Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Published:

Silicone penile prosthesis without suprapubic lipectomy for buried penis: a pilot study on the efficacy of HimplantTM

International Journal of Impotence Research (2025)Cite this article

Subjects

Abstract

Adult acquired buried penis (AABP) is a condition where the penile shaft becomes concealed by surrounding tissues, often due to obesity, leading to significant physical and psychological distress. This pilot study evaluates the efficacy of HimplantTM (International Medical Devices Inc., Beverly Hills, CA, USA), a subcutaneous silicone penile prosthesis, for correcting AABP without concurrent manipulation of suprapubic fat. Twelve adult patients (mean age 39.1 ± 10.8 years) underwent HimplantTM insertion between January 2023 and May 2024. Standardized pre- and postoperative measurements showed a mean increase of 3.52 ± 0.41 cm in flaccid dorsal length and 2.78 ± 0.54 cm in midshaft girth (p < 0.0001). A non-validated follow-up questionnaire revealed that 85.7% of respondents (6/7) reported improved self-confidence in both daily life and sexual activity. The overall complication rate was low and limited to minor, conservatively managed issues; there were no penile infections, penile skin erosions, or other cases requiring implant removal. Notably, no recurrences of AABP were observed during a median follow-up period of 16.5 months. These findings suggest that HimplantTM may offer a safe, effective, and minimally invasive surgical solution for AABP, improving both functional outcomes and psychosocial well-being.

Access through your institution
Buy or subscribe

This is a preview of subscription content, access via your institution

Access options

Access through your institution

Buy this article

  • Purchase on SpringerLink
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: HimplantTM insertion.
Fig. 2: Preoperative and 3 days postoperative front view of flaccid penis.
Fig. 3: Front view of flaccid penis of patient 7.

Similar content being viewed by others

Data availability

All data generated or analyzed during this study are included in this published article and its supplementary information files.

References

  1. Cohen R. Adult acquired buried penis: a hidden problem in obese men. Cureus. 2021;13:306–7.

    Google Scholar 

  2. Elist JJ, Baniqued M, Hosseini A, Wilson SK. Correction of retractile penis with subcutaneous soft silicone penile implant. Int J Impot Res. 2020;32:317–22.

    Article  CAS  Google Scholar 

  3. Redman JF. Buried penis: congenital syndrome of a short penile shaft and a paucity of penile shaft skin. J Urol. 2005;173:1714–17.

    Article  Google Scholar 

  4. Pestana IA, Greenfield JM, Walsh M, Donatucci CF, Erdmann D. Management of “buried” penis in adulthood: an overview. Plast Reconstr Surg. 2009;124:1186–95.

    Article  CAS  Google Scholar 

  5. Higuchi TT, Yagamuchi Y, Wood HM, Angermeier KW. Evaluation and treatment of adult concealed penis. Curr Urol Rep. 2012;13:277–84.

    Article  Google Scholar 

  6. Boutari C, Mantzoros CS. A 2022 update on the epidemiology of obesity and a call to action: as its twin COVID-19 pandemic appears to be receding, the obesity and dysmetabolism pandemic continues to rage on. Metabolism. 2022;133:155.

    Article  Google Scholar 

  7. Falcone M, Bettocchi C, Carvalho J, Ricou M, Boeri L, Capogrosso P, et al. European association of urology guidelines on penile size abnormalities and dysmorphophobia: summary of the 2023 guidelines. Eur Urol Focus. 2024;10:432–41.

    Article  Google Scholar 

  8. Falcone M, Plamadeala N, Cirigliano L, Preto M, Peretti F, Ferro I, et al. The outcomes of adult acquired buried penis surgical reconstruction. Life. 2024;14:1321.

    Article  PubMed Central  Google Scholar 

  9. Amend GM, Holler JT, Sadighian MJ, Rios N, Hakam N, Nabavizadeh B, et al. The lived experience of patients with adult acquired buried penis. J Urol. 2022;208:396–405.

    Article  Google Scholar 

  10. Theisen KM, Fuller TW, Rusilko P. Surgical management of adult-acquired buried penis: impact on urinary and sexual quality of life outcomes. Urology. 2018;116:180–4.

    Article  Google Scholar 

  11. Tang SH, Kamat D, Santucci RA. Modern management of adult-acquired buried penis. Urology. 2008;72:124–7.

    Article  Google Scholar 

  12. Food and Drug Administration. Premarket notification: silicone block. U.S Food & Drug Administration. New Hampshire Avenue, Silver Spring; 2017.

