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Circumcision

Circumcision is a surgical procedure whereby the foreskin of the penis is surgically removed. Many men are circumcised. Some were circumcised for religious reasons and some were circumcised as it as a standard option given in the United States shortly after birth. Circumcision allows for; easier hygiene, a decreased risk of urinary tract infections, a decreased risk of sexually transmitted infections, the prevention of penile problems such as phimosis, and a decreased risk of penile cancer.

Many men may not be circumcised because it may not have been common in the local region or because of tradition or other reasons such as being born prematurely. For the latter, it is too risky to circumcise a newborn that is premature due to infection risks. Typically, a circumcision is done 8 days after childbirth because maximal clotting and healing capacity is reached.

Circumcision Diagram

Circumcision Diagram

If a patient 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 might migrate into the foreskin, and result in collagen formation and thus a thickened foreskin.

The thickened foreskin may cause an issue cosmetically or even medically not allowing the foreskin to freely retract back over or behind 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 as successful.

 

SUCCESSFUL CIRCUMCISED PATIENT

 

Images 15 and 16 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 a very large bump-out from under the skin. This was an implant surgically placed to increase vaginal (clitoral) stimulation. 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. Lastly, the plastic implant under the skin was removed.

 

Successful Uncircumcised Patient

 



1. Normal uncircumcised patient
2. Normal uncircumcised patient (with enlargement)

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 a patient decides to have a penile shaft girth enlargement without getting a circumcision first, the patient must be prepared, if needed, to have the circumcision done afterward. If the patient under no circumstances wants to be circumcised, then it would be too risky to have a penile shaft girth enlargement and the patient may possibly not be approved to move forward for this particular penile shaft enlargement procedure.

Being uncircumcised does not prevent a patient from having their glans and scrotal areas enlarged, these treatments do not interfere with the foreskin.

 

Circumcision Corrective Surgery

 

Some patients that have been circumcised may still need to be re-circumcised. The reasons for this are many. The primary reason for a circumcision revision or to be “re-circumcised” is to remove the excess foreskin that should have been removed with the original circumcision. The recommended range of remnant foreskin is ½” – ¾”, if the remnant is over this range, a proper pre-procedure evaluation is required to determine if a re-circumcision is recommended or not.

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 when it exceeds the ½” – ¾” range 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 above the recommended range, consider having a re-circumcision to remove the excess foreskin.

This will allow for a 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 a fairly simple procedure. . Most men think that it is very painful, and it need not be.

When patients apply a topical numbing cream, they will feel minimal to no discomfort during their recovery.

 

Circumcisions Performed at Loria Medical

 

A circumcision can be performed alongside a penile shaft enlargement procedure, which is called a “Circumcision + Shaft Supplemental Procedure” as one of our procedure options. The circumcision is performed and approximately 80% of the typical permanent dermal filler is used to enhance the girth of the penile shaft. This is the maximum amount that can be injected during this procedure because of the new circumcision incision line. Since the circumcision is done just under the glans, Loria Medical is unable to do a glans enlargement procedure during that visit.

Most patients will use this circumcision plan as a 2-visit combination and will opt for the circumcision plus shaft supplemental enhancement and after 30 days of healing, could return for a second visit getting a full shaft girth enhancement plus a glans enhancement procedure. This dual combination trip will get a patient a circumcision plus one shaft supplemental plus one full shaft enhancement and one glans enhancement in total.

If you opt to get a circumcision first before proceeding with a male enhancement procedure, Loria Medical recommends that you contact your local Urologist to have the circumcision performed, your insurance may cover the circumcision procedure.

When scheduling your circumcision please talk to your Urologist and tell him that you want just a very little amount of remnant foreskin, a range between ½” – ¾” 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, or you could also schedule directly with us wherever available, to have your circumcision performed by our trained physicians.

 

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 so it does not enlarge, 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.  There are three main outcomes

  1. The first one where everything heals nicely, and your penis keeps the same proportions with an enlarged girth.  Some minor complications related to inflammation could be seen during the recovery process, but the overall outcome is completely satisfactory.
  2. The foreskin thickens and could give a flaccid ‘top-heavy’ aspect to the shaft, something that usually evens out during erections. The foreskin will inevitably cover the glans during the flaccid state, but as the penis engorges during the erection this foreskin will redistribute.
  3. The foreskin thickens and won’t retract to expose the glans. Even during the erection, the foreskin and its opening won’t dilate enough in order to allow the glans to be exposed, this situation will undoubtedly lead to a circumcision.

The last two worst-case scenarios, although unlikely to happen, are worth mentioning, and patients must understand the risks if deciding to move forward with the procedure without being circumcised. A circumcision, which is a simple procedure, could be performed before, during, or after the penile shaft enhancement, but preferably prior to or along with the enhancement procedure. Once you have developed new collagen, not all physicians performing circumcisions might be familiarized with the enhancement procedure and how to perform the circumcision afterward.  You may want to schedule that circumcision at a Loria Medical location who are best able to handle this type of procedure.

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.

The remnant of the foreskin does not pose any major complication during or after the healing process of a standard circumcision.  In combination with a shaft enhancement, many patients find a new level of improved sensitivity as sexual activities tend to be more stimulating.

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 newly uncovered glans. This adaptation does not have to be uncomfortable or produce pain. A topical pain medication prescription is provided, and it will aid you during this transition phase.

Yes, you can. You can always have the enhancement procedure and then a circumcision afterward if needed. However, the recommendation is to have the circumcision prior to the procedure. There are several reasons for this. The first 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.

The 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.

No. The presence or absence of foreskin does 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.

Circumcised patients tend to have the glans rim flare out more than uncircumcised patients.

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 additional collagen on top.