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A prospective patient called to my attention, that my post-operative photographs of a testicular (scrotal) enhancement were published on another doctor’s web-site.  Although the copies were grainy, there was no question these were my photos and of course the labeling was really inappropriate.

The doctor claims to be an innovator and inventor, but ironically had not even given me credit for the photos.  Although I am dismayed, I guess I should be flattered.

Harold M. Reed, M.D.

When is a circumcision cosmetically performed.  Well for one the detail and match up has to be right on. We don’t want to see puckers when large suture, like howser for mooring a ship, are used every 3rd to 4th space when smaller sutures could have been used.  Surely, we don’t want to see residual pin hopes and ghost lines, which are tell tale signs of an adult circumcision.  The skin should be not so loose it is draping over the rim of the penis or so tight it is tenting the pubic skin during erection or causing a penile scrotal web (turkey neck).

That part’s not supposed to go in the vagina and of course detracts from perceived length.  Is you doctor attentive to you precise requests and giving you good eye contact and pre-marking you with your approval and allowing you to watch work in progress with a hand held mirror to be absolutely sure, it is being done your way.

Harold M. Reed, M.D.

Gynecomastia or enlargement of the male breast may produce an unwanted feminizing appearance. This is typically caused by an increase in stromal (connective) and ductal tissue, however a serious underlying cause should always be considered. The incidence of occurrence in naval military exams is about 8 in 100,000. Gynecomastia is noted normally to some degree in pubescence with incidence as high as 65% in boys aged 14 to 15 years. By late teens this finding lessens to 7.7%. Cosmetic surgeons consider 3 grades:

I. a button of extra tissue under the areola (the pigmented area surrounding the nipple)

II. diffuse enlargement with indistinct peripheral margins.

III. further mass effect with excessive skin involvement.

To see before and after examples, visit our web-site and click on photographic examples

http://penisdoctor.com/gynecomastia.htm

Did two yesterday and both patients are doing well.  Seem to enjoy being housed at the Baltic Hotel which is nearby and had a chance to visit both.  One an aspiring audio engineer for cinema with a bright future ahead.  Both had tight frenulums which required removal.  One had the raphe reconstructed as allowing it to heal by secondary intention would have taken 2 weeks.

The penile scrotal web or turkey neck is a problem for some pateints.  It creates the optical illusion of a shorter penis on the underside and during penetration the scrotum gains entrance into the vagina.

Penoscrotal webs can be appreciated on uncircumcised men, but more commonly seen on circumcised men when the doctor does not allow for enough remaining skin on the underside of the penis.  The remedy in our practice is not the Z-plasty incision which leaves a wavy scar line on the underneath (correcting that tomorrow) but rather to make a narrow inverted  V over that portion of the web that attaches to the underside of the penis and allowing it to drop downwards where it belongs, and close the penile skin multilayered and applying steristrips as this area is prone to tension tears,

The underside is closed typically with a minimally extended incision parallel to the normal chevron crease lines of the scrotum for concealment.

Harold M. Reed, M.D.

Have heard of and seen  tight frenulums pulling down the head creating the SST deformity.  Like the tilt down nose of the Concorde jet, but never saw it cause angulation of the penile shaft.  Think this may be my first case, where the frenulum which was attached to the distal shaft actually produced a 45 degree downward angulation of a medically induced erection in the office confirming “penetration not possible in all positions.”  

The remedy is release of the frenulum.

Please visit the Penis Doctor Blog again soon for new posts.