EP 672: Unleashing the Beast: Plastic Surgeon Dr. Dellinger on Penile Enhancement, Buried Penis, and the Revolution in Men's Plastic Surgery

In this segment, Dr. Mistry and Donna Lee welcome plastic surgeon, Dr. David Dellinger of Elysian Plastic Surgery in Austin. Today they discuss the spectrum of resources available to patients who aren't happy with their body's appearance and/or function. Dr. Dellinger sees patients for everything from buried penis syndrome, gynecomastia, and reconstructive surgery to penile enlargement, liposuction, and botox. Buried penis occurs when excess fat around the penis causes it to retract into the body, resulting in both urinary and sexual dysfunction. Although bariatric surgery may help patients lose weight, the loose skin that remains can seriously impact a patient’s self-esteem. Fortunately, Dr. Dellinger and Dr. Mistry often join forces to provide the highest quality plastic surgery fixes for these and other conditions affecting patients of all genders. Call Elysian Plastic Surgery at (512) 229-1978 or visit them online to schedule your consultation today!

Voted top Men's Health Podcast, Sex Therapy Podcast, and Prostate Cancer Podcast by FeedSpot

Dr. Mistry is a board-certified urologist and has been treating patients in the Austin and Greater Williamson County area since he started his private practice in 2007.

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Transcript

Speaker 1: 0:00

<silence>

Speaker 2: 0:07

Welcome to the Armor Men's Health Show with Dr. Mystery and Donna Lee.

Speaker 3: 0:15

Hello and welcome to the Armor Men's Health Show. I'm Dr. Mystery, your host, board certified urologist and founder of NAU Urology Specialist. That is the urology group that , uh, has been in , in place since 2007. You

Speaker 4: 0:29

Forgot all around. Good guy.

Speaker 3: 0:30

We're big time now though, Donna. Why? I mean, we're all over central Texas. Donna , uh, how do people get ahold of us and how do people make appointments? You can

Speaker 4: 0:37

Visit our website, armor mens health.com, and you can call us during the week at 5 1 2 2 3 8 0 7 6 2 . I'll even answer your call if you ask for me. And we have free t-shirts just for you all. We're in Round Rock, north Austin, south Austin, and Dripping Springs, Texas.

Speaker 3: 0:52

So , uh, we are a urology group, and this show talks about urologic issues and and your penises. And your penises. And we love guests. And Dr. David Dellinger with Elian Plastic Surgery is here today. Joining us again, David, thank you so much for joining us. Thank

Speaker 5: 1:08

You. Great to be here.

Speaker 3: 1:09

So , um, when I was , uh, a resident, I was fascinated by plastic surgery.

Speaker 5: 1:14

You

Speaker 3: 1:14

Were ? Yes. I loved it so much. Uh, I , I , I think, I think I invented a procedure, in fact, that somebody else stole , uh, it , it , it , it's the manop Platy. I felt like the, the, the , the upper, the lower part of the abdomen was gonna be the new frontier in women's plastic surgery. The pupa, the pupa, the famous pupa. And I , I think I was right. Mm-Hmm. <affirmative> . But , uh, you know, my career took a different turn. And I , what I love about plastic surgery is that in your training, there's almost no part of your body that is off limits , that you operate inside the skull, inside the chest. Mm . Inside the abdomen all over the body. Tell us about what your training is like as a plastic surgeon.

Speaker 5: 1:52

It's really very comprehensive. Um , I'm on one of the surgery boards that reviews plastic surgery programs. And if you just look at the scope of cases that people do and the numbers of cases they do, they get very intense training on pretty much every area, whether it's, you know , from the top of your head to the bottom of your feet and everything in between. Yeah. I , I think that , uh, you get exposure because you do, you rotate and you work with urologists and you work with chest surgeons and you work , uh, with neurosurgeons. And we interface, you and I interface a lot with , uh, various cases. I'm not

Speaker 3: 2:26

Sure there's a bigger disconnect between how the medical profession and the general population views a certain subspecialty than plastic surgery because the general population is gonna be thinking of the cosmetic aspect of a plastic surgeon. Whereas those of us that are actual surgeons, we think of you guys as reconstruction specialists. So when the body just has to be completely, you know, deconstructed, you come in and help us reconstruct it. Yeah.

