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The penis is an important genitourinary organ and its reconstruction needs certain requirements in order to obtain a satisfactory outcome. This paper presents modifications in the technique of total penile reconstruction utilizing the free radial forearm flap (RFF) including the use of the remnant phallic skin and corpora, the use of the deep inferior epigastric artery as a donor artery to supply the flap after transfer and the use of the saphenous vein to augment flap venous drainage. These modifications shared in improving the outcome as regards a better operative time, avoiding exposure of large vessels, namely the femoral vessels, and providing sensory and erotic sensation to the flap.

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Background: Abdominoplasty is one of the most commonly performed cosmetic procedures. Achieving functional and aesthetic outcome is a major goal. The scar's final position is affected by multiple factors, so it is important to attempt to decrease, the possibility of distortion in the outcome. Perfect scar is a main aim, and a hidden scar is one of the most desirable concerns.Objective: Aim of study is to assess the result of fixation of lower abdominal flap in high lateral tension abdominoplasty and its long-term impact on scar positioning.Patients and Methods: Thirty patients were enrolled in this study, divided into 2 groups with group (A) underwent high lateral tension abdominoplasty without lower flap fixation, and group (B) with lower abdominal flap fixation, objective and subjective assessments; including measurements and patients' satisfaction (VAS scale) was obtained. Statistical analysis of the collected data was done.Results: Rise of scar was more in group (A) (without lower flap fixation) than group (B) (with lower flap fixation). Patients' satisfaction scores were excellent in (80%) cases in group (B) and (60%) in group (A). Conclusion:Symmetry and proportion are essence of aesthetic surgery. Fixation of lower abdominal flap in abdominoplasty is highly advised according to our results to reach a cosmetic balance and patients' satisfaction with a hidden well designed symmetric scar.