About  two (2) years ago I had thickening 8 months after lenghtening. I was at 8 inches length. The thickening cost me -2 to -2 1/2 inches. I want my length back. A simple release of the adhesions would allow the “gtip ” to restore my original length.  This is my second inquiry and the first doctor said it was not a difficult procedure. I am older and in good health. I will diligently use traction once the release is made. Can you use a transcrotal incision?     Jimmy

Hi Jimmy,

Truly sorry for your loss.  There is so much I would like to say, that will be revealed after you become an established patient.   The attached file is enclosed only as it may be of interest. 

A transscrtoal incision is perhaps not the best apporoach as we need to be right over the scar tissue and adhesions when surgery is being done.  May I propose an infrapubic incision which (being on the lower pubis) avoids the shaft of the penis itself.   If the scarring is very involved a supplmental incision along the dorsal coronal sulcus may also be required.

Our office has become a clearing house for correction of these problems.  You are invited to call our amiable office manager Anne, perhaps tomorrow, and set up an appointment for consultation.

With every best wish for a speedy resolution,

Harold M. Reed, M.D.
305-865-2000

 

 

I was wondering about a circumcision. My mother didn’t have me circumcised as a baby and everytime my girlfriend and I have sexual intercourse it rips the skin on my penis. What should I do? Would a circumcision be the best way for me to go?  Justin

Dear Justin,

Hope the attached is helpful.  Each tearing episode only creates more micro trauma and loss of normal skin elasticity and loss of healthy vasculature. 

The remedy is a cosmetic adult circucmsion.  Have done about 5000 procedures in the past 35 years.

Anticipate we will show you every courtesy.

Wait 6 or 7 weeks and it will be a whole new ball game.

Harold M. Reed, M.D.
305-865-2000

Potential problems that could develop are: A. Skin septa (connective tissue strands) even if released may still may cause the inner skin to wrinkle slightly as the tension applied that seems to completely stretch the foreskin is often applied at the mid shaft by the patient to get some idea of what to expect. Applying the traction further away at the base requires more force and if so greater potential for incisional breakdown.
B. Lymphedema or persistent swelling of the entire penile skin.

For illustrations see
http://www.penisdoctor.com/photo-circumcision.htm
 
Harold M. Reed, M.D.

In the past few months we had seen several cases of bona fide phimosis which has not responded to conservative measures.  You may wish to scan some before and after photos ttp://www.penisdoctor.com/photo-circumcision.htm  taken during our adult circumcisions.  What surprises us is that patients have quietly suffered with this for so long when the remedy is so simple.  Often it is their wife or girl friend that pushes them to Dr. Reed’s office, and not uncommonly they accompany the patient to Bay Harbor to be present, lend moral support, see our facility and even watch.  Hey, that’s OK.  We love vocal anesthesia supplements, and tender hand holding.

Important to keep in mind that the phimotic process, read scarification, involves more of the foreskin than just the very tip, and if a substantial amount is not removed back towards healthy skin, a waist banding effect will occur.   Or thinking about this another way, the more inner skin removed the lower the circumcision, but patient health is number one.  Bye-bye cracking, oozing, bleeding and recurrent micro-trauma and pain.

All in a days work,

Harold M. Reed, M.D.
305-865-2000

To say “your sutures are absorbable, they’ll melt out,” may result in tell tale cross hatch marks or ghost lines and pin holes which will last a life-time. That’s why in Henderson County an owner can build his own home and be his own general contractor as long as the plans pass and he meets interval inspections.

But the owner has to live there for 1 year and the house cannot be sold or rented during that time. They figure if it is his home (his penis) he’ll do a more careful job.

Four ingredients are needed for suture removal, a careful technician could be a well trained nurse or medical assistant, or PA, a bright overhead light, delicate plastic surgery scissors and pick ups, and the availability of loupes (magnifying glasses like the kind jewelers use).

These type of sutures come in the same category as eyelid sutures. No rough handling, no digging, please. Usually an ER nurse can do this, or look for an urgent care center if they are sewing up faces, or a plastic surgeon’s office, or a urologist who is cosmetically oriented.

Harold M. Reed, M.D.

