Low and Loose Circumcision

A low and loose circumcision removes a minimal amount of foreskin and leaves the remaining skin with a relaxed tension. For adult men that are considering circumcision, there are several important factors to consider when deciding how to continue life with this definitive organ. Adult circumcision allows men to take control of their manhood, and craft an aesthetic that suits their lifestyle and identity while honoring religious and health considerations. You have the final say as to how you look and feel. And, Dr. Mohamed Bidair can help you get there. To plan your approach and learn more about the options available to you, schedule a consultation at California Adult Circumcision in La Mesa. We proudly serve the needs of men in the San Diego area and beyond.  Call (619) 486-5005 to get started on the rest of your journey as a man. 

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What Is Low and Loose Circumcision?

When you elect to undergo circumcision as an adult, and choose a skilled specialist like Dr. Bidair, your results will be tailored to suit your desires. Circumcisions can be specially performed to leave the remaining foreskin in such a way that satisfies its owner. 

About the Prepuce

The foreskin, or prepuce, has an inner and outer layer of skin that becomes exposed when retracted, or when the penis is erect. When a circumcision is performed, incisions are made in the inner and outer layers, and the remaining skin of the layers is stitched together. Depending on the amount of skin removed from each layer, the surgeon can control the length of the remaining foreskin, and its tension.  

Low and loose circumcision is a description of how the foreskin is altered during the circumcision. During a low and loose circumcision, a minimal amount of foreskin is removed and the remaining foreskin is close to the glans, or head of the penis.  

Styles of Circumcision

A circumcision repositions and reduces the foreskin in a strategic manner: it isn’t just a simple “cut.” Dr. Bidair must consider the final outcome when choosing where and how to perform the circumcision. The length of the shaft and the quality of the existing foreskin will determine how Dr. Bidair approaches the procedure to produce the patient’s desired results. This is a highly customizable procedure, and every man is different. 

In most cases, circumcision can be performed in four ways:

These descriptions refer to how the foreskin will sit along the shaft of the penis after the circumcision surgery is complete. Whether circumcision is “high” or “low” refers to where the scar is oriented on the shaft of the penis. A low circumcision leaves more foreskin so that the circumcision scar is close to the head, or glans. High circumcisions reveal more of the shaft and have a scar line that is closer to the body. 

Depending on how much of the inner and outer foreskin is removed, Dr. Bidair can typically control the tension of the foreskin. For example, to achieve a high and tight circumcision, the foreskin is completely retracted so that the interior wall is exposed. The exterior wall of the foreskin is removed so that the inner layer of the foreskin is exposed, and the scar line from the sutured layers is high and tight on the shaft. 

This is dramatically different from the appearance and sensation of an uncircumcised penis. For men who want to pursue a circumcision but still want to feel like themselves, a low and loose circumcision offers a more subtle change. 

With a low and loose circumcision, a small amount of both the inner and outer foreskin is removed without any tension applied to the shaft skin. The glans is exposed, but the sensitive sulcus, or area below the coronal ridge is still covered by the remaining foreskin. The penis can hang in a natural, relaxed position when flacid, and the leftover foreskin can still be mobilized when erect. ⁽¹⁾

Benefits of Circumcision

Apart from the religious or social motivations to undergo a circumcision, there are many health benefits to choosing circumcision as an adult: 

The main benefit of adult circumcision is how it allows men to take control of their appearance and maximize sexual potential. For men that enjoy the sensation of a mobile foreskin during sexual activity, a low and loose circumcision allows them to continue to relish this sensitive aspect of the organ, while revealing the glans. This is also an appearance that many sexual partners have reported to prefer. By consulting with Dr. Bidair, you can achieve a more optimal look and feel for your penis. ⁽²⁾

Low and Loose Circumcision Benefits

To learn more about the benefits of a low and loose circumcision, contact Dr. Bidair. If you are outside the San Diego area, the doctor also offers virtual consultations. 

Personal Consultation in La Mesa

There are many aspects of our bodies that we can control, and circumcision is an example of one of the ways that medical science has allowed men to improve their health. 

However, like all medical procedures, it’s your unique anatomy that will determine the kinds of procedures that will be viable. During your personal consultation with Dr. Bidair, you can expect a discreet and honest approach, and the opportunity to speak frankly, man-to-man. Dr. Bidair will perform an examination, review your medical history, and inquire about your lifestyle to determine which mode of circumcision would best serve you. 

If a low and loose foreskin contour will address your concerns and benefit your anatomy, Dr. Bidair will be able to advise the next steps to prepare for this procedure. If another circumcision style would better suit your anatomy, he will recommend it. 

Procedure

The staff at California Adult Circumcision will provide you with detailed instructions to prepare you for your low and loose circumcision. Your anatomy will dictate the specific ways to prepare for this surgery. Please follow them closely to ensure the best results.

To accomplish a subtle, relaxed, low, and loose circumcision style, Dr. Bidair must consider all aspects of the patient’s foreskin. The relationship between the prepuce (foreskin) and the glans (penile head) will determine Dr. Bidair’s approach.

Sleeve Method

For men with a naturally loose prepuce, a sleeve technique is often the best approach. 

Dr. Bidair will incise around the circumference of the foreskin, and close the incision with dissolvable sutures. The shortened exterior skin of the foreskin is attached to the reduced length of the interior skin at the specified location. This technique is similar to the way a tailor would hem a garment, hence the name.

Dorsal Slit Technique

For men that have a tight foreskin, or suffer from paraphimosis Dr. Bidair may need to perform the dorsal slit method of circumcision. He will begin by anesthetizing the patient to ensure their comfort. Next, Dr. Bidair will make an incision down the foreskin parallel to the penis. Once he has opened up the foreskin, and freed the glans, he can retract the foreskin to the discussed distance, and make the necessary incisions to remove the excess skin. The foreskin is then sutured in place. For a low and loose circumcision, this will be just above the sulcus, keeping enough foreskin intact for a loose fit. ⁽³⁾

Proximal Circumcision

For those with naturally loose skin who intend to keep a relaxed tension and avoid removing most of the foreskin, a proximal circumcision may be appropriate. A proximal circumcision preserves the majority of the foreskin by only removing a band of skin near the base of the penis. The foreskin is then retracted to the desired location, and sutured in place. 

To achieve a low and loose effect, Dr. Bidair will opt for the technique that best suits your anatomy and desires. The details of your circumcision are ultimately up to you, and Dr. Bidair will explain the best method for your circumcision during your personal consultation. To learn more about the benefits of circumcision, and more about what to expect, follow Dr. Bidair’s blog. 

Recovery

Depending on whether you’ve chosen general or local anesthesia, you’ll spend some time being monitored until it’s determined that you are able to return home. Please arrange for transportation, as you will not be able to drive immediately after your procedure. Most patients find that discomfort can be managed with over-the-counter pain medication and can return to desk jobs after a day or two. For the first week or two of your recovery, you’ll need to avoid strenuous activities. You will also need to abstain from sexual intercourse for at least 2-4 weeks. 

References

1. Morris, B. J. & Eley, C. (2011). Male circumcision: An appraisal of current instrumentation. Biomedical Engineering, University of Rijeka, Rijeka, 315-354. DOI: 10.5772/18543 
2. Morris BJ, Moreton S, Krieger JN. Critical evaluation of arguments opposing male circumcision: A systematic review. Journal of Evidence-Based Medicine. 2019;12(4):263-290. doi:10.1111/jebm.12361
3. Abdulwahab-Ahmed A, Mungadi IA. Techniques of male circumcision. J Surg Tech Case Rep. 2013;5(1):1-7. doi:10.4103/2006-8808.118588