Circumcision is a surgery that should match a patient’s aesthetic and functional requirements. Many circumcisions take place in infancy. In fact, according to the CDC’s National Center for Health Statistics around 60% of all male newborns are circumcised. (1) If circumcision takes place later in life, the decision to do so comes with some unique choices. And, if that patient is unsure what their options are, their urologist should explain the choices they have in a detailed, but understandable, way.
There are four widely used adult circumcision techniques; high and tight, high and loose, low and tight, and low and loose. But what do these terms mean? How do they differ from one another? And which of these circumcision techniques is the right option for you?
As a circumcision specialist with a medical career spanning three decades, Dr. Mo Bidair is at the forefront of adult circumcision in Southern California. Serving Southern California, Dr. Bidair provides his expert advice and uses it to determine the circumcision technique that best suits each of his patients. Speak to him about your adult circumcision by booking a personal consultation with him at Alvarado La Mesa Urology Center. Call (619) 486-5005 or contact us online to schedule your appointment.
- 1 Before and After Photos
- 2 Reasons for Adult Circumcision
- 3 Pros & Cons
- 4 Expert Consultation
- 5 Infant Circumcision vs. Adult Circumcision
- 6 What Do the Terms Mean?
- 7 Circumcision Options
- 8 How Do I Decide?
- 9 Cost of Circumcision in San Diego, CA
- 10 FAQ
- 11 References
Before and After Photos
Reasons for Adult Circumcision
Although infant circumcision is very common in the United States, some men are circumcised in adulthood. There are both medical and cosmetic reasons for doing so.
Circumcision for Medical Reasons
Medical conditions of the foreskin (prepuce) and head of the penis (glans) include the following.
These conditions cause physical changes that may cause discomfort, hygiene issues, difficulty urinating, and sexual dysfunction, and are all medical indications for adult circumcision. (1) Some men may choose circumcision as a preventive measure to limit the risk of sexually transmitted diseases like human papillomavirus (HPV) and genital herpes.(2)
Circumcision for Cosmetic Reasons
Cosmetic circumcision is all down to aesthetic preferences. Treatment is based on a patient’s ideal vision of the shape and appearance of their penis, and a surgeon’s ability to reach those goals. And with the considerable experience and artistic talent of Dr. Bidair, you can be assured that your procedure will be performed to the highest surgical standards.
Pros & Cons
Circumcision is a uniquely personal surgery. Every patient should consider the benefits and drawbacks of circumcision very carefully, and receive guidance from a medical professional, even in the earliest stages of planning. If you are uncircumcised, you should have a clear understanding of what the procedure will entail, and discuss your aesthetic preferences with Dr. Bidair. Similarly, if you require a revision circumcision to correct a poorly performed procedure, you should be informed about the benefits and limitations of reconstructive surgery.
Dr. Bidair has helped thousands of men over his 30-year career, using an individualized approach, and making the process as convenient and straightforward as possible. That’s why he offers both in-office and phone consultations.
Consultation is a collaborative effort between doctor and patient. And one of the most important discussions you will have with Dr. Bidair is choosing the type of circumcision that suits you best. There are benefits and drawbacks to each technique that may vary from patient to patient. While you are under his care you will work with Dr. Bidair, to discuss how you can expect each style to affect appearance and sensation, and move forward from there.
Your professionally-informed choice will depend on specific factors. The following factors may affect the kind of circumcision you can receive
- Individual anatomical features
- Medical conditions
- Reconstruction following a prior surgery
With Dr. Bidair’s guidance, you can find the perfect fit to achieve your desired results!
Infant Circumcision vs. Adult Circumcision
There are different surgical approaches to circumcision. Infant circumcision is performed using one of a wide variety of small devices which remain in position until separation occurs. These include the Mogen clamp, the Gomo clamp, and the Plastibell. (3) But adult circumcision is different.
Although there are WHO-approved adult circumcision devices available, many doctors prefer to use surgical tools for greater precision and control of aesthetic outcomes.
What Do the Terms Mean?
Descriptive terms for each circumcision type directly correspond to the amount of tissue removed and where the resulting scar tissue forms.