  13. Food and Drug Administration. Premarket notification: pre-formed penile silicone block. U.S Food & Drug Administration. New Hampshire Avenue, Silver Spring; 2019.

  14. Elist JJ, Valenzuela R, Hillelsohn J, Feng T, Hosseini A. A single-surgeon retrospective and preliminary evaluation of the safety and effectiveness of the penuma silicone sleeve implant for elective cosmetic correction of the flaccid penis. J Sex Med. 2018;15:1216–23.

    Article  Google Scholar 

  15. Alter GJ. Pubic contouring after massive weight loss in men and women: correction of hidden penis, mons ptosis, and labia majora enlargement. Plast Reconstr Surg. 2012;130:936–47.

    Article  CAS  Google Scholar 

  16. Jun MS, Gallegos MA, Santucci RA. Contemporary management of adult-acquired buried penis. BJU Int. 2018;122:713–15.

    Article  Google Scholar 

  17. Alter GJ, Ehrlich RM. A new technique for correction of the hidden penis in children and adults. J Urol. 1999;161:455–9.

    Article  CAS  Google Scholar 

  18. Falcone M, Sokolakis I, Capogrosso P, Yuan Y, Salonia A, Minhas S, et al. What are the benefits and harms of surgical management options for adult-acquired buried penis? a systematic review. BJU Int. 2023;131:8–19.

    Article  Google Scholar 

  19. Siegal AR, Celtik KE, Razdan S, Sljivich M, Kansas B, Shah B, et al. A multi-institutional update on surgical outcomes after penile silicone sleeve implantation. Ther Adv Urol. 2024;16:17562872241241858.

    Article  PubMed Central  Google Scholar 

  20. Pariser JJ, Soto-Aviles OE, Miller B, Husainat M, Santucci RA. A Simplified adult acquired buried penis repair classification system with an analysis of perioperative complications and urethral stricture disease. Urology. 2018;120:248–52.

    Article  Google Scholar 

  21. Tausch TJ, Tachibana I, Siegel JA, Hoxworth R, Scott JM, Morey AF. Classification system for individualized treatment of adult buried penis syndrome. Plast Reconstr Surg. 2016;138:703–11.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Past Emeritus Staff, Cedars Sinai Medical Center, Los Angeles, CA, USA

    James Elist

  2. Men’s Enhancement Center, Beverly Hills, CA, USA

    Keon Amirazodi

  3. Department of Urology, Spartan Men’s Health Clinic, Leesburg, VA, USA

    Kambiz Tajkarimi

  4. Miami Men’s, Miami, FL, USA

    Adam De Fazio

  5. Section of Urology, Dartmouth Hitchcock Medical Center, Lebanon, NH, USA

    Britney L. Atwater

  6. Institute for Urologic Excellence, La Quinta, CA, USA

    Steven K. Wilson

Authors
  1. James Elist
    View author publications

    Search author on:PubMed Google Scholar

  2. Keon Amirazodi
    View author publications

    Search author on:PubMed Google Scholar

  3. Kambiz Tajkarimi
    View author publications

    Search author on:PubMed Google Scholar

  4. Adam De Fazio
    View author publications

    Search author on:PubMed Google Scholar

  5. Britney L. Atwater
    View author publications

    Search author on:PubMed Google Scholar

  6. Steven K. Wilson
    View author publications

    Search author on:PubMed Google Scholar

Contributions

JE performed the operations and designed the study. Under the supervision of JE, KA collected patient data and demographics, and conducted patient follow-ups. KA wrote the original manuscript. KA, KT, ADF, and BA read, revised, and helped write the manuscript. Final revisions to the manuscript were made by KA and SKW.

Corresponding author

Correspondence to James Elist.

Ethics declarations

Competing interests

JE: International Medical Devices. KA: The author declares no competing interests. KT: International Medical Devices. ADF: The author declares no competing interests. BA: The author declares no competing interests. SKW: International Medical Devices, Rigicon, Uramix.

Ethical approval

All methods were performed in accordance with the relevant guidelines and regulations. This study falls under the institutional review board approval from the Advarra IRB with the study number Pro00036006. Informed consent was obtained from all participants. Written informed consent was obtained from all participants for publication of images in this manuscript.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Elist, J., Amirazodi, K., Tajkarimi, K. et al. Silicone penile prosthesis without suprapubic lipectomy for buried penis: a pilot study on the efficacy of HimplantTM. Int J Impot Res (2025). https://doi.org/10.1038/s41443-025-01125-3

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1038/s41443-025-01125-3

Search

Advanced search

Quick links