Why Do Puckers Occur After Circumcision?

Dr. Reed, had a circumcision about 3 weeks ago and have puckers, sent you a photo?  What could cause this and will this go away?  Juan

Dear Juan,

Saw your photo and what I am seeing is appreciable swelling, and an edematous frenulum.  Although the sutures are out, they were widely placed apart and there is still a fair amount of swelling.  To answer your question, a 2 layered closure helps to re-establish the lymphatics, and more closely placed sutures with more even but not tight provides for a more uniform appearance. The puckers bare where swollen (edematous)_ tissue has a chance to “breath”  When and where sutures are applied too tightly of course that limited area is not going to swell.  The length of some of the suture tracts is unnecessarily long and one area is Z like in appearance.  My recommendation is to take warm tub baths with a 1/2 cup of table salt for 15 minutes twice a day, shower before leaving the tub, and try to max out on any possible reduction in swelling.  I would wait a good 4 months before having a revision done, as operating in an area of recent surgery is not conducive to good wound healing.  More like adding  “insult to injury.”

Please stay in contact with us and we look forward to taking care of you.

With kindest regards,

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

305-865-2000

Our practice and specialization is listed by the Urology Care Foundation ( American Urological Association)   http://www.urologyhealth.org/find-a-urologist

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