Adult Circumcision

Offered at our convenient location in San Diego

While most circumcisions are performed shortly after birth, circumcision can be performed in adulthood with the same results.

There are many reasons for circumcision. Some men want to feel more comfortable around their peers, or they simply prefer the appearance of a circumcision. Other men already have a circumcision, but are not satisfied with it — we can revise a circumcision that is not aesthetically-pleasing.

Have questions? Dr. Bidair has answers. Contact our office to learn more about Adult Circumcision today.

Contents

1 About Adult Circumcision
2 Before and After Photos
3 Cosmetic Proximal Circumcision
4 Benefits of Circumcision
5 Circumcision Surgery: What to Expect
6 Recovery
7 Result
8 FAQ

About Adult Circumcision

The idea of circumcision is to remove the redundant skin covering the head of the penis.

The results vary depending on where the incision is made and how much skin is removed. When the incision is close to the head of the penis it is considered a “low cut.” Alternatively, when the incision is made farther away from the head it is considered a “high cut.” The other variation is the looseness of the penile skin. Some men prefer a tighter look when the penis is soft while others prefer a looser look. While most of my patients’ preferred style can be achieved there are some anatomic restrictions. The final decision depends on the specific anatomy of each individual. The specifics are discussed in detail during the consultation. (See our Before & After Gallery)

View More Photos

Cosmetic Proximal Circumcision

This is a more involved surgery. It is for men who want to preserve the entire inner skin of the foreskin. The incision is made at the junction between the penis and the body. The healing from this technique is prolonged due to expected postoperative swelling that lasts longer than the more traditional technique.

It is also unlikely to achieve a tight postoperative look when soft after this technique. (See our Before & After Gallery)

Benefits of Circumcision

Cosmetic:	Circumcision is common in American society and some men want the same aesthetic appearance as others. We also commonly see men who want to revise the appearance of their circumcision.
Hygiene:	A circumcised penis is easier to keep clean for some men, thus preventing diseases such as balanitis.
Phimosis:	A condition that happens when the foreskin cannot be easily pulled back over the head of the penis. Men with this condition frequently experience pain during sexual intercourse or masturbation.
Paraphimosis:	Somewhat the opposite of phimosis, this is a condition where the foreskin becomes trapped after being pulled back and then swells behind the head of the penis.
Balanitis & Balanoposthitis:	Inflammation of the penis head and foreskin caused by the lack of aeration and the accumulation of smegma under the foreskin.
Cancer	Men with a circumcision have a much lesser risk of penile cancer. Circumcision at infancy completely prevents penile cancer. Studies have also shown that cervical cancer for females is significantly reduced when their male partner is circumcised. More recent studies have also shown a reduction in prostate cancer incidence in circumcised men.
HIV and Other STD’s	Circumcised men have 50% lower incidence of HIV than uncircumcised men. Men with a circumcision are 10 times less likely to contract HIV from a female partner.The incidences of most other STDs are lower for men with a circumcised penis.

Circumcision Surgery: What to Expect

Dr. Bidair uses plastic surgery techniques to achieve the best-possible outcome. Each procedure takes approximately 1-1/2 hours, more than twice the time spent by most urologists. His precision and surgical techniques aim to achieve an aesthetically-pleasing result: a smooth, straight line with minimal scarring or suture tracks.

More importantly, Dr. Bidair understands that circumcision is an individual choice and that every man is different. You will have plenty of time to consult with Dr. Bidair and talk through your needs, desires and wishes.

If you have concerns at any time, we are here to help. We pride ourselves in excellent pre-operative and post-operative care, even if you are coming in from out of town. We make every effort to communicate promptly and clearly.

Most of all, we want you to be satisfied with the results of your procedure.

Recovery

Sedentary activity, including travel, is possible immediately following the procedure. After one week, moderate activity is allowed. Sexual activity may resume after approximately two to four weeks.

The bandage should not be changed or removed early in the healing process.

The bandage is of a lightweight style that will not affect your appearance or ability to walk. The bandage must be kept dry and a plastic cover must be worn when bathing. We recommend that you wear briefs instead of boxers to provide appropriate support during recovery.

You will be given specific instructions for care and length of time that the bandage must be left in place. Since your circumcision will be sutured with dissolvable sutures, it will not be necessary to have them removed by a doctor.

When the bandage is first removed, the wound will definitely not look like your final result. Don’t be discouraged! This is normal and it will have a good, healthy appearance within one to three months.

Result

FAQ

Will it change the size of my penis?

No, there should be no change in the size of the flaccid or erect penis after the procedure. We make sure there is enough skin to stretch to cover the penis when erect.

How will it affect my sensitivity?

None of Dr. Bidair’s patients have reported a change in sexual sensitivity after the procedure. There are websites that report an increase or decrease in sensitivity in the head of the penis, but again, he has not heard this feedback.

Will it affect my urination?

