| Message No.43
Questions
from M, North West England
Hi
I have wanted to get circumcised for some time now - not because I need it for any medical reason, but just because I prefer the look of a fully exposed glans. I have never had the courage to actually do anything about it because of fear of embarassment and because until now I didn't realise that other guys actually chose to be circumcised.
Through a chat forum I have made contact with another guy who feels exactly the same as me. We are both very nervous about actually going for it and have both delayed individually doing anything about it.
We have decided that the whole thing would be a lot easier if we gave each other some moral support and supported each other with it. My question therefore is would it be possible for us to attend a consultation and get circumcised at the same time?
Also, we both want to have very similar circumcision styles - high and tight with removal of the frenulum so that the head of the penis looks very bare when flacid. I assume that you are able to perform this kind of look?
I look forward to reading your response on the website
Reply from Dr Zarifa
Thank you for your email, in reply to your questions, the answer is YES to both.
I can arrange an appointment for you both to have appointments for consultation and circumcision following each other.
Your request for high and tight with frenulum removal is one which very popular and I am happy to perform.
I hope this information is helpful to you.
Regards Dr Zarifa
Message No.42
Hello,
I have read your website quite thoroughly. I am seriously considering having a circumcision. I do not have any problems with my foreskin at all, I just think that a circumcision looks a lot neater and is probably more hygenic. I currently wash my penis (foreskin retracted) 2/3 times a day so there has not been a problem there. I am 43 years old and petrified about the operation and pain that may follow.
1. Will it be very painful afterwards?
2, After the operation, for how long will it feel uncomfortable against underwear? 3. How long after the operation before I wil be able to have sexual intercourse?
Thanks
Custom House Reply
Thank you for your email: I will answer your questions in the order you have asked:
1.The procedure is carried out with local anaesthetic and the usual report from previous clients is that it is not painful, but you are aware you have had a procedure done. Some patients do not require anything afterwards, others take a paracetamol if required.
2. Reports from clients, say it is not uncomfortable against their underwear. 3. Resuming sexual intercourse depends on the individual and you yourself will know when you are suffiently healed and ready. Better to wait for a few days more than stress the wound prematurely.
I hope this is helpful to you.
Message No.44
From DC
Questions:
Three questions regarding the procedure, which may be useful to other people considering circumcision: 1. Scarring. How likely am I to have scars and where would these be situated? I've read quite varying comments on this - some are less than half an inch - whilst others are significantly worse.
2. Tightness. I have seen that other doctors offering this service have said it is possible to specify a tight or loose circumcision. Could you outline the differences? Is this possible with you?
3. I am 23. Am I more likely to have two tones of skin colour or does this vary from person to person? I get the impression, those that had it done at an early age do suffer from this?
Reply
Thank you for your email. In reply to , I will answer your questions in the order you have asked:
1.Medically speaking, any wound or cut will result in scarring when healed. The shape, size and prominence of the scar would depend on where it is, the direction of the cut, and skill of the surgeon.
2. Tightness is a matter of your choice and the surgeon performing the operation, so it is possible, within feasable limits, to accommodate most patient's wishes
3. Yes, two tone may well be evident since the colour of the outer skin is different from the inner skin. That of course also varies from one person to another. This result is not related to age at which the circumcision is performed.
I hope this answers your questions.
Kind regards, Dr Zuhair Zarifa
Message No.44
From J
Question:
I have no problem retracting my foreskin, However, when fully errect my frenulum is pulled tight to the extent of turning white and my errection is pulled downwards. I have had this condition as long as I can recall . I went to see a doctor when I was 15 who just said "they come in different shapes and sizes, you'll have to just live with it!".
My questions are:
1. based on my description and attached photos, is this Frenulum breve?
2. Is my errection likely to be straighter after operation, or is it more likely that it has been pulled this way for so long that it will remain this way?
3. Can u confirm total cost of £340
4. How long is waiting list?
5. Would I be able to drive myself 7 miles home in an automatic car after operation? Thank you for your email: In reply to your questions I will answer in the order you have asked.
