Figure 1. Preoperative photograph of buried penis.

Figure 2. (A) Lines corresponding to surgical incision. (B) Lateral flaps were defatted and brought down to base of penis to "unbury" it (small arrow). Penis has been degloved and unburied (large arrow). (C) Prosthesis placed and inflated. Flaps have been defatted and trimmed and are now positioned at penile base. Prosthesis cylinder, reservoir, pump, and connections have been placed. Distal end of penis (arrow) shows area of previous scar that could have been excised and may have contributed to poor surgical outcome.

Figure 3. (A) Operative procedure as shown in Figure 2. Preoperative outline of surgical incision. (B) Flaps have been raised and defatted. They are also going to be trimmed (dotted lines) and will be re-approximated to penile base (large arrows). Prosthesis cylinders have been placed. (C) Completed panniculectomy and penile degloving. Split-thickness skin graft to be applied.

Figure 4A. Anteroposterior view demonstrating split-thickness skin graft covering penis.

Figure 4B. Side view of split-thickness skin graft over penis with prosthesis placed. Patient's head is to right and feet are to left.