In genito-urinary surgery, I see a lot of men and women who have issues with their genitalia. Labiaplasties I believe are best performed by plastic surgeons as they have an aesthetic eye and in their specialty learn about how to best achieve minimal scars, less dog ears and the best result. Occasionally I have performed surgery on labia majora but most often the labia minora is what requires attention. The mons pubis can also have liposuction to reduce its prominence. The operation is usually not too complicated, and the recovery fairly quick. Men on the other hand are more concerned about their penile size. Penile lengthening can be performed by dividing the suspensory ligament of the penis. This can gain 1-2cm in length and I believe more than that is an overestimation. The widening or fattening of the penis can be achieved in various ways. I prefer fat injections with which I have had good results. I believe inserted dermis fat grafting or alloderm into the penis is fraught with danger as one can lose parts or all of the penile skin when degloving the penis to insert the dermis fat graft or the alloderm.

Reversal of vasectomies (vasovasostomies) are good operations with good success rates. One needs to find the divided epididymis and reconnect it microsurgically. As plastic surgeons perform a lot of microsurgery in other areas of their specialty such as free flaps, nerve repairs, arterial and vein repairs I believe they are eminently qualified to do this procedure. I have done a lot of these procedures with very pleasing results. The results thus far are very promising. One does this procedure during the same operation in which the Urologist performs his radical prostatectomy. The sural nerve is taken from one leg as a nerve graft and used to bridge the defect in the nerve that was sacrificed for cancer removal. A small patch of numbness is left over the lateral aspect of the foot. It might take 6-24 months for erectile function to return.