1.Frenulum Breve? Yes it does look like it. 2. Excision of Fenulum will almost certainly decrease the tightening of frenulum and help at the area of the corona of the head, however, is the under surface of the penis tight and painful? If so it may help.
There is another condition called PEYRONIE'S disease which also may cause bending, but it does not look likely. I am sorry that I am unable to be more specific, I am sure you understand the difficulty I will be more than happy to assess and proceed after consultation if you wish 3. Yes the total cost of Frenulum removal is £340 of which £100 is included for the mandatory consultation. We give you the option to leave it, and pay only £100 for consultation, or proceed and pay the remaining amount then or at a later appointment.
4. Waiting time? Currently we are looking at 1- 2 weeks but this may change from time too time
4. Drive yourself away afterwards? Yes
Message No.43
From S in SE
Hi - you may remember me from before, I had a circumcision from Dr Zarifia, and then had a lump removed and a bit of a redo at the same time. Well it all turned out great and I am really happy with it.
Question
The thing I am enquiring about is; when he was doing the op I asked him if he could close up the piercing (Prince Albert) that I had and no longer liked. He said it would be no problem but couldn't be done at the same time. What I was wondering was how much this would cost to have done, then hopefully that will be it.
Reply Thank you for your kind comments. The fee for close up piecing is £700. Regards Dr Zarifa
Message No.42
From Y
12th May 2004 I'm a 25yr old male with phimosis - as far as I can remember, I've never been able to retract my foreskin. I'd like a partial circumcision, so that I have some foreskin remaining to pull back and forth over my glans. I just want to remove the tightness.
Is this something that you can arrange?
Custom House Reply
Thank you for your email. This is not an uncommon problem and can be dealt with. If you would like to make an appointment to see me, please contact Sylvia either by email or her direct line number is 020 7474 7684. I look forward to hearing from you.
Best wishes, Dr Zuhair Zarifa
Message No..41
From Kate I am pregnant with our first son and my husband is keen for him to be circumcised, but I have some questions for you. 1 How soon after the birth should this procedure be performed? 2 How exactly is it performed on a tiny baby? 3 What anaesthetic, if any, is used? 4 How do we care for the wound afterwards? 5 Also, is this done at your surgery and should both of us be there? I would very much appreciate some answers as I am quite anxious about the whole thing. Thank you in advance,Yours sincerely, Kate Custom House Reply Thank you for your email. In reply to your questions: 1. How soon after the birth should this procedure be performed? This is your choice, we perform the procedure at all ages from newborn to adult. 2. How exactly is it performed on a tiny baby? It is performed by 'Freehand' - a method which relies on the surgeon's skill and experience rather that clamping with purpose made gadgets. 3. What anaesthetic, if any, is used?
Local anaesthetic is used, (an injection at the base of the penis) 4. How do we care for the wound afterwards?
Bathing regularly. (We give you an antiseptic powder to use after the first bath) 5. Also, is this done at your surgery and should both of us be there?
Yes it is performed in our dedicated treatment room here at tCustom House Surgery. It is your choice who is with the baby but it is nice for baby to have a voice that he knows. I hope this is helpful to you.Yours sincerely, Dr Zuhair Zarifa
Message No.40
From IW, Spain
Dear Dr Zarifa, I was circumcised in 1989. Unfortunately the photochromatic stitches came loose too soon under the corona leaving a puckered and unsightly appearance. In addition to this, the join was not perfectly aligned and so the tension is not even.The stitches elsewhere produced skin tunnels. I was retrieving bits of hardened plastic many years later!!! The frenulum was left intact even though Dr Hasan cut very close to the glans there.The end result is uncomfortable and extremely unsightly. The skin bunches up and rolls over the underside of the glans. At times it rolls over the corona too. This leaves my glans feeling over sensitive. I would dearly like to feel more comfortable and at ease with my penis and after reading your web site I realise that you are perhaps the man to help me. I would like my frenulum completely removed and the tension adjusted and tightened on the shaft. I am not too keen on photochromatic(disloving) stitches once again as you can well imagine. The only problem I have is that I live in Spain and taking a few days off to fly to London requires some twisting of arms! I would like to know if the fee of 700 pounds includes frenulum removal too. Looking forward to hearing from you soon, Custom House Reply Thank you for your detailed email. Dr Zarifa is happy to see you for a consultation and a re-do Circumcision. In reply to your question, the answer is Yes, £700 does include the frenulum removal. If you are happy to see me, please let me know when you are in London and I will do my best to arrange an appointment during this time. We do have Friday dates available, if this is convenient for you. I look forward to hearing from you.
