Cosmetic circumcision revision


Cosmetic circumcision revision

Approximate time70 min

Circumcision revision is a plastic surgery procedure designed to improve the appearance of the penis following an imperfect circumcision. About 5% to 10% of men have issues resulting from a circumcision that may require corrective surgery.

Many men circumcised at birth or later in life aren’t satisfied with the appearance of their penis and some even experience embarrassment or a loss of self-esteem as a consequence. In some cases, this results in difficulties establishing and maintaining intimate relationships.

To ensure optimal results, the cosmetic circumcision revision procedure is tailored to a patient’s individual anatomy. This surgery can be performed at any of our clinics under local anesthesia.

Why do some men undergo circumcision revision?

There are several reasons why certain men may choose to have this procedure. In some cases, the patient has an uneven and very pronounced circumcision scar and simply wishes to hide or remove it for esthetic reasons. In other cases, the individual is experiencing chronic pain and/or irritation as a result of their circumcision scar and wants to alleviate these problems.

Sometimes, after a circumcision, the skin on one side of the penis is bunched or uneven. Other times, the circumcision scar may be overly large or uneven. A circumcision can also cause trauma, pain or difficulty managing basic hygiene. This is particularly the case if the procedure was left unfinished. In most cases, these issues can be corrected.

In addition, the removal of the frenulum during a circumcision procedure could negatively impact the appearance of the penis. It could also cause discomfort during sexual intercourse. At Cliniques Marois, we perform both frenuloplasty and frenuloplasty revision procedures at our four private urology clinics. This surgery is performed under local anesthesia and involves minimal discomfort.

What are the different types of circumcision procedures?

A circumcision can be full or partial.

A full circumcision involves the complete removal of the foreskin and leaves the glans wholly exposed.

A partial circumcision, however, is different in that the glans remains protected by residual foreskin and the preputial mucosa. However, compared with a full circumcision, a partial circumcision doesn’t provide the same degree of protection against sexually transmitted diseases such as HIV and fungal balanitis.

Both the full and partial circumcision procedures facilitate personal hygiene.

What are the different circumcision styles?

The different circumcision techniques, or “styles,” can be applied to both partial and full circumcision procedures, with each producing unique esthetic and functional results.

First of all, a circumcision can be either “tight” or “loose,” depending on the amount of skin removed at the circumcision site. This will impact how tight the skin of the penis will be (when both flaccid and erect) after the surgery.

A loose circumcision removes less foreskin so that, following the procedure, the skin is drawn more loosely over the penis. Conversely, a tight circumcision removes more skin so that, following the surgery, the skin is drawn more tightly over the penis.

A circumcision can also be either “high” or “low,” depending on how much of the preputial mucosa is removed. This determines how near the circumcision scar will be to the glans. A high circumcision causes the circumcision scar to be close to the glans, whereas a low circumcision causes it to be more distant.

These two sets of techniques can be used in conjunction:
  • In a high and tight circumcision, the skin of the penis is drawn tight when flaccid and the circumcision scar is close to the glans. There’s a risk of minor discomfort during erections.
  • In a low and tight circumcision, the skin of the penis is drawn tight when flaccid and the circumcision scar is further from the glans.
  • In a high and loose circumcision, the foreskin is completely drawn back and a smaller area of the mucous membrane is preserved. There is no tension in the penis when flaccid or erect.
  • In a low and loose circumcision, the circumcision scar is further from the glans and the mucous membrane is preserved, without tension. Generally, this corresponds to a partial circumcision.

    Why should you choose Dr. Marois for your cosmetic circumcision revision?

    Dr. Marois’ urology clinic is a private practice with a fully equipped minor surgery room. The clinic complies with all standards established by the Collège des Médecins du Québec.

    As a specialized urology surgeon, Dr. Marois is qualified to perform all circumcision revision techniques and to determine which is most appropriate in light of the patient’s anatomy and the presence of any underlying conditions. Patients can expect more esthetic results than those that what would be obtained from a standard circumcision closure. The most common revision procedures involve straightening the circumcision scar and removing excess or uneven foreskin.

    Dr. Marois is a meticulous surgeon who’s dedicated to achieving esthetic results. For most men, it’s important that their circumcision look as natural as possible.

