Scrotox and Scrotoplasty – yes, we can help you with that.

Posted on November 16, 2021

By: Dr. Asaf Yalif

In the past, male concerns about discomfort or unsightly appearance were basically taboo to discuss. Their only options were to see a urologist for “functional” issues with their scrotum. Luckily we now live in a time were you can openly talk about issues you may be having with your scrotum, including aesthetic refinements in addition to functional problems. In short, we have evolved to better serve our male clientele!

And so, when urban and suburban Atlanta men come to our offices in Atlanta and and Alpharetta for consultations, they are curious about what are the latest trends and techniques that can help with their symptoms. From non-surgical to surgical there are many options available. Today’s post is by no means exhaustive but does represent some of the more common complaints our patients ask about and how we can address them for men.

“I have pain when I exercise” –

Excess scrotal tissue can affect a man’s ability to exercise comfortably. From tissue that hangs too low, to tissue that reactively over tightens with exertion, to just being plain uncomfortable when biking/running, etc. The list of complaints with regards to athletic activities is long and varied, but in the end they all share one theme – discomfort in the groin with exercise.

“I have a web between my scrotum and penis” –

A scrotal web is a very common problem where the scrotum essentially creeps onto the base of the penis. This creates an ambiguous appearance to the peno-scrotal junction and may affect intimacy and self-image.

“I just don’t like how it looks” –

It is not uncommon to have a complaint that “it just doesn’t look right” or that the testicles hang too low. Everyone has different elasticity to their skin so there can be great variability in what is normal for scrotal volume and skin. Remember, the scrotum’s job is to help the testicles temperature regulate to insure adequate sperm production. That may have, over years, led to a significant laxity in the skin at the scrotum as the testicles move up/down to regulate that temperature.

Can Botox/Scrotox help? –

When there is pain related to spasticity of the cremaster muscle (the muscle that helps move the testicle up/down to temperature regulate) Botox can help relax that muscle and relieve the spasm. It can also affect the appearance of the scrotum, making it smoother with wrinkling subsiding over time. So it can address functional and aesthetic complaints.

It is a reasonable option, though needs to be repeated every 4-6 months to maintain the effect. In consultation we can discuss if your issues may be related to the cremaster and if Scrotox might be right for you.

Scrotoplasty – what is it?

Scrotoplasty is procedure comprised of several techniques designed to address overall reduction in scrotal volume, improvement in appearance and symptom resolution. It is customizable to your particular complaints and Dr. Yalif tailors the procedure to your particular needs.

The procedure usually involves removing some excess skin, plicating the fascia around the testicle so it doesn’t hang quite so low, and the closing the skin in a fashion that the resultant scar should be both minimal, and once fully healed, not terribly noticeable.

During the procedure we can also address a hyperactive cremaster muscle by dividing it. Dividing the cremaster has been shown to improve pain related to cremaster dysfunction, as noted above. If the cremaster is not part of your complaint the new usually do not cut it.

We can also address a scrotal web at the same time by removing additional skin and reorienting the remaining skin to help insure that the scarring will not recreate the web.

We can also address other local problems like hernias or varicoceles (abnormal blood vessels) during the procedure. And Dr. Yalif is well versed in revision scrotoplasty and often able to address issues that may have arisen from a prior

Scrotoplasty – does it work?

Yes! Yes it does. While the initial recovery is uncomfortable the long-term result is overwhelmingly positive. Most of our patients wish they had known about it sooner.  We really can address all of the complaints, whether aesthetic or symptom based, and can create a more comfortable, more youthful, more functional scrotum. Here are a couple of examples.

Recovery –

I’m not going to lie; the first week or two are quite uncomfortable. After all it is a sensitive area and we are operating there. That being said the incision is designed to allow some leakage so we recommend either adult diapers or a pad in the underwear for the first several weeks. You are allowed to walk, but we don’t want you to exercise until the stitches have dissolved – typically at 4-6 weeks. As you feel better you can resume more normal activities. The scar will initially be thick, but we advocate for scar massage to soften it up and make sure it heals as expected. Final results are typically obtained by month 2-4.

Still have questions –

We are always happy to answer your questions online and in person. You can also call one of our offices at (404) 476-8774 (Alpharetta & Atlanta) to schedule an appointment.

As a Triple Board Certified Plastic Surgeon I make sure to spend significant time with you to help you realize your goals in both surgical and nonsurgical enhancement.  With our years of experience and technical expertise, I know that I am more than capable of providing you with a result that exceeds your expectations.