A circumcision is perhaps the highest cosmetic calling given to a urologist
After seeing so many circumcised men who look very much like they were done later in life, because of large suture tracts, and irregularly meeting skin, I developed perhaps a unique approach to be sure this did not happen to my patients, and have found no need to vary over the past 15 years.
Firstly, I confer with the patient to find out exactly what type of result he is looking for, tight or loose, no unpigmented skin or some left, removal of the frenulum or preservation of the frenulum, etc. Secondly, only fine plastic surgery suture is used to create perfect alignment. It is possible to operate within tolerances of 1/32″ or about 1/2 mm.
Pain is virtually non-existent among our patients. They smile as they leave the office, and by and large remain free of discomfort as evidenced by our followup contact with them. This is attributable to a multi-layered penile wrap which patients are encouraged to wear for 5 to 6 days, unless there is a definite indiction to remove earlier.
While bruising is minimized, some spotting is to be expected and usually stops the day following the procedure.
The complications we have seen among patients who present for revisions are overzealous (tight) circumcisions to the point full erections are not possible, overly loose circumcisions with skin draping over the head of the penis, irregular and mismatched suture lines with rotation of the skin, skin tags, skin bridges, buried suture remnants. Another problem has been loss of sensation, especially which occurs with unnecessarily deep incisions. This is completely avoidable.
While severe infections are generic to any incision we have not seen this in 35 years of my practice.