Dear Reed, Need a circumcision revision, doesn’t looks right. Reasons loose skin all aorund, waddle underneath, and time to remove the frenulum. Age 27.
Reviewed your photos. You are a young man and that is a plus. Your penile skin looks very healthy, the hygiene is good, and zero evidence of inflammation. You have a slight tendency for scrotal folds to rise alongside the penile shaft, and this is a normal variant but could be exaggerated if the circumcision is made too tight. I would favor leaving the pigmented shaft skin where it is, especially on the top side. The inner skin needs to be lifted (undermined) and unfurrowed, so there won’t be a wrinkling tendency. Rsedundant inner skin has to be excised. The frenulum (doing its job) is retracting especially the underneath skin over the glans. Yes, would remove that and if there is still more additional ventral or underside skin, I would remove that with a V-dart, otherwise you’ll critique the result once again and notice a waddle and wonder why the doctor didn’t attend to that.
In our operating room, we have a hand held mirror on a table within easy access of the patient so he can follow what we are doing and be sure, everything is proceeding as discussed. This for me is more than a circumcision, it’s cosmetic surgery.
The first 2 photos are 17 days post-op and the third and forth are a mature result. Note the ultra fine sutures to reconstitute the skin longitudinally along side where the removal had been, and work extends somewhat onto the underside of the glans. Bye-bye waddle, bye-bye frenulum, bye-bye loose cut.
Harold M. Reed, M.D. FICS
Senior Member of the American Urological Association
Member Society of Genito-Urinary Reconstructive Surgeons
Founding Member and Treasurer of American Academy of Phalloplasty Surgeons
Founding Member Sexual Society of North America
International Society for Sexual Medicine