Dear Dr. Reed,
I had an adult circumcision about 6 years ago. After healing and things settled I noticed a hard scar about the size and shape of a grain of rice along the incision line. The incision line otherwise healed very well. The scar I am speaking of is part of, or within, the skin (not attached to actual shaft underneath). It seems as if it were an object trapped in a pocket between layers of tissue as the object can be pinched and “wiggled” around ever so slightly within the skin. My circumcision was done using super fine dissolvable stitches and there were no upsets or other complications during healing. I am wondering if you might have any thoughts or experience on this matter. I am strongly considering a revision that would tighten while also removing this object
Good morning, good Sunday Jack,
Scars of this type may be related to how surgery was performed, perhaps your underlying suture layer, if one was employed, perhaps a cautery effect. We also use relatively fine fast absorbable sutures, 4-0 and 5-0 Vicryl Rapide, however, we insist that they be removed on the 12th post-operative day. We tell patients if you go the many a doctor or urgent care center in your home town they will argue, they’re absorbable they do not have to be removed. However, 10% of patients that let them melt out have some scarring or white cross hatch marks.
Next, I would ask you to look at any other surgical scars on your body an see how they healed.
You might consider a low dosage (dilute) Kenalog judiciously injected all the way around. This may also be a remnant of a preputial scar. We have talked about this before on procircorg.
If this doesn’t, work and the subcutaneous band bothers you enough, this can be revised, by an extremely careful surgeon and you’ll have your desired tightening also. A cosmetic circumcision. Loosening can be secondary to weight gain which is noted more if you stand up. You should be pre-marked in accordance with your exact wishes.
Please provide a followup.
Harold M. Reed, M.D. FICS
Senior Member of the American Urological Association
Member Society of Genito-Urinary Reconstructive Surgeons
Founding Member and Treasurer of American Academy of Phalloplasty Surgeons
Founding Member Sexual Society of North America