What scrotoplasty is
Scrotoplasty (also called scrotal reduction or scrotal lift) is a male intimate surgery procedure that removes excess scrotal skin and gives the scrotum a more compact shape. It does not touch the testicles, the vasa deferentia or the organs of erection: it acts on the skin covering.
It is a little-known and still little-studied procedure: a 2021 systematic review found only 11 useful papers out of more than 1,400 examined, almost all descriptions of single cases or techniques. For this reason the choice of technique relies heavily on the surgeon's experience and on the individual patient's anatomy.
When it is indicated
Sagging scrotum and scrotal laxity
With age, after significant weight loss or because of a particularly elastic skin constitution, the scrotum can become sagging and redundant. In the review cited, the authors speak of excessive laxity when at rest the scrotum hangs more than 1–2 cm below the tip of the penis. The most frequent complaints are:
- discomfort with tight clothing, when walking, cycling or doing sport;
- chafing and skin irritation;
- discomfort during intercourse;
- an appearance that the patient finds embarrassing.
Penoscrotal webbing
Penoscrotal webbing (or webbed penis) is when the scrotal skin "climbs" up the underside of the penis, like a membrane. The penis looks shorter than it is and intercourse can be uncomfortable. It can be congenital or appear after a circumcision or other surgery in the area.
The two conditions are often present together.
How the procedure is performed
Technique: it depends on the indication
- Redundant or sagging scrotum: I remove the excess skin and close, trying to place the scar along the raphe (the natural midline of the scrotum) or in a fold, where it is less noticeable.
- Penoscrotal webbing: I separate the scrotal skin from the base of the penis and redistribute it, for example with a Z-plasty, so that the angle between penis and scrotum becomes well defined again.
The design of the procedure is decided at the consultation, case by case: how much skin to remove is the most delicate choice, because removing too much makes the scrotum tight and uncomfortable.
Anaesthesia, instruments and suturing
- Anaesthesia: local anaesthesia combined with sedation.
- Incision and haemostasis: I use the CO₂ laser and radiofrequency (Ellman, 4 MHz), which allow a precise cut and good control of bleeding in a highly vascular area.
- Suturing: I use slowly absorbable stitches. Scrotal skin is thin, mobile and heals slowly: the stitches need to hold for longer, and about 4 weeks are needed for complete healing.
- Histological examination: the removed skin is sent for histological examination only if it shows skin abnormalities.
The procedure lasts about an hour and is performed at Aesthetic Clinic in Turin; consultations can also be held in Asti and Alessandria. You go home the same day, accompanied.
Combination with other procedures
Scrotoplasty can be combined with other male intimate surgery procedures in the same session, for example correction of a penis "hidden" by pubic fat or penile enhancement surgery. Whether they can be combined is assessed at the consultation.
Recovery: the real timings
| Activity | When you resume |
|---|---|
| Driving | Not on the day of the procedure, because of the sedation |
| Work | After 5 days |
| Healing and absorption of the stitches | About 4 weeks |
| Sport | After 4 weeks |
| Sexual intercourse | After 4 weeks |
| Swimming pool and sea | After 6 weeks |
In the first few days the scrotum swells and an extensive bruise may appear: this is normal, because scrotal skin is lax and readily accepts fluid and blood. Relative rest and ice (never in direct contact with the skin) help to reduce swelling. I also advise wearing a suspensory or supportive underwear for 4 weeks: it supports the scrotum and relieves its weight on the operated area.
Risks and possible complications
In surgery 1 + 1 does not always make 2, and the scrotum is an area that heals slowly. The possible risks are:
- swelling and bruising, which can be considerable in the first few days;
- haematoma, which rarely requires drainage;
- infection or partial wound dehiscence (reopening of the wound), more likely in a moist area subject to friction;
- a scar that is visible, thickened or irregular;
- insufficient correction, because over time the scrotal skin can become lax again, or excessive correction, with a tight and uncomfortable scrotum;
- temporary changes in skin sensation.
Scrotoplasty does not alter the testicles and is not designed to affect fertility. Correcting the webbing can make the base of the penis more visible, but it does not increase its real length: it is important to come to the procedure with realistic expectations.
