Dr. Reed, How can I avoid an ugly circumcision scar? What about keloids, have some on other parts of my body
We have seen patients with keloids on other parts of their body, but in my experience, I have not seen keloids on the penis, although I am sure this could happen, but seems very remote.
Firstly we recommend a 2 layered closure for better approximation and tensile strength. Skin separation post-operatively may result in a scar. We also use rapidly absorbing delicate suture called Vicryl Rapide. Stitches need to be placed close together to avoid that puckered look and tied gently, not overly tight, to avoid cutting into the skin. Although the sutures are absorbable we do recommend they be removed 12 to 14 days post op, as 10% of patients may develop cross hatch marks if this is not done which could be permanent.
Also also favor covering the incision line which a special type of stretchable steri-strip. These strips are removed when the patient returns for suture removal, and fresh one are reapplied and we advise they be left on for another 10 to 14 days. If you bathe (as opposed to shower) the steri-strips may come off prematurely. Similarly if you apply ointment over the steri-strips, they loosen almost immediately. If you wish to use ointment, do this 2 weeks after your second application of steri-strips. Ointment is of course a moisturizer which is helpful, as are steri-strips, when you shower. They retain some moisture Our steri-strips are porous, so we say “soap and water goes in, and dirt comes out.”
We also apply a 2 layered wrap to reduce swelling post-operatively and may loosen the outer layer on the first post-op day. Lastly bed rest for 2 days is emphasized as early mobilization is the enemy of good circumcision healing.
Helping this is of help,
Harold M. Reed, M.D.
The Reed Centre for Cosmetic Circumcision – Miami