There are many different ways of doing a circumcision. Dr Zarifa is a fully qualified surgeon who has performed this procedure many hundreds of times. He uses what is known as a 'freehand' technique relying on skill and experience rather than patented devices.
Referral from a GP is not required if you wish to undergo circumcision but for young people, teenagers under 16, we need written parental consent and prefer them to be accompanied by a parent. Otherwise, age and written permission may need to be verified before Dr Zarifa can proceed. Patients are assured of a friendly welcome and an informed, non-judgemental attitude when discussing their personal wishes.
Circumcision is one of the oldest and simplest and time-proven surgical procedures but there are
points to note... |
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If you want your son to be circumcised it is often best to do it as early in life as possible. An infant circumcision is simpler, usually requires no stitching and heals very quickly with proper care. This may involve the parent pulling back the 'collar' of remaining foreskin to keep the glans (head of the penis) fully exposed and applying a cream we provide to prevent the foreskin stump adhering to the rim of it. Such a precaution will normally be part of a changing/bathing routine until the wound has settled down.
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Parents are provided with a direct line contact number in the unlikely event that they need to speak to Dr Zarifa personally about any concerns they may have after the operation
Circumcising a baby boy also has the advantage that he has no fear in anticipation nor memory of it afterwards. As he grows up with a circumcised penis it will seem natural to him and he will never need to face the procedure or make the adjustment of having it suddenly looking and feeling different as happens with a later operation.
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If it is being done for religious or personal/cultural reasons, it often helps for a boy to know that his father or brothers or other family and friends are circumcised. Boys like to 'belong' to a group in this respect.Where the reason for circumcising is a medical one, boys will usually accept it happily, knowing that a small operation like this is going to end any pain or problem they might have experienced.
Avoid communicating any personal anxieties but try to be positive and encouraging in what you say. Much will depend on your son's age but keep your explanation simple and, especially if your son is very young, do not use alarming words like 'cut'. It is enough to say something like; 'his skin will be pushed back' or 'fixed' so the tip of his penis is exposed and gets washed every time he has a bath. Do try to be encouraging and tell him that it will be better for him like that.
Parents are provided with a sedative to give to their son just prior to the appointment. This relaxes and helps minimise anxieties. Custom House staff and Dr Zarifa are friendly and well used to putting patients at ease.
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It is not essential, but parents are encouraged to sit in with their sons to support and comfort them during the brief operation. A local injection is given to eliminate pain during the procedure which takes only a few minutes. After a suitable interval checks are made and the patient is free to leave. They normally walk away with little or no discomfort. but it is wise to rest up and avoid any active sports or knocks to the area as the penis heals. Dissolving stitches are used where necessary which eliminates the need to return for their removal.
Initially, after the healing. there is a period of adjustment as your son experiences heightened sensitivity from the newly exposed glans in contact with his clothing. Be prepared to reassure him this is normal and he will get used to it. Consideration of the type of underwear or even padding at first may help.
Teenagers
who are approaching adulthood may appreciate the advantage of a detailed consultation in accordance with the adult price schedule.
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After making an appointment for your son's circumcision and a short time before he attends, you need to explain to him what will happen, why it is being done and that afterwards his penis will look and feel different. It is best not to discuss this too far in advance so he has less time to worry about it.
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It should be appreciated that due to variations in personal anatomy and the way people respond differently to surgical procedures, no two circumcisions are exactly alike. Generally a circumcision is performed to remove most of the foreskin so as to leave the glans permanently exposed.
However, sometimes operators and methods leave more foreskin which is usually called a 'loose' result or conversely they remove it all, which is then referred to as being 'tight'. Patients differ in their preferences on this and also on the positioning of the scar which will vary in its prominence according to the healing response of the individual. These requirements should be raised by the patient at the consultation.
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Re-do circumcision
Custom House Surgery has also been able to assist those who have been circumcised earlier in life and are unhappy with the result. Re-do circumcisions are often performed to remove excess foreskin left from a previous operation. Other options to modify may be limited and can only be explored with the patient at the consultation. Dr Zarifa is accustomed to listening to patients' wishes in this matter and meeting their ambitions where their situation allows. Because it is a remedial procedure re-do circumcision is usually more tricky and time consuming to perform and therefore more expensive than a normal circumcision.
Circumcision should not be undertaken without careful consideration. It requires the removal of tissue which changes the appearance of the penis forever; modifying what nature creates as an internal part, advantageously into an external one. This has positive implications for personal hygiene, health, body image and sexual sensations for the man and his partner. Although circumcision is only a minor operation, all surgery carries risks, and can, albeit very rarely, result in complications.
Every care is taken to avoid them. However, there is always a slight chance that post operative healing and the final outcome may not be everything you expect. Dr Zarifa has a mandatory consultation process which is not hurried. He will explain his technique fully and particularly invites your questions so that all your concerns are covered. It is a good idea to prepare yourself with a written list to remind you of these whilst attending.
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Please note, results cannot be guaranteed for a number of reasons:
Anatomically we are all unique. No two penises are exactly alike, nor will they respond identically to circumcision, either in healing or outcome. Some foreskins are thick, others thin. The glans varies in size and shape. Individuals have different skin types and colouring which affects the prominence or otherwise of the resulting scar. Boys circumcised as very young babies seldom need stitches and normally heal very rapidly to give an impressive result. This cannot usually be matched in an older boy or in an adult because the penis is much more developed.
Patients have different requirements concerning the amount of remaining foreskin which Dr Zarifa will do his best to meet if you make your wishes clear.
Those seeking a re-do circumcision may find their earlier surgery limits Dr Zarifa's scope for remedial work. Ambitions may not be attainable simply because there is insufficient remaining tissue from the previous circumcision. This should be discussed in detail at the consultation.
Our 'Patients Comments' page carries dozens of appreciative messages received from satisfied patients. To date Dr Zarifa has had only one complaint. This has resulted in highlighting the issues described above, along with a full revision of the information in our aftercare leaflet.
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Frenulum Removal
This can be a variable part of circumcision or a single separate procedure. The frenulum is the web of skin which attaches the inside lower tip of the foreskin to the glans where it stretches on retraction down the cleft on the underside. It differs in individuals, being very tight in some when, on retraction, it pulls down on the head of the penis causing pain. A tight frenulum, which is called frenulum breve, may be an uncomfortable problem. In others the frenulum is apparently absent because it was either torn early in life or never developed.
Quite often the frenulum is automatically removed during a circumcision. However, some men wish to have a circumcision but retain the frenulum. Very occasionally patients opt to have only the frenulum cut and removed, preferring to retain their foreskin and remain uncircumcised. You should discuss all these points with Dr Zarifa at the consultation.
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