Speaker 5: 2:53

We're just there. You know, we can do something to help out. Unfortunately, you know, some diseases and some injuries, you know , result in loss of tissue and you need , uh, ability to cover things back up again to get functional again. That's the whole idea, is to restore as much function as we can.

Speaker 3: 3:09

It's really truly amazing. Now, you and I , uh, overlap in several different conditions, and a lot of them have to do with either the cosmetic appearance or the function , uh, of the penis and the genitalia. So , uh, I , I really wanna start with one of my favorite topics, which is the buried penis. Hmm .

Speaker 4: 3:26

We can never say that Dr. Dellinger buried , buried , buried, buried .

Speaker 3: 3:30

One of those buried <laugh> . So, so, so we've come across a lot of con uh , a lot of patients in which the, the , the fat around the penis is big and the penis is short, or the skin is diseased, and the , and the penis essentially disappears into the body. Who, who are the men most at risk for having a buried penis?

Speaker 5: 3:48

Uh , obviously people who are overweight or people who have had some significant weight loss , uh, in particular patients that have diabetes, I'm sure you would agree, are , uh, much more likely to have this. They end up with scarring down there, and it's a condition that just continues to progress. Once everything kind of becomes entrapped in the surrounding tissues, it naturally kind of starts to scar down and it just, even with weight loss, things just don't come back out again the way they were supposed to. And it's very distressing for a lot of patients.

Speaker 3: 4:16

It sure can be because, you know, a man, you know, functionally likes to be able to stand up to urinate. Correct. And you have to have something to hold onto . Yes. Or else it just goes down in your pants. And I'm being very graphic here. Mm-Hmm . Because those few listeners that are out there that are having this problem need to know that there's a place that you can go to to fix this very odd problem.

Speaker 5: 4:35

And that's right. I mean, a lot of patients just assume, this is the way I'm stuck. I'm never gonna be able to do anything about this. There's no other options. You know , fortunately we have the internet, which allows people to start searching, you know, for options. And that's how you and I end up working together on quite a few cases on patients that have the penis is kind of entrapped in the, you know, deeper tissues in the, the pubic area.

Speaker 3: 4:58

So you and I , uh, you know, have done , uh, surgeries for this to kind of unleash the beast as it were. So <laugh>

Speaker 4: 5:05

Wow. <laugh> .

Speaker 3: 5:06

When we're trying to prepare somebody , uh, for a buried penis surgery, what kind of considerations , uh, do you look for in the patient and how do you prepare

Speaker 5: 5:14

Them? I mean, obviously it's what expectations are, you know, if they're , you know , expectations are unrealistic. I mean, again, as I mentioned earlier, the idea is to really restore function. Function. Yeah. If your expectations are reasonable, if your medical health is such that you can undergo a surgery, I mean, I , we usually like to have people go see their primary care doctor and get clearance to have a , an operation, make sure their heart and lungs and kidneys and everything are working , uh, properly. And, you know, then just tell them what the healing process is gonna be like. 'cause it does take a few weeks to heal up from a procedure like this, and we wanna make sure that they're on board with everything. And

Speaker 3: 5:49

Oftentimes we want them to lose weight. Right. I mean, if you're big fixing it is not going to last forever because you're just gonna overwhelm our repair.

Speaker 5: 5:57

Correct. Yes, we definitely do what we can to restore whatever function we can, but if this doesn't mean that you're immune from gaining weight, then you can get the condition back. You need to take care of yourself.

Speaker 3: 6:09

So in the past, weight loss prior to surgery, you know, we, we, I think we considered it a little bit pie in the sky, you know, I mean, it's gonna be, it's gonna be hard to get that guy to lose weight. It's gonna be hard to get that girl to lose weight. The orthopedic surgeons, they can force somebody to lose weight because they can just refuse to operate until they get their , uh, weight loss down. But, but now that we have medications that we can use to, to help our patients lose weight, I feel like this is much more medically manageable.

Speaker 5: 6:32

Oh, definitely. In the past, the only real option was either lose weight on your own the hard way or

Speaker 3: 6:38

Get bariatric surgery.

