Fixing penile shape and restoring erections: a reconstructive surgery guide

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Combined reconstructive approaches can restore both form and function. For carefully selected patients with penile dysmorphology and venogenic ED, simultaneous venous procedures and corporoplasty may improve erectile function and correct deformity, reducing the need for prosthesis in some cases.

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The Reconstructive Surgeon's View (Dr. Hsu): This represents the pinnacle of penile surgery—addressing "Form" and "Function" simultaneously. Many patients suffer from a double burden: a physical deformity (curvature, hourglass shape, or shortening) and the inability to maintain an erection (venous leak). Treating one without the other is incomplete. This approach is holistic; we use precise geometric reconstruction (grafting or plication) to straighten the shaft while simultaneously performing venous stripping to restore the hydraulic pressure. It is complex, demanding surgery, but it offers the only path to a truly "ideal" outcome where the patient looks normal and functions naturally. The Patient's View: "It wasn't just that I couldn't perform; I was ashamed of how I looked. I felt broken in two ways. Finding a solution that didn't just give me a rigid erection but actually fixed the shape and look of my penis was life-changing. It restored my confidence completely. I don't feel like I have a 'medical' penis; I feel like I have a normal one again." The Psychosexual View: Penile dysmorphology drives immense psychological distress, often more so than simple ED. When a patient sees a deformed organ, it creates a feedback loop of anxiety that worsens their erectile function. By surgically "idealizing" the shape, we aren't just doing cosmetic work; we are breaking that anxiety loop. The patient wakes up with an organ that looks capable, which is the first step in believing they are capable.

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