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Also known as
Suprapubic fat pad sculpting, suprapubic liposuction, monsplasty
Definition
Suprapubic lipectomy (SPL) is a surgical procedure involving the removal of excess fatty tissue from the suprapubic area, which is located just above the pubic bone. This procedure is often performed to address a concealed penis, particularly in patients undergoing penile prosthesis implantation (PPI), where a large suprapubic fat pad can obscure the penile length and impact patient satisfaction. The procedure aims to improve the visible length of the penis and enhance patient and partner satisfaction. SPL can be performed through an abdominal crease incision, and in cases of simultaneous PPI, the same incision can be utilized to access the base of the penis for prosthesis implantation. The closure involves Scarpa’s fascia, subcutaneous fat, and the abdominal crease skin incision.1
Clinical Context
Suprapubic lipectomy is clinically indicated for patients with a concealed penis, often due to a prominent suprapubic fat pad. This is particularly relevant for individuals undergoing penile prosthesis implantation (PPI) for refractory erectile dysfunction (ED), where the concealed penile length can lead to patient and partner dissatisfaction. Patient selection criteria include the presence of a significant suprapubic fat pad that conceals the penis. The surgical procedure typically involves an incision in the abdominal crease, through which excess adipose tissue is removed. When performed simultaneously with PPI, the same incision allows access for both procedures. Expected outcomes include an increase in visible penile length and high rates of patient and partner satisfaction. Studies have shown significant improvement in satisfaction with penile length post-procedure.2