Buck’s Fascia

What is it?
Buck’s Fascia (18629 bytes)

Adapted by CIRCLIST from an original
image © 2003 W.B.Saunders
It is Buck’s Fascia, not the shaft skin of the penis, that holds in place the internal structures of the phallus. Because the layer of subcutaneous fat and loose connective tissue (coloured yellow in the drawing) is not firmly anchored to the shaft skin, considerable longitudinal movement of the shaft skin is possible. Put simply, the shaft skin isn’t attached other than to the skin of the abdomen and, via the foreskin, to the sulcus. Everything between is as mobile as the sleeve of a pullover on an arm, capable of being shortened and then tensioned along its own length by virtue of being unattached to what’s underneath.

What happens to Buck’s Fascia during circumcision?
A tight circumcision removes much of the shaft skin. That’s what produces the tightness. Buck’s Fascia is not affected. Many circumcision techniques remove the underlying connective tissue so that is (briefly) exposed. Sleeve dissection (see 'double circular incision' under Instruments and Techniques ) does not remove this underlying material - it, along with nerves and blood vessels, remains between the shaft skin and Buck's Fascia. A circumcision technique formerly practised in some remote parts of Arabia removes the foreskin and shaft skin completely leaving Buck's fascia exposed, details here.  In any case, whether a lot, a little or no skin remains, Buck's Fascia is what defines the shape and form of the penis.

Buck’s Fascia may be modified, for example in hypospadias repair surgery, but circumcision leaves it untouched.

The following resources were used in the preparation of this web page:
USA flag (316 bytes) Medscape logo (5542 bytes) A Pictorial and Video Guide to Circumcision Without Pain : Adv Neonatal Care 3(2):50-64, 2003.
Malaysia flag (1767 bytes) Sunathrone new logo (5253 bytes) Demonstration surgery by Sunathrone Biomedical, Kuala Lumpur 2006, attended by CIRCLIST representatives.

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