    In the days following the procedure, all patients are guaranteed a follow-up appointment with one of our nurses by telephone.

    Contact us to schedule a consultation for a circumcision revision at a urology clinic in Montreal, Laval, the South Shore or Quebec City.

    What does the circumcision revision procedure involve?

    The duration of the circumcision revision is generally much longer than that of the initial circumcision, though the duration varies depending on the complexity of the selected procedure. During the surgery, the patient is set on his back and a screen is placed below his head to prevent him from seeing the operation. Next, the local anesthetic is administered, a sterile field is set up and Dr. Marois disinfects the surgical site. The efficacy of the anesthetic is always verified prior to beginning the surgery. The operation itself therefore involves minimal pain and discomfort. Additional anesthetic can be used if needed.

    Various techniques may be used during the circumcision revision and the ones to be employed will depend on the nature of any underlying problems. In order to obtain the best possible results, Dr. Marois only ever uses established techniques. Generally, a mark is made on the skin to indicate the extent of the revision. Various instruments may be used to ensure a perfectly circular excision of skin. Frequently, a scalpel is used to correct irregularities. Bleeding is stopped using an electrocautery, and the frenulum of the penis is generally cut.

    Lastly, the surgical wound is closed using surgical glue and therefore without any visible stitches. This is the most esthetic option for closing the surgical wound, and will prevent secondary scarring. This closure technique is only possible if the edges of the surgical wound can be perfectly aligned. At the end of the circumcision revision procedure, a compression dressing is applied. Polysporin is used to prevent the dressing from sticking to the wound.

    How is the anesthetic administered during a circumcision revision?

    Receiving the local anesthetic is the most unpleasant part of the circumcision revision procedure. However, the discomfort only lasts for about 15 seconds. This step is crucial to ensuring that the procedure is comfortable for the patient. It involves two steps:
    • First, an anesthetic cream is applied to the penis and glans.
    • Second, a topical anesthetic is administered by an injection of pressurized anesthetic liquid under the skin. The patient can expect to experience a pinching sensation, a bit like being struck by an elastic band. Several injections of this kind will be administered around the base of the penis.
    The administration of these anesthetics greatly diminishes the discomfort caused by the penile nerve block, as the patient won’t feel the accompanying pinching sensation. The penile nerve block is the final anesthetic that is administered. It involves several injections of a specialized anesthetic under the skin around the base of the penis. About ten minutes after the final injection is administered, the penile nerve block will be at its most effective and the procedure can begin.

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    How to prepare for an adult circumcision

    The day before the operation
    The area around the penis must be shaved.
    The day of the operation
    We recommend that the patient be accompanied and avoid drinking coffee or taking other stimulants the morning of the circumcision.

    Patients who are particularly nervous or who have already had vagal shock before, should advise our nursing staff beforehand, and they will be given medication before surgery.

    It is also recommended to bring headphones and a music player such as an iPhone, iPod or other player to aid in relaxation during the procedure.

    Post-operative recommendations for adult circumcision

    The day of the surgery
    Take Tylenol (650-1000mg) for the pain every 4 hours. You can also take a painkiller according to prescription if you are still in pain.
    The week following the surgery
    Change the Kling bandage (rolled bandage) with Polysporin ointment (not cream) once per day for 7 days after showering and as needed during the second week. If the Kling bandage falls off on its own after the procedure, there is no need to worry; simply replace it. If the bandage is too tight and keeps you from urinating, you will have to undo it and then redo it less tightly.
    Avoid physical activity for 1 week.
    The month following the surgery
    It is highly recommended to continue to put a rolled bandage at night during the 2nd and 3rd weeks to avoid traction on the wound by nocturnal penile tumescence.

    Take 10-minute baths starting in the 2nd week to help dissolve the absorbable sutures.

    If surgical glue was applied to close the wound, the glue crust will fall on its own after about 10 days. It often falls completely without any consequences. Showers must be short to avoid excess moisture. Baths are only allowed when there is no more glue crust.

    Avoid sexual activity for at least 1 month.
    2 months after the surgery
    An appointment will be scheduled 2 months after surgery.

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    Would you like to make an appointment, or do you have any questions? Write to us and we will get back to you as soon as possible!

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