Related pages
- Penile enhancement: filler and fat grafting (lipofilling)
- Surgical penile lengthening
- Circumcision in adults: webbing can also appear after a circumcision
Frequently asked questions
What is scrotoplasty?
It is the procedure that reduces excess scrotal skin and, when needed, separates the scrotum from the base of the penis (penoscrotal webbing). It acts on the skin and not on the testicles.
What is penoscrotal webbing?
It is the condition in which the scrotal skin climbs up the underside of the penis like a membrane, making it look shorter and sometimes making intercourse uncomfortable. It can be congenital or appear after a circumcision.
Will there be scars?
Yes, as after any procedure. I try to place them along the median raphe or in the natural folds of the scrotum, where they are usually barely noticeable, but the final quality of the scar varies from person to person.
Does the procedure affect sensation or fertility?
Scrotoplasty acts on the skin and does not touch the testicles and vasa deferentia, so it is not designed to affect fertility. In the first months skin sensation may be temporarily altered.
Will the penis look longer?
If there is webbing, correcting it makes the base of the penis more visible and the profile improves. The real length, however, does not change.
Why does healing take 4 weeks?
The skin of the scrotum is thin, mobile and heals slowly. For this reason I use slowly absorbable stitches, which hold for longer, and I advise waiting 4 weeks before resuming sport.
When can I go back to work and to sport?
To work after 5 days, to sport and sexual intercourse after 4 weeks, to the swimming pool or sea after 6 weeks. You must not drive on the day of the procedure, because of the sedation.
Where is the procedure performed?
At Aesthetic Clinic in Turin. Consultations can also be held at the Asti and Alessandria locations.
Scientific bibliography
-
Thomas C, Navia A – Aesthetic Scrotoplasty: Systematic Review and a Proposed Treatment Algorithm for the Management of Bothersome Scrotum in Adults
Source: Aesthetic Plastic Surgery, 2021 – Springer
What it covers: systematic review of aesthetic scrotoplasty: of more than 1,400 articles examined, only 11 were useful. It proposes a treatment algorithm: median vertical resection for excess skin and Z-plasty at the penoscrotal junction for webbing.
Why it matters: it is the most complete synthesis on the subject and honestly shows how limited the evidence still is.
-
Schifano N, Castiglione F, Cakir OO, Montorsi F, Garaffa G – Reconstructive surgery of the scrotum: a systematic review
Source: International Journal of Impotence Research, 2022 – Nature
What it covers: review of reconstructive and aesthetic scrotal surgery. Reduction scrotoplasty and correction of penoscrotal webbing are described as simple, safe and effective solutions, although more robust studies are needed.
Why it matters: it places aesthetic scrotoplasty in the broader context of scrotal surgery, authored by Italian researchers.
For a broader overview of male intimate surgery:
Medically reviewed by Dr Giulio Maria Maggi, Plastic Surgeon — last review:
Article written by
Dr Giulio Maria Maggi
Aesthetic Plastic Surgeon — Turin, Asti and Alessandria
Medical Director — Aesthetic Clinic (Turin)
Registered with the Turin Medical Council (Ordine dei Medici di Torino) no. 20595
Full Member of AICPE — Italian Association of Aesthetic Plastic Surgery (verify)
Expertise and areas of interest
Dr Maggi trained specifically in intimate medicine and surgery by working for 12 years alongside Prof. Renato Marten Perolino, urologist and plastic surgeon, at Villa Maria Pia Hospital and, privately, at Clinica Fornaca and Clinica Cellini in Turin. From him he learned male-to-female gender-affirming surgery, and he was first operator in breast augmentation procedures on Prof. Perolino's patients in gender transition. He also trained internationally with Prof. José Guerrero Santos in Guadalajara and with Prof. Andrew A. Jacono in New York, for the Deep Plane facelift technique.
He focuses in particular on:
- Functional and aesthetic intimate surgery, male and female
- Deep Plane facelift
- Blepharoplasty
- Liposculpture and fat grafting (lipofilling)
- Breast surgery
- Body contouring
Clinical approach: «Prima comprendere» ("Understand first"). No promises of results: indications, risks and limits explained frankly, so that every patient can make a truly informed choice.
