All bleeding is stopped with the use of electrocautery. The procedure is completed with suture closure of the incision with interrupted, fine, absorbable sutures. The needled utilized for skin suturing is an atraumatic cosmetic surgery one. Additional incision closure is with paper wound closure tapes to further reduce tension on the sutures and more accurately reapproximate the edges. Finally a sterile compression dressing is placed. All these steps are done with the intent of optimizing rapid healing of tissues and minimizing suture marks and tunnels. It is recommended that the dressing be left until the fifteenth day following the procedure.

Procedure FAQ's

Q: For what reasons do you perform circumcisions?

Ans: The most common reasons for which I perform circumcisions are:

Q: I wish to have a circumcision performed. What are the out-of-pocket costs?

Ans: Fees will vary from patient to patient depending on the degree of complexity, however a good approximation iRss.10000, which is payable by cash and major credit cards (Visa, Mastercard, American Express). Please contact our linice so that we can assist you with your specific questions.

Q: Is a consultation visit necessary prior to deciding on circumcision? What is the cost?

Ans: Yes, it is important to have a consultation visit. The consultation is included and the time required is approximately 30 minutes. Both the consultation and procedure may be performed during the same clinic visit, requiring an overall time of one and a half hours.

Q: What is the recovery time for adults after circumcision?

Ans: I suggest a week of moderate activity following circumcision. Sedentary activity and travel is possible the same day.

Q: What technique do you use for adult circumcision?

Ans: I use the free hand or sleeve resection technique most commonly. The incision lines are marked on the inner (mucosal) and outer layers of the foreskin where the patient wishes. Incisions are done with a scalpel rather than scissors as it gives a more precise incision. Skin closure is with absorbable sutures of the quality used for cosmetic surgical procedures.

Q: Can you perform revisions to improve the cosmetic appearance or tightness of an earlier circumcision?

Ans: Yes

Q: Do you have an age limitation for circumcision?

Ans: No, in fact, I have performed circumcision for men over eighty years of age. The more important factor is the state of their general health to allow for minor surgery.

Q: Do you routinely remove the frenulum in adult circumcision?

Ans: I recommend removal unless the patient desires retaining the frenulum.

Q: Do you perform circumcision for cosmetic reasons?

Ans: I respect the aesthetic wishes of my patients and will gladly perform circumcisions for purely cosmetic reasons.

Q: What is the postoperative care of adult circumcisions?

Ans: Your circumcision will be sutured with absorbable (dissolvable) sutures. There will be a compressive bandage on the penis. The dressing should be left on for fifteen days, after which time it can be removed in the bathtub. The compression dressing should not be changed or removed early. A cosmetic covering should be used during bathing. Sexual activity may be resumed after approximately three weeks.

Q: Do you do frenulectomy (removal of frenulum)?

Ans: Yes, I do this if the patient desires it, either at the time of circumcision or as a separate procedure.

Q: How is the local anesthetic done? What medication do you use?

Ans: The injection is done at the base of the penis utilizing a
combination of a short acting product (Lidocaine) and a long lasting agent (Marcaine). The patient usually only feels one needle stick and after that, no discomfort.

Q: What do you do differently from other physicians doing adult circumcision?

Ans: I treat circumcisions as cosmetic procedures. I always want to incorporate any specific cosmetic concerns each patient presents to me. I make measurements in the attempt to remove enough skin so that no skin rolls over the corona of the glans and that the incision is symmetrical. I close the wound with very fine sutures which are generally used in facial cosmetic surgery. These measures are to make the outcome look very tidy and as free of suture marks as possible. technique has now over 100 cases with no wound complications.

Q: What is the most common reason for which you perform adult circumcisions?

Ans: Almost all the procedures I perform is for cosmetic/social reasons. From discussions with hundreds of men, I have learned that many men experience reduction of self esteem due to being the "odd man out" in this circumcised American culture. Men seem to appreciate my practice as a discrete and non-threatening solution to getting that mainstream look.