Message No.39
From PC
I was circumcised as an adult about 15 years ago and have always been very pleased that I decided to be circumcised. I now would like to have a re do circumcision where my frenulum is completely removed and the skin on the shaft is tight so there are no folds of skin next to the rim when my penis is flaccid. As regards the position of a new circumcision scar I would like your opinion as I have been looking on the circlist web site and have seen a circumcision with the scar at the base of the penis. Do you think that this is a possible position for the scar on a re do circumcision or do you think it is best to make a new scar further down the penis shaft. I am looking forward to the answer and opinion from Dr Zarifa regarding the new scar position. May be I should also add that I do quite a bit of part time work as a life drawing model ( have in fact passed the Ram audition for this work) so my penis is on view to others and this is the main reason why I am keen to go through this operation again to get a penis with a completely exposed head - a better aesthetic look.
Dr Zarifas reply
Yes I can remove the frenulum fully with no problems. I can also remove the skin fold at the back by cutting more of the 'outside' proximal skin. With regard to the scar line, that depends on the site of the old scar as well as how much was saved or otherwise of the soft inner skin. It is always advisable to save as much as possible of that and have one scar only. Your last question would rely on the answer given above. The choice is totally yours, this is a life style operation and I hope it would be as you expect. I have no views, however, the vast majority of my patients do ask for 'high and tight', but again, it is your choice. Regards, Dr Zuhair Zarifa
Message No 38
From P of London
Question
I am considering circumcision as I believe I have a definite case of paraphimosis. Some 2yrs ago I was down for this procedure on the NHS. But when I attended the hospital the surgeon's opinion was that I did not need a full circumcision. Needless to say after having the operation he turned out to be wrong. I was very annoyed as I was terrified of being put under a general anaesthetic. I would like to know if the full procedure and recovery from it would be any easier as I have had the frenulum released from the glans in what I believe is called a ventral slit (underside?). I was annoyed because I did mention to the surgeon that being as I am going under a general, I'd rather have it done and dusted to save having to go through it again. I am sure I will have this procedure done in the very near future and I have been impressed by the reviews on your board. Could you please advise me further? Kind regards
Custom House Reply:
Dear Sir,
Thank you for your email: In reply to your questions:
I understand you had a ventral slit: I am not sure under what circumstances that was carried out and why not a dorsal slit as that is the more frequent procedure for paraphimosis, but the information given does not add up.
We do the circumcision under local anaesthetic and the full recovery hopefully is smooth and would take about 2 weeks in total.
I suspect from what you say I need to see you before I can advise you more fully.
I am sorry I cannot be more specific and I hope you appreciate the difficulty in giving advice without examination.
Regards, Dr Zuhair Zarifa
Message No 37
From L of Hampshire
Question
I was circumcised at the age of 42, 8 years ago, due entirely to a repetative medical complaint. The proceedure was carried out on the NHS under general anesthetic. The result,for me, has been fantastic and I'm so pleased that I was unable to read the anti circ rubbish (that is published currently on the net) at that time or I may not have undergone the surgery that has enhanced my life. My problem is that since that time, my frenulum, (unfortunatly not removed), seems to have enlarged over the years and gradualy become much more sensitive than before. I believe this to be a possible cause of my increasing 'premature ejaculation' situation that is so frustrating for myself and my partner. We have used a delaying spray on the area with promising results but doing so everytime is a chore. My question is: Do you believe that removal of the frenulum will help in this case? Conversly, would it be possible that the loss of sensation caused by excising the frenulum may achieve the opposite effect which could be regarded as just as frustrating?
