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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. <refname="hodges2001">Hodges FM. [http://www.cirp.org/library/history/hodges2/ The Ideal Prepuce in Ancient Greece and Rome: Male Genital Aesthetics and Their Relation to Lipodermos, Circumcision, Foreskin Restoration, and the Kynodesme]. ''Bull. Hist. Med.,'' 2001 Fall; 75(3): 375.</ref><ref>Pseudo-Galen, but presented as Galen in ''Definitiones medicae'' 164, in Kühn, MG (n. 9), 19: 445. See Jutta Kollesch, ''Untersuchungen zu den pseudogalenischen Definitiones Medicae'' (Berlin: Akademie-Verlag, 1973).</ref> The Greeks valued a longer prepuce, and pathologized the state of having a deficient prepuce, especially one that has been surgically ablated(i.e. circumcised).<ref>Hodges FM. [http://www.cirp.org/library/history/hodges2/ The Ideal Prepuce in Ancient Greece and Rome: Male Genital Aesthetics and Their Relation to Lipodermos, Circumcision, Foreskin Restoration, and the Kynodesme]. ''Bull. Hist. Med.,'' 2001 Fall; 75(3): 375.<name="hodges2001" /ref> It must be remembered that this medical conceptualization happened in the historical context of the legal efforts to abolish ritual circumcision throughout the Seleucid and Roman empires.<ref>Hodges FM. [http://www.cirp.org/library/history/hodges2/ The Ideal Prepuce in Ancient Greece and Rome: Male Genital Aesthetics and Their Relation to Lipodermos, Circumcision, Foreskin Restoration, and the Kynodesme]. ''Bull. Hist. Med.,'' 2001 Fall; 75(3): 375.<name="hodges2001" /ref>
== Treatment of Lipodermos ==
:''"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>Hodges FM. [http://www.cirp.org/library/history/hodges2/ The Ideal Prepuce in Ancient Greece and Rome: Male Genital Aesthetics and Their Relation to Lipodermos, Circumcision, Foreskin Restoration, and the Kynodesme]. ''Bull. Hist. Med.,'' 2001 Fall; 75(3): 397.<name="hodges2001" /ref> 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 ===
The surgical techniques developed in antiquity to repair the lipodermic penis have been described in modern medical journals,<ref>Jody P. Rubin, "[http://www.cirp.org/library/restoration/rubin/ Celsus' Decircumcision Operation: Medical and Historical Implications]," ''Urology'', 1980, ''16'': 121–24; Dirk Schultheiss ''et al''.,"[http://www.cirp.org/library/restoration/schultheiss/ Uncircumcision: A Historical Review of Preputial Restoration]," Plast. & Reconstruct. Surg., 1998, ''101'': 1990–98.</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.''
{{SEEALSO}}
* [[Aposthia]]
* [[Foreskin]]
* [[Foreskin restoration]]
{{REF}}
[[Category:Physiology]]
[[Category:Foreskin restoration]]
[[Category:From Intactipedia]]
[[Category:From IntactWiki]]