After washing the skin with soap and shower gel / gel, the antibacterial solution can be applied all over the intimate area and then it can be left to act for 1-2 minutes
• Afterwards, rinse with water and possibly soap so as not to impregnate the underwear, especially if Betadine is used
• in the morning of the intervention, I recommend that after washing thoroughly with soap and shower gel / gel, apply the antibacterial solution on the entire intimate and suprapubic area and after 1-2 minutes of operation, or just rinse with water (in in the case of Betadine), or not at all (in the case of Chlorhexidine) and to use a clean towel that only dampens the skin until it dries
• The operation must be completed using new, clean, steam-lined underwear (to reduce the amount of bacteria in the fabric)

The techniques of ventral elongation of the penis

The technique of ventral elongation of the penis is also called scrotal deepening. As mentioned above, when practicing dorsal elongation of the penis, I recommend that patients opt for deepening of the scrotum because from a dynamic point of view, the more efficient the advancement of the corpora cavernosa, the more advanced the penoscrotal junction will be. a good thing if it is hypertrophic and has a high insert. Therefore, the principle of this procedure is to highlight as much as possible the base of the corpora cavernosa on the ventral face, either removing the excess skin of the scrotum, or moving the insertion of the skin of the scrotum from the trunk of the penis, as far as possible, to the scrotum. The decision of the technique itself is made during the consultation when I evaluate the laxity and excess of the skin of the scrotum and the level of its insertion at the base of the penis.

Penoscrotal webbing through the technique of removing excess skine

This technique involves removing a rhombic or V-shaped flap that extends between the base of the penis and the central area of ​​the scrotum. I recommend it when there is an excess of scrotal skin through which the patient will also benefit from a scrotal lifting effect. Removing excess scrotal skin from the base of the penis will provide a better appearance of the ventral base of the corpora cavernosa because the penis will look longer when the patient sits on his back than before the operation.

Z-plastic for lowering the scrotal skin insert

This technique is reserved when the insertion of the skin of the scrotum is high at the base of the penis, but it does not exist.

After ventral elongation of the penis

The recovery period after the ventral penis lengthening procedure is 2-4 weeks. Considering that I associate this procedure with the dorsal elongation procedure, I recommend to the patients that the period spent in Baia Mare postoperatively to come to dressings and controls be in accordance with the last mentioned one. That is, during the period when we make sure that things are evolving well at the level of the suprapubic region where the incision for dorsal elongation was placed, we will be able to evaluate the area of ​​the peno-scrotal junction where the ventral elongation procedure was performed. If this procedure is performed individually (at the patient’s request) or in conjunction with the thickening procedure, the follow-up period may be 2-14 days, depending on the patient’s ability to remain in the area for check-ups. For us, patient safety is paramount, so the risk of complications is zero.

At the peno-scrotal junction, the sutures will be absorbable to approximate the deep tissues, but on the skin I use non-absorbable threads that will be removed after 10-12 days, because I want the edges of the suture to be as sparse as possible to completely eliminate the risk of the hairs penetrate through them and produce a small infection. At the same time, the overflow of the sutures will produce an almost imperceptible scar at this level.

Because the scrotum is a region where sero-bleeding infiltrate and postoperative edema can sometimes be quite severe, I recommend that patients do not exercise moderately and excessively, except for light walks and long stretches in inclination (lying on their back) associated with ice application. for a period of 2-5 days. The ice must be applied according to the standard protocol, namely, it must not come into direct contact with the skin, but placed in a bag that closes tightly and then the bag covered with a towel. During hospitalization we will use special containers so that patients have superior comfort.

Complications of the ventral elongation of the penis

One of the most significant complications after the ventral elongation procedure is excessive bleeding, which can lead to hematoma. This means an accumulation of excess blood, manifested by large clots that can cause compression on the testicles and then become infected.

Another complication that can occur is the accumulation of excess lymph, which can lead to the appearance of a serum. Lymph is the body’s fluid responsible for detoxifying the blood, but its accumulation in excess in a subcutaneous area that cannot be covered by its ability to be absorbed by the lymph nodes can lead to serums that can become infected.
Infection is a common phenomenon in any medical or surgical procedure, no matter how mild or minimally invasive, and even if it occurs quite infrequently, it should be considered because the area has quite limited possibilities for effective aseptic care.

Even if we mentioned these complications, taking them very seriously, through the prophylaxis measures taken both from the education we do to our patients and through the operative and postoperative protocols, the risk of them occurring is very low. However, we recommend that patients listen to our instructions because all this is based on the postoperative safety that we can guarantee through standard controls, which involve the need for patients to stay in the region for a few days to be able to see the clinic. the postoperative evolution is according to our expectations.

I recommend the ventral elongation of the penis every time I perform the dorsal elongation.

The principle is based on the idea that once the penis has been advanced by the technique of disinsertion of the suspensory ligament, it will go down more and with that it will pull down the peno-scrotal junction which, if high, will bring more skin. scrotum down. The technique of ventral elongation is thus based on better relief of the corpora cavernosa on the ventral face and when the patient sits on his back, the penis looks longer. Thus, if practiced individually, without the dorsal elongation, the penoscrotal webbing technique offers a longer penis only through a visual aspect of the ventral face, but when associated with the dorsal, it offers a visual gain over the functional one through lowering of corpora cavernosa. The bottom line is that I always recommend combining dorsal and ventral techniques for a complete result.