The 16 month wait for the original operation has encouraged me to use the private medical care sector this time.
Reply from ZZ
Thank you for your email: In reply to your questions:
Excision of Frenulum will obviously remove it: A lot of sensation and enjoyment frequently comes from stimulation of the head of the penis rather than frenulum alone.
I am sorry I am unable to advise you further. Your questions seems to relate to sensations rather than any thing else: However your problem could be helped by excision of frenulum. I am unable unfortunately to advise you on the sensation outcome, that is a decision/conclusion you have to make.
Regards Dr Zuhair Zarifa.
Message No 36
Hello, I am impressed by what I have read so far on your website although I just have a couple of questions:
Question
*What stitches / sutures do you use? I believe it was dissolvable ones? However I have heard from some people that these leave 'stitch tunnels' if they dont properly dissolve? Has anyone had a problem with these? Are they easy to remove yourself? Can non-dissolvable ones be used and removed at a later date?
Reply from Dr Zarifa
Disolvable sutures are used. As far as I am aware we have never had any reports of 'stitch tunnels'.
Question
*Is there any post-op. care? Is the circumcision looked at again later by the doctor to check sutures etc.?
Reply from Dr Zarifa
1 An aftercare leaflet sheet and anaeseptic powder is given at the time of the procedure.
2 The wound is checked before the patient leaves the surgery. We provide a contact number and are happy to follow up at his request, although follow up is not normally necessary.
Question
*If I wanted to book an adult consultation and surgery - how soon this year can that be? Any day is OK.
Reply from Dr Zarifa
We do our best to accommodate the clients lifestyle and offer appointments during the day and two evenings per week. As I write, there is approximately 2 weeks waiting time.
Regards, Dr Zuhair Zarifa
Message No 35
Question
If I was under anaesthetics, would they affect my mobility, ie: driving, talking?
Reply:
Thank you for your email. In reply to your questions:
1 Yes you would be awake, a local anaesthetic is used (an
injection at the site area)
2 The operation would not affect your mobility, however it is advisable to have someone drive you home if you come by car.
It is OK for you to travel on public transport.
I hope this answers your questions.
Best wishes Dr Zuhair Zarifa
Message No.34
Date 2 April 2003
From Mrs MB,York
Question
We have two boys aged 4 and 6. Our eldest was circumcised as routine at our doctor's suggestion when he was born overseas. We have been very happy with the result and had no problems. Our second son was born in the UK and our GP refused to circumcise him or refer us to someone who would. Now we have discovered Custom House Surgery we would like to have him done. Has anyone any experience of having their child circumcised at this age and can they offer any advice on how to talk to him about it, how they cope, how long to heal etc.? TIA
Message No.33
Date 3 April 2003
From Jo,Uxbridge
Answer
We had our son circumcised last year just before he started school. We didn't tell him anything until the day before and then explained that the doctor was going to take his skin back so his winkie would look like his daddy's . At the appointment he was a bit quiet but the doctor was very friendly and it all went well. Our son walked out after OK, but was a bit uncomfortable as we travelled home and the anaesthetic wore off. We kept him resting up for a couple of days but after that he was fine. At first he kept saying the new bit (at the tip) tickled when he walked but he soon got used to it and now seems to have forgotten all about it. The only thing is I have to make sure the bath water isn't quite as hot as it used to be or he feels it on his sensitive part.
Custom House Comment
We provide a sedative which is administered by parents at a prescribed time prior to the appointment. This does much to calm the young patient. Our staff are very experienced in providing reassurance and of course the local anaesthetic makes the procedure painless.