There should be no changes in your urination after healing. However, during healing there may be some spraying from the bandage. If the procedure is performed for balanitis or phimosis, your urination will improve a great deal.

Can guys get circumcised at any age?

Yes. There is no minimum or maximum age for the procedure. Most of my patients fall between the teenage years to about 60 years old. However, I have performed cosmetic circumcisions on many patients in their late 60s and 70s as well.

How is the newborn circumcision done?

The procedure for newborn circumcision is relatively simple. A small circular clamp device is used to collect and remove the redundant skin foreskin in one movement. The clamp stops the bleeding vessels and bonds the edges of the skin together. The bonding of the skin edges eliminates the need for sutures. Newborns have a lower blood pressure than adults so there is no need for suturing.

How is the adult circumcision done?

The penis is numbed with an injection at the base with a mixture of two medications. The first is a quick acting agent called Lidocaine and the second is a long lasting agent called Marcaine. Patients usually feel only the first needle prick and no discomfort after that.

If you are afraid of needles or tend to become faint at the sight of needles, a relaxing agent like Valium can be used. Or, Dr. Bidair can arrange to have your procedure done under general anesthesia (i.e. you will be put to sleep). Please specifically request general anesthesia at the time you make your appointment.

Before making an incision, Dr. Bidair marks the inner and outer layers of the foreskin. Incisions are done with a scalpel to ensure a precise and clean result.

The skin is closed with dissolvable, high-quality sutures, the same as those used in plastic surgery. Sutures are required because adults get strong erections during the sleep cycle, and the sutures hold the skin in place.

Is circumcision surgery painful?

The penis is completely numb during the procedure. You will not feel any pain. You will be given pain medications after the procedure to take in case there is pain. Some patients do not take any pain medications post operatively but I recommend using some pain medications for the first few days as needed. It is rare that patients require pain medications after a few days from surgery.

How long does the procedure take?

Most Urologists who do not perform the procedure for aesthetic purposes complete the procedure in about 20 minutes. However, Dr. Bidair takes about 1.5 hours per procedure. The extra time is used for accurate symmetric measurements, for using small sutures that are more time consuming to use but yield better results, and for employing plastic surgery techniques to minimize scar formation and suture tracks.

Who will be in the procedure room when I am getting the procedure?

Dr. Bidair and his assistant will be in the room.

How long is the recovery time?

You will be able to walk and travel immediately following the procedure with minor discomfort. For the first week we recommend keeping your activity to moderate levels, including limiting the amount of exercise you do. Sexual activity can usually resume after two to four weeks.

Will I walk normally right after the procedure?

Yes. You will walk perfectly normally after the procedure.

Can I get on a plane right after the procedure?

Yes. Most of our patients are from out of town. They fly in the morning of the procedure and leave the same evening.

Can I drive for a few hours after the procedure?

Yes. The numbing medicine keeps the penis numb for about 4 hours after the procedure. You are not allowed to take any pain medicine while you are driving. If you plan on driving more than 4 hours after the procedure, we recommend spending the night in San Diego or somewhere within the 4 hour driving radius.

What happens if I get an erection while I’m still healing?

For the first few days after surgery you will likely feel some degree of discomfort or minor pain when you have an erection. This is normal and there should be no bleeding because of it. You will be given pain medications after the procedure to make you more comfortable. Dr. Bidair recommends taking the medicine before going to bed in case you have an erection while you sleep.

Is a pre-exam required?

No pre-exam is required, but we do require a consultation before the procedure. The consultation can be combined with your circumcision appointment and takes about 30 minutes.

Can any urologist perform a circumcision?

Yes, but while all urologists are trained to perform circumcisions, most do not conduct the procedure with cosmetic results in mind. Dr. Bidair uses plastic surgery techniques to ensure the end result is clean and healthy looking. And he takes great care to understand your needs so you are satisfied with the outcome.

Am I awake during the procedure?

Most patients choose to use a local anesthesia and are awake during the procedure. However, general anesthesia is available if you wish to be completely unconscious.

Is there an age limit?

No. Circumcision can be done at any age, from birth to the very old. For those under 18, we require a guardian’s consent.

Will the bandage be visible?

No. The bandage is lightweight and will not be apparent under your pants. Nor will it affect your walking. We recommend that you wear briefs to keep the dressing well supported.

I’m traveling from out of town. Do I need to stay overnight?

No, you don’t need to stay overnight and can fly or drive back home the same day.

What is a “high and tight”?

“High and tight” refers to how the circumcision looks. “High” means the circumcision line is closer to the body. “Tight” means the skin is not loose even when the penis is soft. “High and tight” is the most common look and is desired by most patients. See also: images of new circumcisions.

Can you perform a frenulectomy?

Yes. A frenulectomy is the removal of the frenulum. The frenulum is the ridge of skin that connects the foreskin to the area close to the urethral opening. Some men prefer to have this ridge of skin removed along with their circumcision. Dr. Bidair can discuss this option with you.