penisdoctor.com

June 4, 2011

Hi Dr. Reed,

Have a preputial or penile skin bridge, noted ever since birth and I believe it is high time, I got it taken care of.
Please advise.  Enclosed you’ll find a photo. 

Evan

Good afternoon Evan,

We see these ever now and again and removing them is usually easy but ideally should be done under sterile conditions in our operating room.  As with circumcision we advise bed rest for 24 hours to minimize any bruise effect.  We’ll use highly absorbable and fine sutures, but still for the best cosmetic result, they should be removed in 12 to 14 days.

You’ll be pretty.  You may wish to see a  recent example of our work on http://penisdoctor.com/photo-circumcision.htm
look for photos 18/1-3.

Harold M. Reed, M.D.

February 13, 2011

Dr. Reed,

Someone referred to you from the yahoo.com website. I was circumcised last April and my surgeon used dissolving stitches. There some raised bumps where the stitches were. There was tunnels but they’ve gone away.  

I’ve been putting vitamin E on it cause I heard that helps heal scars. I just want the raised skin gone. Even if its a little discolored, just no raised skin. I didn’t start treating the scars till six months after surgery(roughly two months ago).

Someone told me it can take up to 18 months to completely heal. I just wanted to know if this is permanent or if it should heal or if there’s anything more I can do?

If you can’t help me I understand I just don’t have health coverage anymore so I can’t ask my doctor. I got the circumcision done cause I was really insecure about it and the skin was WAY too tight.

Thanks in advance.

Donald

Hi Donald,

These raised bumps may be chronically inflamed areas that are the remnants of suture tunnels.  Best remedy is removal together with curettage or delicate knife and closing with ultra fine fast absorbing suture and keep the steri-strips on for 3 or more weeks.

There are also non-surgical ways to loosen your overly tight skin.  Will discuss during your consultation.

Please see our web-site http://penisdoctor.com/photo-circumcision.htm and look at photographic examples 11/1-3.  Been there, done that.

Have a restful Sunday,

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

Phil

February 13, 2011

Good afternoon Phil,

Suture tunnels and skin bridges are seen frequently in our practice, and they need to be opened to see the light of day and stop the continuous exudation of skin secretions and malodor.

Please look at our web-site http://penisdoctor.com/photo-circumcision.htm, photos 11/1-3 and you’ll see a few examples.  Sometimes when the bridge is unroofed, the pigment of the inner skin may be slightly different than the outer, but still this is preferable and there are ways to more closely match skin tones which are non-surgical.

If you have loose skin and wish a revision, the tunnels are often removed with the specimen.

Sincerely,

Harold M. Reed, M.D.

I sent you an email a little over a year ago asking about a skin bridge I have. After my in depth description of my bridge you replied that I had a preputial bridge.I would like to have this bridge removed for hygenical reasons as well as cosmetic, as its not very attractive. I guess my question is what would something like this cost approximately? I would like to have this procedure done in the very near future. I would appreciate any info you can give me. Thank you.     Daniel

Good afternoon Daniel,

Thanks for your continued interest in what we do.  Fees are as follows, consultation $250 and surgery for preputial bridge $500.  I assume you either have had, or are not interested in circumcision or circumcision revision.  Anticipate that the base of the bridge on either side usually 1 to 3 mm wide will heal with a small area whose skin color may be somewhat different from your present skin pigmentation.  Usually this is not especially noticeable.

Sincerely,

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

Hi Dr. Reed
 Thanks for the information about circumcision. Actually, I have been thinking about this procedure for a while, not because of medically necessary, but for hygienic reasons. Does medical insurance company usually cover such a procedure?   Tony Ambrose

Good morning Mr. Ambrose,

Most insurance companies will fund for a circumcision if there is a medical reason, such as chronic irritation, phimosis, tearing, bleeding, balanitis xerotica obliterans, preputial skin bridges, perhaps recurrent penile warts or lesions on the inner skin.

We are contracted providers and accept Blue Cross/Blue Shield (non HMO) and Medicare. Or we would be pleased to fill out your insurance form for maximal reimbursement to you directly.

If you have more specific questions, perhaps you could call your carrier to learn about the unique benefits of your policy. At any rate, you have a friend in Bay Harbor Islands (greater Miami) and anticipate we will show you every courtesy.

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

Now one thing i’m still trying to understand is the Dorsal Slit Technique vs the sleeve resection technique, will the dorsal slit technique have as staight cut as with a scalpel? and what is the benefit of one versus the other?

thanks,

Donald

Good morning Donald,

A dorsal slit is not a circumcision and is reserved for very serious infections of the foreskin and head of the penis, where all the doctor wants to do is make a longitudinal cut on the top side of the foreskin (without removing it) to allow the foreskin to fall away (downwards) from the head of the penis until the head or glans has sufficient time to heal, and then a formal circumcision will be done.

The other option is using a clamp which works for children, infants and neonates but in my opinion not the best for adults, because you cannot really see what is going on under the clamp before you make the incision and the result is more generic than responsive to the patient’s unique requests.

Hope this makes sense,

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

The reason being usually a loose circumcision.  The doctor cannot see what is going on underneath the clamp.  Following surgery, if no attempt is made to separate the overlying skin, adhesions or synechia will develop and this ultimately leads to a skin bridge.   Most skin bridges will not bleed but underneath there is often accumulation of smegma which is not healthy.   Here is a typical letter from a patient with skin bridges.

I am an 18 year old with two thin skin bridges– well, I used to have two! My girlfriend and I are both very prude as we are committed to being abstinent until marriage, but it proved to be a bad thing in this case. We were kissing and grinding last night, clothes on, when I suddenly felt a sharp pain “down there.” Not wanting to ruin the moment, I dismissed it and went on my merry way. It didn’t occur to me to check it out until things had calmed down and I noticed some discomfort.

If you have any more information that you think would be beneficial to me, I would be very appreciative for it.

Thank you for your help!

“mypantsaresofancy”

Hi Fancy Pants,

Fortunately the bleeding was episodic and now you have an area of opened skin which like any superficial cut, should heal fine, as long as you keep it clean.  you may wish to apply an antibacterial ointment.

Yes, removal of skin bridges should be covered by insurance especially given your recent history.  Not to worry.

Harold M. Reed, M.D.