Being a Plastic Surgery rather than a Urology based service,we are perhaps better attuned and more sympathetic towards such considerations.
Circumcision is perhaps the commonest of all surgical procedures, and it is usually regarded as an ‘all or nothing’ procedure.
However, this does not always have to be the case.
Circumcision is often performed by relatively inexperienced surgeons, who may be over-radical in the amount of skin removed, or remove the skin in an untidy fashion leaving behind disfiguring skin irregularities and suture marks.
Although we a specialist Genito-Urethral Reconstruction Centre, we also undertake basic procedures such as standard circumcision, conservative foreskin shortening and frenuloplasty, and can discuss the options of how much skin should be removed to achieve the desired outcome and thereby hopefully create a more refined result.
For those who have already had circumcisions elsewhere, and achieved an unsatisfactory outcome, it may be possible to correct skin asymmetries and tidy up irregular or ugly scars so as to improve the cosmetic result.
Skin Lesions and scars.
Various birthmarks, acquired scars and skin lesions, or unduly prominent veins may be cosmetically unattractive to the patient and can often be removed or modified to improve the aesthetic appearance. Peno-scrotal webbing.
Sometimes the scrotum attaches to the underside of the penis further forward than is normal, producing a ‘turkey neck’ webbed appearance, particularly on erection. This abnormal webbed appearance can be corrected surgically.
Occasionally a testicle has been removed for problems such as torsion or cancer, and the resulting appearance is socially distressing for the patient. In such cases where a more natural appearance is desired, a silicone prosthesis can be inserted into the scrotum to mimic the appearance of a testicle.
Genital size concerns.
Genital based body image disorders are very common amongst men, and in most cases, perceived size concerns are unfounded and the actual dimensions fall well within the range of ‘normality’.
Where anatomical misperceptions remain stubbornly removed from reality, this is often referred to as Body Dysmorphic Disorder.
Such patients’ expectations are usually quite unrealistic and surgically unachievable, and therefore often better addressed by professional psychological counselling.
Surgical penis length and girth enhancement procedures carry significant risks and complication rates, are not all that effective in how much can be gained, they can leave
noticeable scars and contour irregularities, and so alas are generally not appropriate for relatively normal individuals just seeking ‘a bit extra’.
Better, in most such men, to go down the route of using mechanical penis traction devices +/- body image counselling.
Nevertheless, judicious use of penis lengthening or penis reduction operations can occasionally have a useful role, though really only in very carefully selected circumstances e.g. lengthening after partial amputation due to trauma or cancer surgery, or in conjunction with management of some birth abnormalities.