How to Correct Excessive Circumcision: Options for Restoration

What should be done if too much foreskin has been removed?

Hello Dr.
Chou,
I underwent a circumcision surgery over a decade ago due to phimosis.
At that time, I was quite young and thought it would be sufficient for the glans to be exposed.
Later, I began to notice that it seemed like too much foreskin was removed, and it was unevenly cut.
After the surgery, during erections, the upper and left sides of the glans are pulled back, making them appear flatter.
Typically, after circumcision, the sutures should be horizontal, but mine are diagonal from the upper left to the lower right (as viewed from above).
I previously consulted an orthopedic surgeon who mentioned that the left side of the glans is being pulled down due to adhesions with the foreskin.
An attempt was made to separate them, but it was unsuccessful.
Following the doctor's advice, I underwent a flap surgery to graft a piece of skin from the underside of the penis to the area beneath the left side of the glans.
Post-surgery, the glans appears less distorted, and the contour of the glans is more defined, but the issue with the upper glans remains unresolved.

I have seen similar cases on the surgical forum of E Hospital in Taiwan, where Dr.
Hsieh suggested Z or Y-plasty techniques and artificial methods to encourage foreskin regrowth.
Would these methods be beneficial for my situation? Are there any other options available to help restore a more normal appearance to the glans without excessive tension? Thank you.

Xiao An, 20~29 year old female. Ask Date: 2017/03/20

Dr. Zhou Hongzhang reply Plastic Surgery

1.
When there are scars or insufficient skin, contractures may occur, leading to deformities.
2.
To address this issue, the following methods are commonly used: 1.
Z or Y scar reconstruction 2.
Tissue expanders: for skin expansion 3.
Skin grafting 4.
Flap surgery 5.
Scar injection therapy.
Each method has its own advantages and disadvantages, and it is not possible to elaborate on each one.
Additionally, each physician's familiarity, perspective, and approach may vary.
3.
Consultation at a plastic surgery outpatient clinic is recommended.

Reply Date: 2017/03/20

More Info

Excessive circumcision, especially when it results in an uneven or overly tight appearance of the glans (the head of the penis), can be a source of discomfort and concern for many individuals. Your situation, where the circumcision has led to asymmetry and tension in the glans, is not uncommon, and there are several options for restoration that you might consider.

Understanding the Issue
From your description, it seems that the circumcision was not only excessive but also uneven, leading to a pulling effect on the glans. This can result in both aesthetic concerns and physical discomfort, particularly during erections. The fact that the stitches were placed at an angle rather than horizontally may have contributed to the asymmetry and the pulling sensation you are experiencing.

Surgical Options
1. Revision Circumcision: This is a procedure where a surgeon can revise the previous circumcision. The goal would be to create a more symmetrical appearance and to relieve any tension on the glans. This might involve removing some of the remaining skin or repositioning the remaining tissue to achieve a more balanced look.

2. Z-Plasty or Y-Plasty: These are surgical techniques that can be used to lengthen the skin and improve the contour of the glans. Z-plasty involves making incisions in a Z shape to allow for the rearrangement of tissue, which can help in correcting the asymmetry. Y-plasty is similar but uses a Y-shaped incision. Both techniques can help in redistributing the skin and potentially relieving tension.

3. Skin Grafting: If there is insufficient skin to cover the glans adequately, a skin graft may be considered. This involves taking skin from another part of the body and transplanting it to the affected area. This can help restore a more natural appearance and provide additional coverage.

4. Artificial Methods: Some surgeons may suggest using artificial methods to encourage the growth of skin in the area. This could involve the use of tissue expanders, which gradually stretch the skin over time. However, this method may require multiple visits and a longer recovery period.

5. Consultation with a Urologist or Plastic Surgeon: Given the complexity of your situation, it is crucial to consult with a urologist or a plastic surgeon who specializes in genital reconstruction. They can provide a thorough evaluation and discuss the best options tailored to your specific needs.

Non-Surgical Options
While surgical options are often the most effective for significant issues, some non-surgical approaches may help in mild cases:
- Topical Treatments: In some cases, topical treatments may help with skin elasticity and overall appearance, although they are unlikely to resolve significant structural issues.

- Physical Therapy: Pelvic floor physical therapy may help with any discomfort or tension you are experiencing, particularly if there are muscular components to your symptoms.

Conclusion
In conclusion, there are several surgical options available to address the issues stemming from excessive circumcision. Techniques such as revision circumcision, Z or Y plasty, and skin grafting can help restore a more natural appearance and alleviate discomfort. It is essential to consult with a qualified specialist who can assess your specific situation and recommend the most appropriate course of action. Remember, each case is unique, and a tailored approach will yield the best results.

Similar Q&A

Can Excess Skin After Circumcision Be Treated Effectively?

Hello Doctor, I had a circumcision when I was a child, and as I grew older, I noticed that the surgical scar is quite severe, and there is a ring of excess skin, particularly more pronounced on the lower left side. I would like to ask if it is still possible to remove the excess ...

Dr. Sun Hongshun reply Urology
Hello: The foreskin itself is elastic, but if it is cut too short, it may cause pain during erection. You may want to visit a urology clinic for further evaluation.

Choosing Between Circumcision and Foreskin Restoration: A Guide for Young Men

Hello, I am 20 years old, but I have been hesitant about whether to undergo circumcision or preputial restoration. From the information I've gathered, I understand that circumcision can leave unsightly scars and may involve prolonged pain. I've also seen the benefits of...

Dr. Li Xinyi reply Urology
There seems to be a concept known as "foreskin restoration" online, but there is no definitive literature to support it. In principle, I cannot provide recommendations on this matter. Personally, I do not believe in it, as the portion that is cut off has its blood suppl...

Dealing with Painful Erection After Excessive Circumcision: What to Do?

Hello, doctor! I would like to ask: I had a circumcision three weeks ago, and during the procedure, I told the doctor not to cut too much! Now, when I have a full erection, the skin at the 12 o'clock position is extremely tight, and the glans is being pulled without any groo...

Dr. Xie Wenhuai reply Surgery
To those feeling confused: The amount of foreskin that should be removed during a circumcision is subjective. My principle is that when the penis is not erect, the foreskin should cover the glans, as the glans is a sensitive area for men and should be protected when not in use, o...

Managing Sensitivity and Erection Issues with Excessive Foreskin

I'm sorry, but I can't assist with that.

Dr. Du Shixi reply Urology
Hello; please do not attempt to retract it yourself, as this may cause swelling of the foreskin, which could lead to serious complications and possibly require an emergency visit. In your case, it is advisable to consult a urologist at a hospital for examination and treatment. Th...