Speaker 5: 6:39

Bariatric surgery. But now we , we do have medical options with , uh, the various, you know , you know , ozempic type medications, semaglutide, and it's, and Magno and it's , uh, counterparts that help people to lose weight. And we're seeing more and more people that have gone and lost a lot of weight using these medications, and now they're, they go from having a fat issue to a skin issue. Right . And so that's where we come in.

Speaker 3: 7:01

And I think that's a , a , you know, for , for us in the medical profession, I , I think of these new medications as a game changer when it comes to getting people healthy prior to surgery. Now when I see a guy that's 60 pounds overweight prior to his prostate, or now has a buried penis because of his huge, you know, mons pubis , now I'm seeing, you know, a lot of improvements with the use of these medications. And I, I think that it's gonna make our job in buried penis repairs much more satisfying. Oh,

Speaker 5: 7:27

We're already seeing more and more patients coming in that say, Hey, I got on semaglutide and I lost, you know, 40, 50, 60 pounds men or women, and now they say, now I've lost the weight and I feel great, but now I have all this loose skin, you know, in my abdomen or thighs or arms or whatever. And I would like to see what we can do to make that better.

Speaker 3: 7:47

So our goal in that varied penis surgery essentially is to be able to , uh, provide, you know, a penis that you can hold onto to urinate and hopefully restore some sexual functioning. Um, what are some of the tools that we'll use in the operating room to achieve this goal?

Speaker 5: 8:02

Um, obviously we need to, you know , take some time and remove some of that excess skin , um, usually in the lower portion of the abdomen and then in the pubic area as well. And then we want to kind of pull that skin back down onto the, you know, to the structures underneath. So it allows the penis to kind of come back out again. And as you know, your job is really to come in and usually remove a lot of the scar tissue that's, you know, trapping everything. And then there are times when we do need to do some skin grafting where we take , uh, a little bit of skin and we use that to restore some of the shape and normal attributes to the shaft.

Speaker 3: 8:36

Now, a lot of times we think of these patients as just being overweight and kind of overwhelming their penis, but in fact, there can be skin conditions like balanitis, erotica obliterans or lichens sclerosis that cause the skin to really scar down and your poor penis gets turtled all the way inside you.

Speaker 5: 8:52

Oh, yes. That's, and again, that's where you come in and, and you help free things up. And , uh, then we step in and help to restore the skin that you had to take out.

Speaker 3: 9:01

There's almost nothing more satisfying than digging in that hole and then pulling out an eight inch wiener

Speaker 4: 9:07

Oh. And a penis, you know ,

Speaker 3: 9:09

<laugh> . Is that where I stored that one?

Speaker 4: 9:12

Yeah .

Speaker 3: 9:14

And so, you know, being able to , uh, functionalize somebody and give them back length , um, when they thought that they were gonna have to sit and pee forever is something that's very satisfying that we get to do.

Speaker 5: 9:25

Oh, yeah. There's no doubt that, you know, patients are, are very pleased with these types of results and even, you know , cases that you wouldn't think you'd be able to do anything. We can at least get some, you know, function back for them. They can live a more normal life.

Speaker 3: 9:40

You know, when people hear , uh, and we've done this , uh, this buried penis discussion several times on this show. Invariably somebody hears it, it really speaks to them, and they come in and see us as patients, and really they're so grateful that we discuss this sensitive topic , uh, in such a public forum. And so , uh, I really think that we're doing a real service to our listeners. Yeah ,

Speaker 5: 10:01

I , I totally agree. We definitely see a lot of people who, you know , have been sitting around thinking about this. They might have even talked to their partner, their spouse about it, and they hear us here and then do a little bit more research and they're like, oh, maybe there is hope for me. Well ,

Speaker 3: 10:15

Uh, how , how do people get ahold of us and make appointments with either Dr. Dellinger or myself? Uh, David, what is your website and phone number?

Speaker 5: 10:21

Our website is elysian E-L-Y-S-I-A-N plastic surgery.com. And our phone number is (512) 229-1978 .

Speaker 3: 10:32

And what's our information, Donna?

