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'''Lipodermos''' (λιποδερμος, lit. "lacking [[skin]]") is an ancient Greek medical disease concept which describes a penis with little or no foreskin. <ref name="hodges2001">{{REFjournal
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Preserved in their original setting in De methodo medendi,<ref>Galen, ''De methodo medendi'' 14.16 (Kühn, MG [n. 9], 10: 1000–1001).</ref> Galen's nonsurgical methods of elongating the prepuce involve different applications of traction and tension. The abridged account of Galen's exposition that appears in Oribasius's compilation states:
:''"When the [[skin ]] of the penis needs only a short stretch in order to give it a natural appearance, I have often obtained the desired result through simple tension: I roll around the circumference of the penis a strip of strong and soft papyrus, after having coated the [[skin ]] with glue. It is clear that it is necessary to glue the end of the strip of papyrus to the part of the same strip placed on the underside of the end. In effect, this device dries quickly and pulls without discomfort. One places under the [[skin ]] of the posthe, on the interior fold, a rounded object of suitable dimension, that one can easily remove when the strip of papyrus is adhered. When I have no such object at my disposal, I often roll up and introduce a piece of papyrus of average size to serve as a support for the one with which I surround the penis. I want to be careful to provide the patient with a way to urinate easily when the paper rolled around his penis is completely solidified and the supporting one is removed. Some of those who use thapsia to return the posthe over the glans construct the round object in question in the form of little lead spout. They stretch the [[skin ]] of the posthe over the exterior of this spout and secure it with a soft leather cord.This procedure can sometimes also be useful for those individuals who are missing a large amount of posthe. I also treat this surgically."''<ref>Oribasius, ''Collectionum medicarum reliquiae'' 50.1 (Raeder, ''OCMR'' [n. 36 ], 4: 55).</ref>
The alternative method that Galen outlines, that of inserting a lead spout under the prepuce and holding it in place by binding the enveloping prepuce with a leather cord would have added weight and perhaps tension, depending on the length of the lead spout, to the restorative technique.<ref name="hodges2001" /> Like the technique of Soranus, Galen's method of manually stretching the deficient preputial [[skin ]] over the glans and winding a leather cord around the "akroposthion" would have a similar effect to that of the [[kynodesme]]. These techniques depend for their efficacy on the principles of tissue expansion, today a major reconstructive technique. Given sufficient application of constant tension, new and permanent [[skin ]] can be induced to grow. Penile [[skin]], noted for its great elasticity, is especially responsive to expansion techniques.
=== Surgical treatment ===
}}</ref> but these papers erroneously portray these operations as having the sole objective of surgically repairing the circumcised penis rather than the lipodermic penis, which, as the ancient sources show, need not necessarily have been caused by circumcision. For instance, Celsus prefaces his account of his surgical technique by specifying that it is to treat "those in whom the defect is natural,"<ref>Celsus, De medicina 7.25.1 (Spencer [n. 21], 3: 421).</ref> rather than those in whom it is caused by circumcision. The Latin translation omits the term lipodermos, but the subject matter and composition fit so well with other explicitly denominated descriptions of lipodermos repair (see below)that the attribution may be taken to be legitimate:
:''"And, if the glans is bare and the man wishes for the look of the thing to have it covered, that can be done; but more easily in a boy than in a man; in one in whom the defect is natural, than in one who after the custom of certain races has been circumcised; and in one who has the glans small and the adjacent [[skin ]] rather ample, while the penis itself is shorter, rather than in one in whom the conditions are contrary.''
:''Now the treatment for those in whom the defect is natural is as follows. The prepuce around the glans is seized, stretched out until it actually covers the glans, and there tied. Next the [[skin ]] covering the penis just in front of the pubes is cut through in a circle until the penis is bared, but great care is taken not to cut into the [[urethra]], nor into the blood vessels there. This done the prepuce slides forwards towards the tie, and a sort of small ring is laid bare in front of the pubes, to which lint is applied in order that flesh may grow and fill it up. <It is seen that a large enough part of the penis has been bared, if the [[skin ]] is distended little or not at all, and if> the breadth of the wound above supplies sufficient covering. But until the scar has formed it must remain tied, only a small passage being left in the middle for the [[urine]]. But in one who has been circumcised the prepuce is to be raised from the underlying penis around the circumference of the glans by means of a scalpel. This is not so very painful, for once the margin has been freed, it can be stripped up by hand as far back as the pubes, nor in so doing is there any bleeding. The prepuce thus freed is again stretched forwards beyond the glans; next cold water affusions are freely used, and a plaster is applied round to repress severe inflammation. And for the following days the patient is to fast until nearly overcome by hunger lest satiety excite that part. When the inflammation has [Page 399] ceased, the penis should be bandaged from the pubes to the corona; over the glans the plaster is applied with the other end of the probe. This is done in order that the lower part may agglutinate, whilst the upper part heals without adhering."''<ref>Ibid. (Spencer, 3: 421–23)(angle brackets in original).</ref>
In addition to the surgical technique outlined by Celsus, the compilations of Paul of Aegina and Oribasius contain abridged accounts of a similar surgical treatment, originally from the Cheirourgoumena (preserved only in fragments), a lost work by Antyllus, a second-century C.E. Greek physician.<ref>Paul of Aegina, 6.53 (Heiberg [n. 36 ], 2: 94)-—a greatly abridged account; ''Antyllus apud Oribasium'' 50.1–2 (Raeder, ''OCMR'' [n. 36 ], 4: 55–56).</ref> Unlike Celsus, Antyllus freely uses the term lipodermos, but like Celsus, he stresses that this operation is of little value in circumcision-caused lipodermos. In a brief commentary, however, Paul of Aegina voices his disapproval of Antyllus's operation, expressing his doubt that anyone would choose to submit to its dangers.