Dr. Reed:

About a year ago I was circumcised by my urologist.   He did not respect my request to leave as much inner foreskin as possible. Nor did he respect my request to remain awake and aware during the procedure. The outcome is a low and sloppy look with suture marks all around.  He also pulled scrotum skin up the shaft leaving a turkey neck web.  The result is that my penis looks much shorter and I cannot penetrate as deeply. 

The frenulum was left.  It is very sensitive and pleasurable upon initial penetration but after thrusting and becoming more erect it becomes painful.

I’d like to have a recirc if possible and have the turkey neck trimmed back and the frenulum removed.

Would photos help in evaluating if this is doable?   Can you give me some idea of fee?…healing time?

I’m 65, gay, and love sex.  But due to what I’ve described, find myself not having it as often as my partner wants.

Oh yes, I want to be as aware as possible and see as much of procedure as possible.

Thanks,
M.  O’Day

January 21, 2010

Good morning Mr. O’Day,
Thank you for your continued interest in what we do.

For most patients we recommend you stay here overnight following your revision procedure, and you can throw in a safety factor of an extra day.  Your sutures should be removed 12 days fter revision by a health care professional.

You can be seen in consultation and done the same day.

Yes of course, we wish to see you before you take off.

Taking your other thoughtful questions…

2.Can the frenulum be removed without total loss of sensation that it offers?We remove the frenulum on most patients, and of the 10 % or less that request it not be removed, 80% return and say, “now Doctor, please remove it.”   Truly doubt there will be any difference in sensation, but if there is any concern then don’t have it removed.,

3. When I am erect, turkey neck is barely visible but my balls are pulled up the shaft.  Is this the usual situation?  I very much want my balls lower for penetration again!If you have hyper-retractile testes or so called “yo-yo” testes, there is a procedure to correct for this.

How much scaring is left by scrotal cuts? Usually a fine white line that lays out like an inverted “Y” with limbs about 3/4″ at most in each direction.

How long is healing?Healing continues over 6 weeks for maximal tensile strength but cosmetically certain refinements such as fading of all redness an take up to 13 months.

How many weeks before sex is possible?You could resume sex typically in 6 weeks. 

4. Could lengthening be doen simultaneously? No for this reason.  Successful lengthening depends upon use of traction within a day or 2 after surgery to maintain what was accomplished in the operating room and build upon that.  If you have a circumcision revision, your penis will be much too tender for traction and also you will rip you suture line apart. 

How much would that cost in addition to other surgery?If you have orchidopexy (to prevent rising in your scrotum), that fee is an added $2,500.  Lengthening as a procedure unto it self is $4,500 and this is posted on our web-site.

Michael, have a serene weekend, and again many thanks for considering our facility,

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

I am interested in penis lengthening and possible eventual girth enhancement. I had testicle implants with a west coast doctor and have been ’stretching’ with some results, however I’d like to make my testicles hang lower. I also have somewhat of a ‘turkey neck’. I would like to know if you can relax the chords on my testicles to make them hang lower and would also like to know what you can do for the ‘turkey neck’. I’d like to know if I can do either of these in conjunction with penis lengthening. Thanks.  Parmuth

Hi Parmuth,

Thank you for your interest in what we do and your excellent clinical presentation.

Several thoughts come to mind.

If the doctor has entered the membrane that surrounds your testicles, this type of surgery frequently results unfortunately in adhesions that bind and fixate the testes  in one position.

That is why our implants are placed in front and below the testes.  We have also noted degradation of testicular function if entry is made into the testicular membrane, the tunica vaginalis.

Peno-scrotal webs are fairly easy to correct.  Please avoid the Z-plasty incision, as this looks like the “mark of Zorro” when it heals

Please review the attached letter and do visit our web-site.  Look at all the documents and photos.  If you feel I am the doctor for you or my level of expertise could provide the best advice that you are seeking, then please initiate a consultation over the phone with our office.

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

 I asked for the Ultimate AMS I was given the step down with out my conscent. Ilost 2′ and some Dimension. The Pump leaks and partially fills when its deflated. Can I get back my inches and a better girth?    Rudy

Good morning Rudy,

Thank you for your interest in what we do.  Hope you can relate to our gallery of “ups and downs.”   Have been doing implants since 1975, and probably have done over 2000.

Fortunately your AMS product has a life-time warranty applicable to any treating physician.

We have been known to perform some magic in situations such as yours, but you do need to be seen at the office so I can best advise you.

Please understand it may be as simple as revising some technical errors during your previous installation, but you do need to have this reversed ASAP as scar contracture will make it more difficult to regain the length loss.

Also bear in mind any operation is associated with risk.  The experience of your urologist and his focus to the problems at hand will help minimize this.

You may wish to initiate a consultation over the phone by sending us your name, address, and phone number in an envelope along with a check for 250.

All the best,

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

I am Randall from Australia and have monitored yahoo groups for some time now. I am interested in coming over for circumcision. I also have a second little one on the way thus am also interested in a future reversable vasectomey however only 26 years old. Can these two procedures both be combined into a days surgery keeping in mind I have to travel the globe. Can I simply refer yself to you for this surgery or do I need to see a doctor and if so do I need referals for both ocedures or just one. I am very interested in seeing if having both these in a day is possible and wouldn’t be too much trauma for the area. I am also interested in having the frenulum completely carved out for smooth underside and excessive scrotum webbing removed and tidied up also. I am after a tight circumcision that leaves about 1.5cm of inner skin.
 
What sort of prices would I be looking at and how far ahead do I need to book?
 
Many thanks,
Randall

 

Hi Randall,

We would be delighted to do simultaneous cosmetic circumcision and bilateral vasectomy.  If you are married we would  appreciate a note from your wife saying she agrees.

Given that you are 26 years old, with good height weight conformation, and in good health (not on any medications), you do not need a referral.We would be glad to evaluate you for penile scrotal web, a phenomenon which is seen more frequently on circumcised men owing to excessive pulling or removal of tissue on the under side of the penis.

A tight circumcision is no problem and you will be given a hand held mirror to evaluate work in progress.

You may exercise some caution regarding the remnant of only 1.5 cm of inner skin in that when a small circle has to be worked into a larger circle them may be a tendency for puckers, but there are techniques to avoid this such as taking out a V-dart on the underside of your pigmented (outer) skin.

We are seeing quite a few Australians here every year. Anticipate that we will show you every courtesy.

All the best ,

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

 

 

 

Penoscrotal or peno-scrotal or penile-scrotal web or “turkey neck” as said in the vernacular gives the illusion of shorter penile length and often causes some irritation during penetration especially with tugging on hairs and drawing in of the scrotum into the vagina.  This often occurs because of an overzealous circumcision where too much skin is removed on the underside drawing the scrotum onto the shaft of the penius.

The remedy is resection of the peno-scrotal web.  Although some authors favor a Z plasty we have seen these patients and for me it looks like the mark of Zoro on the penile shaft and scrotum.

I believe our approach is more cosmetic because the penile incision remains in the midline as an extension of the raphe, and the scrotal incisions even on a fresh post op are difficult to discern.

Our fee is $250 for consultation. The charge for release of peno-scrotal web and reconstruction including local anesthesia and use of the facility is an additional $2500.

Please do look at our photgraphic example and see if you agree, back to normal.

Harold M. Reed, M.D.