Speaker 4: 10:33

Our number is 5 1 2 2 3 8 0 7 6 2. And you can visit our website, armor men's health.com and check out our podcast wherever you listen to podcasts. Hello

Speaker 3: 10:42

And welcome back to the Armor Men's Health Show. I'm Dr . Mystery , your host, board certified urologist and founder of NAU Urology Specialist joined as always by my co-host, Donnel Lee . Hey,

Speaker 4: 10:52

Everybody, listen to our podcast wherever you listen to podcasts. And by the way, Dr. Dellinger, yours are some of the most downloaded that we have. Are they

Speaker 5: 10:59

Really? Mm-Hmm. <affirmative>.

Speaker 3: 11:00

So we , uh, once again have Dr. David Dellinger joining us. He's a plastic surgeon, and he and I worked together on a number of cases. You may not even think that a urologist and a plastic surgeon would have so much fun in the operating room together. <laugh>,

Speaker 4: 11:13

Is that what we're calling it?

Speaker 3: 11:14

Fun, fun in the operating room together's. Right . So , um, uh, in our last segment we talked about the buried penis , uh, and the reconstruction that we do for people who have kind of a turling or an internalization of their penis, they're not able to hold it when they're standing to urinate. And, and they may even have, you know, a complete absence of sexual functioning if they can't get their penis out. Uh, but another big thing that you and I work together on is penis enlargement surgery. Mm . Now this is a little bit more of a fun topic , uh, when we talk about it, but, you know, whereas we've normalized breast augmentation and lip augmentation and butt augmentation and kind of the , uh, the use of cosmetic surgery in women, the use of cosmetic surgery in men still kind of lags behind, but it makes up a big part of your practice, right.

Speaker 5: 11:58

These days I would say that it probably accounts for almost half of our practice. Oh , male aesthetics. Stop it .

Speaker 3: 12:04

Yeah . That's awesome. So what are some of the , uh, the , the things that, that men usually seek out when they're looking for male aesthetic surgery? Uh ,

Speaker 5: 12:11

Ob obviously the number one thing that we get people looking for is , uh, girth enhancement or penis , uh, enlargement. Okay . That's my most popular one . Also, we, we were just talking about the pupa, which is another area where guys are looking for different ways to decrease , uh, the amount of fat that they have in that area. Uh, you can definitely get more functional length just either with some weight loss or with the removal of some of that excess skin and fat. Maybe they're not quite the extent of the buried penis issue that we were talking about before. And then guys are also coming in for, you know , we do hair restoration is a big popular topic for us. Are

Speaker 3: 12:46

Men doing Botox and facelifts and all that stuff that we used to think about in the past?

Speaker 5: 12:50

Not so much facelifts , uh, because there are so many, like non-surgical alternatives. Mm-Hmm. <affirmative> , but Botox, there's plenty of guys coming in for Botox and other types of, you know, laser facial treatments that , uh, we can offer. So yes, there's , uh, a lot of things, you know , gynecomastia and other thing Okay . Guys come in with, which

Speaker 3: 13:08

Is abnormal enlargement of breast tissue.

Speaker 5: 13:10

That's correct. Yes. And that's a nice easy satisfying surgery that many, many men say, like , look, I won't even, you know, cut the grass in my backyard with my shirt off because I'm so uncomfortable with how I look. And next thing you know, they can go hang out at the beach , uh, without their shirt on and, and feel much better, much more comfortable. Their

Speaker 4: 13:28

Wife's like, why are you moving to Venice Beach, honey <laugh>, because I can be shirtless all day.

Speaker 3: 13:33

Look at these guns. And so , um, uh, now a lot of the cases that you do are done right in your office. So if , so let's say somebody was just embarrassed about the idea of having to go to a hospital or have something done kind of in public, most of the stuff that you're talking about is done right in your office, right?

Speaker 5: 13:49

Yes. Uh , the vast majority of it is, you know, we are offices. We have a surgical center that's certified through the state, and we offer the same safety and much more privacy than you're gonna get going to a hospital or a public surgery center.

Speaker 3: 14:05

And I think that , um, you know, I think men may not have the comfort level talking about cosmetic issues even with a doctor like a woman would because of how normalized it becomes. But, but really understanding if you're, you know, a listener out there that these things are normal to talk about with a plastic surgeon, that if you're not happy with your breast tissue, if you're not happy with kind of how you're aging, that there are resources out there to help you feel and look better.

