Dr. i have my babe 3 week ago the Dr. he did the circumcision to my babe he did`t explain to me what is the circumcision my question is if the circumcision is revercible or he can have surgery foreskin restoration please help me thank you.  Alicia

July 6, 2010

Good morning Alicia,

Sounds like the circumcision of your son was not properly discussed with you.

Despite your misgivings now, a circumcision does confer many advantages health wise.  Such as avoidance of phimosis, decreased likelihood of urinary tract infections, deceased likelihood of his acquiring HIV and sexually transmitted disease.  It could be reversed later on after adolescence.  There are conservative (non-operative) means to do this, but chances are your son will appreciate being circumcised.  Doctors need to take time to talk to their patients and the family, so that you can make an informed decision.

Sincerely,

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

April 4, 2010

Good morning Dante,

The purse string suture technique has a lot of appeal in that wedge resection and incision healing is not involved.  I would favor using a permanent suture which would be removed about 6 to 8 weeks later.  Some reactive scarring and contracture should occur as a result and this may achieve the effect you are seeking.  If the distal circle now is very large circumferentially, then wedge resection would be appropriate.

If the purse string suture approach is not effective, we can always revert to wedge resection.

Your call, but I will make recommendations when I see you.

Remember surgery would be inappropriate if the new foreskin does not completely drape a good 1/4″ to 3/8″ over the head of the flaccid glans.

If there is continued interest, please initiate a consultation by sending us a fee of 250 which is a one time charge, includes E-mail chatting, telephone calls, and your first visit to the office, excluding lab tests.

Have a restful weekend,.

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

At 06:25 PM 4/2/2010, you wrote:

Hello Dr. Reed, I can’t tell you how impressed I am that you are dialoging with me about this. This is so atypical to most physicians I have dealt with. I guess as this point I would like to know your professional opinion upon what is the best procedure; the purse-string suture or cutting out a wedge and suturing the foreskin? I must admit that removing any part of what I have worked to hard to obtain seems anathema, but I also know that you have much more experience in these things than I. I also want to make sure (if it is realistic) that I don’t end up with what would be the equivalent of a phimosis. This procedure is not only for me but for the sake of my partner as well. He is uncut, so I’m familiar with how things are ’supposed’ to work. I’m also aware that I should not have unrealistic expectations. If we go with the string, will I need to abstain from any kind erection for those 4 weeks? Is that the same for any other procedure? There is no problem with that, I only need to know what I should expect. The second question I have is about timing. Should I go ahead with some sort of procedure, when is your schedule open to do it, and what is the recovery time? I live in Dallas so I will need to make a special plan to go to Miami. I have friends in Miami, Key West, Orlando and Tampa, so accommodation should not a problem. But I have a job and will need to request time off well in advance. Thank you again for working with me on this. I have waiting a long time (over 3 years) to get to this point. I’m so grateful to have a Dr. that is not freaked out my such questions and requests.  Dante________________________________________ From: Harold M. Reed, M.D. [ Subject: Re: Finishing touch of foreskin restoration April 2, 2010 Good morning Dante, The first article mentions very briefly purse string suture, but does not disclose, whether it is permanent left in or removed later on, or absolvable.  The second article written by Dr. Greer, who I conferred with about 15 years ago, uses a  technique similar to ours, also described by Dr. Willard Goodwin. So, we can do the purse string if you wish. My recommendation  is to leave the suture in for a good 4 weeks if tolerated and some scarring will result around the suture and then, remove it. While I am familiar with the application of a purse string I have not had any experience for the reason you mention. Sincerely, Harold M. Reed, M.D. At 11:23 PM 3/31/2010, you wrote: >http://www.cirp.org/library/restoration/greer1/

 am 25 and when I was 16 went to a urologist because of a downward curve upon erection. I was told to have mild hypospadias with chordee.Apparently it was not detected after birth and/or not serious enough to repair. I was circumcised by a rabbi after birth and feel that i have a tight erection whether caused by chordee or the procedure. I dont know if i was born with hooded foreskin or not, but i want to non surgically restore using t-tape method. Do you recommend this procedure or do you have knowledge of people restoring with the conditions i described? I am a realistic person and dont dream of having a straight erection, but i do wonder if having ‘foreskin’ would be satisfactory or somehow complement my condition and i dont want to live without at least trying. do you have any comments or suggestions? thank you doctor

David

Good morning David,

Thank you for your letter.  Several thoughts come to mind.

We are available for consultation either over the phone or at the office (more desirable).  Our fee is 250.  Your possible chordee or ventral curvature needs to be evaluated, and dorsal hood is a term associated with hyposdias or possible spongiofibrosis.

Yes, we do foreskin reconstruction.  Please visit our web-site at http://www.penisdoctor.com/foreskin.htmlMany patients, as an alternative to surgery, may elect to use stretching devices under urological supervision which could produce an acceptable result in 2 to 3 years.

Our procedure normally involves 2 to 3 stages and the combined fee is $7,600.  Consultation is an additional $200.  Lab fees are $100, but these blood tests can be done in your home town if you wish.  If you are over 40, you will need a letter of medical clearance.

Candidates who wish to schedule surgery with our facility are required to have minimally a letter of medical clearance if applicable and a phone consultation with a favorable response to questions of concern.  Assuming this, you will be given the nod to send in a 50% deposit which is non-refundable.

If you are a smoker, you must stop completely for 2 months before surgery (girth enhancement especially) and please never again.

Smoking causes vaso-spasm, impairs wound healing, produces excessive scarring, tissue necrosis, irritates and inflames pulmonary membranes and enhances anesthetic risk.  However, most of our penile surgery is done under local anesthesia with IV sedation.  This goes also for any products containing nicotine or nicotine like agents including nicorette gum, nicotine patches, Nicotrol inhalers, and second hand smoke.   Again not for 8 weeks before and not for 8 weeks afterwards.  Hopefully never again.

No aspirin or aspirin products, blood thinners such as Plavix, Coumadin, no anti-inflammatory drugs such as Motrin, Advil, Alleve, or Cox 2 inhibitors such as Celebrex or Vioxx for a week before surgery.  No Vitamin E or excessive alcohol or spices for a week before surgery as this may promote bruising.  Bruising can be reduced (many believe) with Bromelain 500 mg 1 twice a day, Arnica montana dose 30C (take 4 small tablets sublingually, 4 times a day), vitamin C 500 mg (3 times a day) starting 1 week before surgery.

With regards,

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