The scrotum is made from majora tissue by advancing the tissue anteriorly and folding it to create a pouch. Scrotal appearance, size and position will depend on each patient's specific anatomy; for example, large amounts of majora tissue will typically lead to a larger scrotum. Reconstruction is sometimes required for wound healing complications, or undesirable scrotal size and position.
Testicular implants may also be inserted based on the patient's surgical goals and healing status. On rare occasion, scrotal tissue expansion is desired. Active tissue expansion (injecting a port with saline every 1-2 weeks to inflate a balloon in the scrotum) has fallen out of favor. Passive tissue expansion (placing testis implants and waiting will frequently lead to looser scrotal skin over 1-2 years for larger testis implants later) is safer and preferred.
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