Plaque incision or partial excision surgery is indicated for men who have more severe curvature, in excess of 60-70 degrees with or without severe indentation or hourglass effect causing a hinge or buckling effect. In these circumstances, an incision is made through the area of maximum curvature, or if there is a large indentation, this area of the plaque will be excised (removed). The defect created within the tunica albuginea must be filled with a graft so that the erectile bodies will trap the blood and remain pressurized for erection. A variety of grafts have been used over the years including dermis, vein, temporalis fascia, fasia lata, tunica vaginalis and now off-the-shelf grafts are being used including pericardial grafts from humans and bovine sources as well as small intestinal serosa from the pig. All of these grafts have been shown to work in a similar fashion. The key to success is patient selection and surgical technique. This is not an operation which is recommended to be done by a surgeon who performs this type of procedure only once to twice per year. The reported success with straightening is in the 90%+ range with the primary side-effect being diminished rigidity which occurs in anywhere from 5-30% of patients depending on their pre-operative erectile status.