- A “tight” circumcision removes more foreskin tissue, while a “loose” procedure removes less.
- “High” circumcision styles leave a small scar closer to the midsection of the shaft, while the small scar in “low” options is closer to the glans.
Dr. Bidair offers the following adult circumcision options at his San Diego location.
High and Tight
The High and Tight is the “closest fit”, so to speak. After a High and Tight circumcision, the glans is exposed completely. When the penis is flaccid, A subtle scar high on the shaft and closer to the glans will remain. When the penis is erect, the skin will be slightly tighter than the other options, but comfortable, supportive and secure in nature.
High and Loose
The High and Loose circumcision technique removes less tissue than the High and Tight. Although the glans is exposed completely, some of the inner skin remains, sitting just below the corona (the edge of the glans) when the penis is flaccid. The overall effect is that the scar will be more central and the remaining skin of the shaft will be looser and more mobile.
Low and Loose
The aim of a Low and Loose circumcision is to remove minimal prepuce from the penis. This results in some foreskin remaining and slightly overlapping the corona. The Low and Loose option is quite similar to the High and Loose, but with a subtle scar placement closer to the glans. As more foreskin tissue remains, it may be manipulated during erection.
Low and Tight
A Low and Tight circumcision allows more of the outer foreskin to remain in place, but allows for a firm, secure sensation below the glans when the penis is erect. This allows for pleasurable stimulation during masturbation or intercourse.
What About Scarring?
Initially, you may have some concerns about healing and scarring. But although the way scar tissue forms is not always predictable, an experienced surgeon can craft the tissue to limit scarring as much as possible. Aftercare is also very important. There are many things a patient can do during recovery to limit scarring. Dr. Bidair understands these concerns, and will be happy to explain the expected outcomes for each circumcision style.
If you are interested in the scar treatment experience, read what one of Dr. Bidair’s amazing patients has to say on our blog.
How Do I Decide?
Whichever style of circumcision you choose, you will receive expert care. And with Dr. Bidair’s guidance, you can select the circumcision style that suits you best. At your consultation, he will perform a genitourinary exam, where he will note skin elasticity and the interaction between the foreskin and glans. He will then discuss any functional difficulties you have such as irritation, difficulty urinating, and intercourse issues. By simply describing your desired goals or by taking a look at before and after photos of prior surgeries as reference points, you can explain your preferences to Dr. Bidair, and he will incorporate them into your treatment plan.
Dr. Bidair will determine if your aesthetic preferences are attainable, then propose the circumcision style(s) that will help you achieve them. Once he has gathered all of the necessary information, he will schedule your surgery date. He will also give you detailed information on how to prepare for your procedure, and explicit aftercare guidance.
Cost of Circumcision in San Diego, CA
The cost of your circumcision procedure will be determined after your physical examination and a discussion with Dr. Bidair regarding your reasons for surgery. To book your personal consultation, please call Dr. Bidair’s Alvarado La Mesa Urology Center office at (619) 486-5005, or use our convenient form to send us your request online.
Are there different styles of adult circumcision?
Yes. Usually, doctors list the types of circumcision they perform on their website. After a physical examination, your surgeon will discuss the options available and incorporate this choice into your treatment plan. Then, during the procedure, they can alter the amount of tissue they remove. You can also choose the positioning of the small scar that remains. This will affect where the remaining tissue lies around the head of the penis.
What are my options if I want a revision circumcision?
Revision surgery treatment plans are highly subjective. The best way to find out your options is to schedule a personal consultation with a urologist, who will then take the details of your medical history and perform a physical exam.
- Male Newborns Percent Circumcised SE. Accessed December 13, 2022. https://www.cdc.gov/nchs/data/hestat/circumcision_2013/circumcision_2013_table.pdf
- Holman JR, Stuessi KA. Adult Circumcision. American Family Physician. 1999;59(6):1514. https://www.aafp.org/afp/1999/0315/p1514.html
- Hohlfeld A, Ebrahim S, Shaik MZ, Kredo T. Circumcision devices versus standard surgical techniques in adolescent and adult male circumcisions. Cochrane Database of Systematic Reviews. 2021;2021(3). doi:10.1002/14651858.cd012250.pub2
- 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