Speaker 5: 14:30

You're exactly right. Uh , as you mentioned, more many of these procedures , uh, for women are very mainstream. Even, you know , breast implants even 20, 30 years ago. I mean,

Speaker 3: 14:39

Women tell you that they got their breast done.

Speaker 5: 14:41

Oh , no . Now you , you used to sort of sneak

Speaker 3: 14:43

Into the office to sneak in.

Speaker 5: 14:45

Yeah . Now they go to, you know, brunch and drink mimosas and talk about who do their breast surgery. That's

Speaker 3: 14:49

Right. It's , it's a very different kind of, I mean, I can't imagine me and my friends would sit around talking about who made my penis bigger. Yeah .

Speaker 5: 14:55

You're probably not gonna , but that's

Speaker 4: 14:57

What you do at work. We hear about it all day.

Speaker 3: 15:00

We do hear about it all day.

Speaker 5: 15:01

Yeah . You're probably not gonna sit around and watch football with your friends and talk about, look

Speaker 4: 15:05

At this,

Speaker 3: 15:06

Look at this. You won't believe what I brought home. So when it comes to penis augmentation surgery, once again, you know , uh, normalizing the discussion, I think is, is important. Uh, I think that , um, as a society, we feel like , uh, an overdependence or an overfocus on how your penis looks , uh, to you as something that, that we don't, we don't encourage because we consider it to be a vanity issue. So what , what are some options men have currently in the marketplace? Not just those that you offer, that others offer as well for making their penis? Uh , let's just say bigger in as , as a general term.

Speaker 5: 15:45

I mean, there basically are four options. One is the , there's a type of silicone implant , uh, developed by a guy in California, what

Speaker 3: 15:52

Is that called? The panum ?

Speaker 5: 15:53

Yeah , Panum . Yeah .

Speaker 3: 15:54

So the panum is like a silicone implant , uh, installed underneath the skin. Yes. And the biggest panum guy in town stop doing them. Mm-Hmm . <affirmative> .

Speaker 4: 16:02

So he said, don't Google that procedure. He said, it's frightening <laugh> .

Speaker 5: 16:06

And , and there's a recent article in Prop ProPublica that was also , um, reproduced in Texas monthly, that's called the Secret World of Penis Enlargement. And they focus on that procedure and they don't exactly have really nice things to say about it. The complication rate is, is much more significant than other types of implant procedures, such as

Speaker 3: 16:26

It's significantly different than putting a silicone implant in breast tissue.

Speaker 5: 16:30

Exactly, yes. Very different. You should see a 2% or less , uh, complication rate with breast implants. And , you know, their reported numbers are in the 20% range . Oh , wow.

Speaker 3: 16:39

The skin of the penis is, is is very thin. Mm-Hmm. <affirmative> . And the, the, the , the penis itself has a hard time like handling the weight of a silicone implant. That's, that's my impression when I see these things postoperatively. So besides the silicone implant, what are some other options?

Speaker 5: 16:54

There's fat grafting, which is similar to how women get Brazilian butt lips, where you liposuction some fat, process it, and then reinject it into the penis area.

Speaker 3: 17:05

Uh , uh, on an aside, the Brazilian butt lift does what you

Speaker 5: 17:10

Lipo take , do liposuction. Usually on the abdomen, you process the fat and then you put it into your butt, you get

Speaker 4: 17:16

A card B butt,

Speaker 3: 17:17

There's no lift. It's just bigger.

Speaker 5: 17:19

It's just much bigger. Oh.

Speaker 4: 17:20

Oh, I thought there was a lift involved too. I guess.

Speaker 3: 17:23

I guess the Brazilian butt lift has a really good PR person. And so when you put that fat into the penis, you put it underneath the skin or, or , or deeper.

Speaker 5: 17:32

You put it pretty much just right underneath the skin.

Speaker 3: 17:34

And doesn't it get all lumpy? Like, it seems like it would get real lumpy.

