Circumcision and Enhancement
Circumcision is a surgical process whereby the foreskin of the penis has been surgically removed. Many men get circumcised due to many reasons, but the main one is religious based. Most Jewish, Christians, and Muslims are circumcised for religious reasons. Some men are circumcised for traditional reasons.
Men who are not circumcised are not of the aforementioned religions, or have not been circumcised because of tradition or other reasons such as being born prematurely. It is too risky to circumcise a new born that is premature due to infection risk. Typically the circumcision is done 8 days after child birth because maximal clotting and healing capacity is reached during this time frame.
If one wishes to have a penile shaft girth enlargement, and he is not circumcised, it is highly recommended to have a circumcision prior to the male enhancement procedure. The reason why it is very important to first get circumcised is due to the fact that the filler that is inserted into the penile shaft may enter into the foreskin, and result in collagen formation and thus a thickened foreskin.
The thickened foreskin may cause a malfunction, not allowing the foreskin to freely flow over the glans.
The images below will show successful penile shaft enlargements with patients who were circumcised and uncircumcised, as well as uncircumcised patients who were not successful.
SUCCESSFUL CIRCUMCISED PATIENT
Image 15, 16 & 17 demonstrate a patient with the foreskin in its natural state, and also with it pulled back.
Then image 17 shows after the circumcision, with a very little foreskin remaining. Image 18 shows how close the circumcision line is to the glans.
This is desirable for penile shaft girth enlargement treatment.
Image 1a & 1b demonstrate an uncircumcised patient with and without the foreskin pulled back. You will notice something strange, a very large bump out from under the skin. This was a piece of plastic surgically placed to increase vaginal (clitoral) stimulation. I added these photos because they were more interesting, and these pieces of plastic were surgically implanted several years prior to coming to our clinic.
Image 2 will show many changes. In the first image the patient was circumcised. Secondly, the patient had a penile shaft girth enhancement, and lastly, the plastic pieces under the skin were removed.
Successful Uncircumcised Patient
Unsuccessful Uncircumcised Patients
Image 10 & 11 show the normal uncircumcised male with normal foreskin function.
Image 12 shows a penile shaft girth enhancement, but the problem is not evident.
Image 13 shows that the foreskin cannot slide over the glans because it has been thickened by the filler material (collagen develop there and thickened the foreskin preventing motion)
If one chooses to have a penile shaft girth enlargement without getting a circumcision first, the patient must be prepared, if needed, to have the circumcision done afterwards. If the patient never wants to be circumcised, then it would be too risky to have a penile shaft girth enlargement.
Those who are uncircumcised can have their glans and scrotal areas enlarged, these treatments do not interfere with the foreskin.
If one wishes to have the flaccid insert placed, for the purpose of acquiring maximal flaccid length, one must be circumcised, there is no option here. The insert will not be stable enough if the foreskin is present and may shift up into the foreskin resulting in a possible breach in the skin, thus necessitating removal.
Circumcision Corrective Surgery
Those patients that have been circumcised may still need to be re-circumcised.
The reasons for this are many. The primary reason to get re-circumcised is to remove the excess foreskin that should have been removed with the original circumcision.
Many surgeons are very conservative with their circumcision technique and leave a lot of foreskin. This is not favorable for having a penile shaft girth enlargement.
This extra foreskin has an increased risk of swelling and ultimately becoming ‘bulgy’ or proportionately larger than the penile shaft below it. It is recommended that those who have had a circumcision but still have a large amount of foreskin, remaining consider having a re-circumcision to remove the excess foreskin.
This will allow for a much more pleasing cosmetic result and appearance.
The image below demonstrates when a patient has excess foreskin and how it can expand after a penile shaft girth treatment.
Adult circumcision is common and not complicated. Most men think that it is very painful, and it need not be.
When patients are provided with lidocaine cream, which is placed on twice daily, they feel minimal to no discomfort at all.
Dr Loria recommends that you contact your local Urologist to have the circumcision performed, your insurance should cover the procedure in full.
When scheduling your circumcision please tell the Urologist you want a very little amount of the foreskin (1/2 inch) to remain under the glans (head of the penis).
If you are not covered under insurance, the Urologist will provide a cost for the circumcision, which should be reasonable.
