Post-Surgical Penile Reconstruction in Salt Lake City, UT

In our practice, we have a particular interest and expertise in aesthetic and reconstructive issues of the penis, particularly after previous surgeries. Men who have had previous “penile lengthening” or “penile widening” procedures may experience complications, ranging from the mild to the severe, and we have developed approaches to improve both the look and function of the penis after these complications. These include both implantable devices (such as penile prosthetics) as well as non-implant surgery (such as penile lengthening or circumcision issues). Many men feel devastated and isolated if they are suffering such complications, and we do a thorough evaluation of the issues prior to implementing a personalized plan to address them.

Examples of Issues Stemming from a Prior Surgery

• Scarring or unsightly appearance after childhood or adult circumcision
• Scarring of the deep tissues after penile augmentation surgery, causing curvature or other deformities
• Abnormal angulation of the penis after previous trauma or penile “lengthening” procedures

Although we cannot undo the past, we do have expertise in addressing many of these issues, and we have treated men from all over the country who struggle with these issues. We have noted that many surgeons “overpromise and underdeliver” and so we strive to provide an honest assessment and realistic expectations of outcomes. We find that this approach helps men understand what is normal, and what improvements can be accomplished.

Each case is quite individualized, so it is impossible to generalize about the different types of flaps and other techniques that we commonly use. However, a common question we get is about the use of grafting materials; we generally prefer amniotic grafts (see below).

What are amnion/chorion membranes?

Amniotic membranes, derived from placental tissue, have been used for over 100 years in a variety of injuries. Originally used for burn injuries, they have also been extensively used in the reduction of scar tissue formation and reduction of inflammation. The placenta is a very unique tissue, and is rich in growth factors and cytokines which aid in its antiflammatory, antibiotic and stem cell recruitment properties.

Although there are many different products that are available that may assist in wound healing and tissue regeneration, amnion/chorion bilayer extracellular matrices (ECM) have been used extensively in some of the most difficult healing situations, such as diabetic foot ulcers, burns, tendon and nerve repairs, eye reconstructive procedures etc.
We have published on the use of these materials for urologic applications. Learn More

Is this safe?

These products are generally derived from donated placenta (from C-sections) and are carefully processed to ensure that they do not harbor viruses, bacterial or any other materials that could introduce problems.

Are these products safe?

The FDA requires these products to be minimally manipulated and to be processed in a way to prevent spreading communicable diseases. Minimally manipulated  means that nothing should be done to alter the biologic/physiologic/structural properties of the tissue.  For amniotic membranes, this means the material MUST be kept in sheets.  If the tissue is ground (for example, for injection), the manufacturer must demonstrate to the satisfaction of the FDA that the mechanism of action for the clinical claim is a result of the intrinsic characteristics and functions of amniotic tissue, and that the manufacturing process does not alter these relevant characteristics. For this reason, most manufacturers cannot claim FDA approval for injectable materials. If you wish to read more into this subject, please refer to this article from the FDA.

As of the writing of this page, human-derived injectable placental tissues that are FDA approved are no longer on the market and there is only one such available product that we are aware of [press release]. Given our desire for the highest safety standards for our patient, we are currently using a product that has gone through the FDA’s 501k pathway.

How do we use these products?

Generally, we use these products in 2 ways. The first is as a graft material in the context of surgery. This is to promote healthy healing and minimize postoperative inflammation. The second is in the postoperative period, using an injectable product that is delivered during a subcision-type procedure.

Why do we use these products?

After any surgical procedure, there is inflammation and the tendency to scar. In complex reconstructive procedures, we are trying to promote fast and healthy healing while decreasing the inflammatory process and the scarring process. Currently, we believe that the amniotic-derived products are one of the best ways to achieve this. Unfortunately, there is no hard data on this and anyone or any site that tells you otherwise is grossly overstating the matter. Until there are robust studies and experience in these specific kind of cases, we need to go on principles of healing and our experience with other kinds of penile reconstructive procedures.

Additional Resources

Dr. Brant, a board-certified urologist, contributed his expertise to articles on penis-enlargement implants and penile reconstruction. His insights have helped individuals and medical professionals make informed decisions about these procedures.

• Inch by Inch
• The Big Short
• The Perils and Promises of Penis Enlargement Surgery