A case report is given of the psychological response to testicular implant in a thirty-year-old man. The patient was articulate and able to report fantasy material that was analytic in quality. Reports are detailed from before the surgery, at the time of surgery, and ten months and three years later. Unfortunately, the nature of the therapeutic contact is not made clear. The report is significant in that it provides greater insight into the psychological meaning of surgical procedure, demonstrates the importance of anatomical abnormalities for the development of identity and overall functioning, and stresses the importance of psychological questions in relation to procedures that alter body image.