Circumcision Questions and Answers
During the enlargement procedure in uncircumcised patients the placement of the filler is done in a way that the foreskin doesn’t get involved to prevent the enlargement, however, 60-70% of the patients with this condition could present some complications related to the evolution of the post-procedure care protocol varying in the intensity or degree of presentation, and three main outcomes, the first one where everything heals nicely and your penis keeps the same proportions with an enlarged girth. The other scenarios, although unlikely, are…
- Thickened foreskin that could give a flaccid ‘top-heavy’ aspect to the shaft, something that usually evens out during erections. Or…
- Thickened foreskin that won’t allow to be retracted and expose the glans.
These two worst-case scenarios although unlikely to happen, are worth mentioning, and patients must understand the risk if deciding to move forward with the procedure without being circumcised. A circumcision, which is a simple procedure, could be performed before or after the PLATINUM enhancement, but preferably prior to it. Once you have built the collagen, not all physicians performing circumcisions might be familiarized with the enhancement procedure and how to perform the circumcision afterwards
If I prevent the foreskin from developing with collagen, will there be a gap under the glans when the skin is pulled back?
If you fall into the percentage of patients that do not develop a thickened foreskin, when erect, as the foreskin is pulled back it stretches and flattens to match the rest of the shaft, with a seemingly nice transition. During the erection, the intact foreskin just stretches and does not interfere.
Loosing sensitivity in the foreskin is irrelevant since it will be removed. The remnant of the foreskin does not pose any major complication during or after the healing process.
Will my Glans lose sensitivity being uncovered all the time, will it cause irritation being uncovered for the first time?
No. This is a great myth surrounding the circumcision in the adult. The glans will go under an acclimatization phase for a couple of days, and then everything will take its course and you will be comfortable with the new uncovered glans. This adaptation does not have to be uncomfortable or produce pain. A topical pain medication prescription is provided.
Yes, you can. You can always have the enhancement procedure and then a circumcision afterwards if needed. However, the recommendation is to have the circumcision prior to the procedure. several reason behind this reasoning, the first one is to prevent any possible ‘complication’ that affects up to 60-70% of uncircumcised patients to a variable degree, ranging from minor cuts and extra swelling that heal nicely, to the two worst case scenarios that will eventually require a circumcision.
That is a possibility. One of the possible outcomes while being uncircumcised is to have a thickened foreskin that could prevent exposing the glans. This difficulty retracting the glans could be partial or total, in both cases we recommend a circumcision.
If the foreskin becomes so thick that you are unable to retract it and expose the glans, you could potentially have issues with the erection. It could either be painful, restrict the maximum length of the erection, or cause tears and/or scarring on the foreskin if it is traumatized during intercourse.
My penile skin slides with the foreskin when I am with my partner, removing this may cause the shaft+skin to slide as one, how will this affect sexual sensation?
General sensation of the shaft during intercourse should not be impaired or affected in a negative way. Keep also in mind that during a circumcision we only remove/trim the excess of skin, nothing more, there should always be laxity after a circumcision. In addition, remember that once the enhancement procedure has been performed, you will be enjoying the benefits of the extra girth, which will enhance the pleasure for both you and your partner.
As a rule, we would always recommend a circumcision beforehand due to all the reasons previously exposed. It is extremely rare for a foreskin to be short enough not to require the advice of a circumcision. However, if you choose to move forward with a shaft enhancement procedure, the least amount of foreskin the better.
The post-procedure care protocol will not vary in general; the main difference might be the recovery which could be prolonged whilst the cuts or skin sores in the foreskin heal, usually quite nicely. Other possible changes might require a modification of the wrap among others. The protocol is then tailored to your own needs and progress, which is why the communication with the staff is crucial, to prevent and address any inconvenience as they emerge. There is no measure that you could take to improve the result in this case other than relying on the staff to guide you during this process.
As previously explained, having a circumcision prior to the procedure drastically improves the outcome and the post-procedure care protocol, which is a lot smoother. Having the circumcision done after the enhancement procedure has been performed offers additional perk other than cosmetic correction of imbalances or thickened foreskin related issues.
Will the shape of my glans change (circumcised PTs tend to have a the Glans rim flare out more than non-circumcised PTs)
No. The presence or absence of foreskin des not influence the shaping of the coronal rim of the glans. If any changes are visible is just an optical illusion. The glans itself on the other hand will be more prominent as it will be exposed, but it won’t modify its actual anatomy.
There is always a noticeable difference in girth, whether it is with a 50%, 80% or 100% treatment. Having a circumcision plus a supplemental procedure (80% fill) gives you the head start in the enhancement journey, you will heal from the circumcision while you are already converting the filler into collagen, making the best time management possible. As far as results go, you will be close to the full procedure, and by the time you come for the next procedure you will already have a foundation to build collagen on top.