Although many men were circumcised as children, some men desire circumcision as adults, either for cosmetic reasons or because of certain health conditions (infections or stuck foreskin, AKA phimosis). Typically, a newborn circumcision is done using a clamp device. With a teenager or adult, a much more precise surgical procedure is required to get a good cosmetic outcome. The skills needed to perform an adult circumcision have not gotten enough emphasis, as circumcision really needs to be thought of as a precise plastic surgery procedure.
A variation of circumcision is when there is a tight frenulum (the tissue between the head of the penis and the underside of the penis). This may cause pain or bending during erection.
Either circumcision or frenulectomy can be performed under a good local anesthetic, or the patient may elect a general anesthetic.
Both procedures are done as outpatients. A special dressing is left on for several days and then is removed, either at home or in the office.
Some men are concerned about the cosmetics and sensation of the penis after circumcision. There are some famous and vocal groups that consider circumcision to be a barbaric practice. It is certainly true that the penis looks and feels differently after a circumcision, but we consider patient choice to be most important. Most studies do not demonstrate worsening of sensation or sexual pleasure after circumcision. Additionally, circumcision does not shorten the penis.
If a patient has unsightly scarring from a previous circumcision, these can also be repaired successfully.
The decision whether or not to circumcise a newborn is mainly based on cultural and religious traditions. Although there are some medical conditions that require circumcision, in general we agree with the view that circumcisions are not medically necessary but rather a choice on the part of parents and family.
If parents want the circumcision to be done by a Urologist rather than in the hospital by a general practitioner, pediatrician, or obstetrician, this can be done in clinic up to around 3 months of age.
Dr. Brant is trained and certified as a Mohel, a designation for someone who has undergone the rigorous training to perform traditional Jewish circumcisions.
Dr. Brant takes great care to ensure the comfort of the child (he even did his own son’s circumcision!). He uses a local anesthetic to ensure a pain-free procedure and favors the Mogen clamp technique, which takes less than 90 seconds.
A set of preprocedure and postprocedure instructions can be found here.