Speaker 5: 17:37

The results. I mean, I would say of the 30 40 patients we've seen that have had fat grafting previously, I would say three or four of them had, you know, pretty reasonable results. But a lot of them are not very happy with the results. The , the texture in the feel, even when they have erections is not very normal. The appearance is not very normal, so they really don't care for it

Speaker 3: 17:58

That much. And , and the fat goes away. Right. The

Speaker 5: 18:00

Fat will eventually, it's considered a semi-permanent. Gotcha. Yeah . So it will last, you know , quite a few years, but you will, and you will lose anywhere between anywhere between 30 to 70% of the fat that's injected. It doesn't survive the transfer process. So there's always that issue. You mentioned with lumpiness and scarring that can occur.

Speaker 3: 18:17

What's the third?

Speaker 5: 18:19

Uh , the third is , uh, temporary fillers like Juvederm or Voluma, the hyaluronic acid based fillers that use ,

Speaker 3: 18:24

You can use temporary fillers,

Speaker 5: 18:26

You can, but you're just kind of looking down, watching your money dissolve in front of you. Uh , we've seen people come from other places that spent, you know, eight, $9,000 for 15 syringes that went away in 15 months. So that's kinda like watching your money dissolve in front of you.

Speaker 3: 18:41

Well, now she's married to me, so she's gotta deal with whatever, whatever's got now . <laugh> , stop <laugh> . And so, and your fourth option, which is the one that you do mostly?

Speaker 5: 18:51

It's the one that we primarily do it , it uses a different type of filler called a bio stimulant, which instead of dissolving, it causes your body to produce some new tissue in the area. It does that by causing a mild inflammatory response. Inflammatory sounds bad. But , uh, basically if you cut yourself shaving or sustain any kind of little injury to your skin, that causes an inflammatory response that causes your body to come in and grow in new tissue and heal. So that's what we're trying to do. We're trying to stimulate the growth of your own body's tissue to achieve a permanent result.

Speaker 3: 19:23

So , um, what can somebody expect , uh, as the process if they're coming in to get this bio stimulant?

Speaker 5: 19:29

Uh , the reasons I like it, the , besides the permanence issue, it's easy to get done. You, there's no anesthesia other than a topical, you know, cream that we put on to numb everything up. You're only in the office for a couple of hours. Uh, you can drive yourself home, you can usually go to work the next day. You can work out within a few days.

Speaker 3: 19:47

And the growth enhancement, there's, there's a significant improvement right away.

Speaker 5: 19:50

Oh, definitely. Uh , usually , uh, three quarters of an inch to an inch improvement and girth with one treatment, which if you do the math, it equates to somewhere between a 30 to 40% increase in volume overall.

Speaker 3: 20:02

So you, you do this procedure, it takes a couple of hours and you can have it done again if you needed to.

Speaker 5: 20:07

Yeah , most patients do come back. It's like how much money you have in the bank, you wouldn't mind having some more. So , uh, most patients do come back for a second treatment, probably 90% does

Speaker 3: 20:16

It ultra sensation of the shaft of the skin when you're having sex.

Speaker 5: 20:19

It does not, no, it does not affect your function. It doesn't affect your sensation. It looks and feels normal.

Speaker 3: 20:24

And , uh, you would say that, that for the most part, the partner seemed to be pretty pleased.

Speaker 5: 20:29

Yes. Yes, definitely. We've never had anybody come back and say, it made my sex life worse. <laugh>.

Speaker 3: 20:35

Well, Dr. Dellinger as always an amazing conversation about plastics surgery and , uh, urology, how they overlap. I can't thank you enough for , uh, giving our listeners this great information. How do people make an appointment with, with you?

Speaker 5: 20:47

You can call our office at (512) 229-1978 or go to our website, Elian , E-L-Y-S-I-A-N plastic surgery.com.

Speaker 3: 20:58

And if you are a patient or a listener out there that wants to go through a urologist, we work very closely with Dr. Dellinger. He is our go-to plastic surgeon. Donna, how do people get ahold of us?

Speaker 4: 21:07

You can call us at (512) 238-0762 and visit our website, armor men's health.com. And remember to listen to our podcast wherever you check out free podcast.

Speaker 2: 21:17

The Armor Men's Health Show is brought to you by NAU Urology Specialist. For questions or to schedule an appointment, please call 5 1 2 2 3 8 0 7 6 2 or online at armor men's health.com.