— In PROCIRCORG@yahoogroups.com,  <dean@…> wrote:
>
> I’m at day thirteen, one day past Dr. Reed’s recommended suture removal date.
Due to the chaos at work this week, I had to schedule removal with my new
primary guy for today and I can’t think of how the experience could have been in
greater contrast to my visit with Dr Reed and his staff.
>
> First, I waited in the lobby for about 40 minutes with about eight or so other
patients. After going with the nurse into the exam room where she did the blood
pressure cuff, it was another twenty minutes before the doctor came in to remove
the stitches. Yes, you did the math correctly: an hour of elapsed time before
seeing the doctor. Read on.
>
> As he began removing the sutures, he bitched about how difficult they were to
remove and that he didn’t see where so many sutures were really necessary. I
guess that last comment is a natural companion to his surprise that I couldn’t
find anyone in the DC area to do a cosmetic circumcision and perhaps why Dr.
Reed gets to clean up other surgeon’s messes. After about the third time he
questioned the point in removing dissolvable stitches, I politely suggested he
call Dr Reed for clarification since it was his specific instruction to remove
them on the 12th day. He kept at it for a few minutes longer, then said he
didn’t have time to do any more today as he had other patients. Ten F-ing
minutes of work, a third of the stitches out, and that’s all he was going to do!
He told me he could do some more tomorrow or I could stick around and he could
pick at it some during the day. I left simply because I’d had enough and
figured my time was better spent trying make other arrangements …even hastily
made ones had to be better than this.
>
> Keep in mind that when I made the appointment, I was very clear that I needed
plastic surgery sutures removed and that there were 20 to 30 of them (my guess).
Did anyone listen to what I said and ask up the line if they were capable or
interested in doing the job? I even presented Dr. Reed’s discharge instructions
to the nurse. Did anyone read them? Of course not in both cases. So, not only
did he waste my time today, he wasted the time I had to find someone who could
actually do the job by the set deadline …and he lost me as a patient. I will
also lose more time away from work just trying to put out this fire.
Ironically, there were clinics closer to my house I tried first who told me
upfront they couldn’t do plastic surgery stitches; at least they were honest.
>
> I have a PA friend of mine who works at Baltimore Shock Trauma who is trying
to squeeze me in tomorrow with their plastic surgery team, but I feel the clock
ticking.
>
> That’s it for now, gotta eat something.
>
> Dean

An overzealous circumcision.  Definetely the underside cannot be too tight lest the scrotum be drawn into the penile shaft.  If there is looseness post circumcision on the underside, chances are the circumference is too loose and this requires a longitudinal incision to gather in the sides, not more circumcsion.

Here’s the letter…

Hello.  I’ve got a question.  I am 28 yrs old.  I weigh 210 lb. and am 5 ft. 8.  I was circumcised when I was 20 yrs. old.  I thought the procedure went okay.  The cut looked alright, but I noticed that the doctor left my frenulum.  I don’t remember if I opted for this or not.  Within the last few years however, I have put on 50 to 60 pounds and I’ve noticed that my penis feels a bit tight.  Is tightness weight related?  I am having 2 problem areas.
 
  #1 When I am erect my scrotum seems to hang higher and pull forward so that I’m not getting full range of my shaft.  When I was uncircumcised and 150 lbs. I could grip the base of my shaft and my hand would come into contact with my pubic area.  Now the base of my hand seems to come into contact with my scrotum. 
 
  #2 I feel like my frenulum prevents me from a full retraction of shaft skin because its tethered to the glans (perhaps pulling my scrotum forward as well during erections).  My glans don’t bend down or anything, but I still feel some tightness between the glans and the top of my shaft.  If I have a (frenectomy?) won’t that loosen that V shaped skin on the underside of my shaft thus loosening more of my shaft skin relieving any forward tension of my scrotum when erect and allowing for a better retraction of shaft skin particularly the underside of the shaft. 
 
FYI, I saw a urologist in my town about my tightness concern.  He recommended that I leave it alone because he thought my penis looked normal and thought I wouldn’t like the scarring that could result from a frenectomy.  He seemed convinced that weight loss would help.  He also recommended that I get a 2nd opinion. 

In that the head of the penis is liked a cocked cap more on the top than the bottom, for this reason,  less tissue need be removed on the underside.  Or another way of saying it is, the underside needs more skin, and if there is a little extra, the weight of scrotum pulls that down.

Harold M. Reed, M.D.