Message No.32
Date 03 April 2003
From Daniel, Southampton
Question
I have read a lot on the internet about circumcision & have learnt a lot. What I would like to know is do you circumcise like they do in America? I have read that they are into high & tight so they remove as much foreskin as possible including inner foreskin & also frenulum removal. Do you do all that?
Custom House Answer
Dear Daniel
Thank you for your email:I use most of the methods to suit the clinical need at the time of the operation. don't limit myself to any specific method but mainly clamp and free hand. Yes it is possible to have high and tight further to discussion and explanation which would take place at the consultation.
I hope this information is helpful to you.
Yours sincerely Dr Zuhair Zarifa
Message No.31
Date 03 April 2003
From H, India
Questions
Dear Doctor Zuhair,
I was circumcised by an illiterate circumciser(barber)in my village in south India when I was 15. While circumcising I tried to jump and run away due to pain and the circumciser completed his task with much difficulty. Since then I have a feeling that my circumcision was not correctly done and I have more skin remaining on the shaft. While flaccid, the skin forms a small roll(circle) on the groove below the corona and there is more thickened skin below the frenulum also, more than that in upper side. Even though my penis appears tight while erect, I can pull skin from the shaft upto above half of the glans. There is also a thin bridge from the glans to the shaft (that bridge looks like thickened mucus)which does not cause any bending during erection. While lying on my back the glans of my erected penis does not become enlarged although it becomes larger than that while I stand or lying on the belly (I feel my glans on erection is not becoming larger like other circumcised penises). Most of the time I have premature ejaculation(other than when I prolong it psychologically) and a feeling to masturbate, pulling the skin up and down. Now I am 47. I doubt that my premature ejaculation and desire to masturbate frequently are due to the loose skin. Is it possible for me to undergo a surgery for tightening the skin? I could understand that such surgeries are usually not done India.
Custom House Answer
Dear H
Thank you and in reply to your email, yes it is possible to have a re-do circumcision, this is not unusual. I would need to see you for a consultation, when we can discuss and explain the operation and you can ask any questions you may have. Please do not hesitate to either email me or telephone Sylvia on 020 7474 7684. I look forward to hearing from you.
Yours sincerely, Dr Zuhair Zarifa
Message No.30
Date 30 April 2003
From N
Question
I was circumcised at 27. The choice was mine and I had wanted it done since my early teens. My circumcision was made by the NHS. I regard it as a medium circumcision but where the frenulum was cut back, the stitches came undone before it healed. I am left with some scarring and flaps. The skin when flaccid bunches behind the glans - which I don't like. I would prefer there to be no skin in that area. Having a medium tight cut, can a revision make it tighter and clear the previous scarring.How is the procedure done. Has anyone on this message board had it done through the Custom House Surgery? | | Message No 29
Question
Hello, I am a 16 year old boy and I would like to find out about male circumcision. I would like to be circumcised for aesthetic reasons and also because I have penile papillae and when the glans is exposed the skin becoumes a little harder and the papillae are less visible (I think) - although this isn't the deciding reason. When you are circumcised does the shaft skin become very tight? And because I live in the southwest could the procedure and consultation be done in 1 day? Thanks,
PS. how much is the procedure
Custom House Reply
Thank you for your email. In reply to your questions: Circumcision does not treat Papillae and you need to know what kind of papillae you have and why you have them: I suggest you visit your Doctor or Genito Urinary Clinic (GUM) to know this and and any possible treatment if indicated.
Since you are 16 years of age it would be helpful and advisable to speak to your parents since it would need their consent. This is not reflection on you but it is the law and my personal preference. A lot of parents are very open about it and would be happy to support you.
The tightness is a measure of how much skin we remove and could be controlled.
Fees are on a separate page of this website (see link at the top). I hope this is helpful to you.
With best wishes, Dr Zuhair Zarifa.
Message No 28
Question
Does an 18 year old count as a child or an adult?
Custom House Reply
Thank you for your email, 18 years of age is an adult. I hope this is helpful to you
Message No 27
From IOW
Question
Are there any people in the 11-14 age group who has had the procedure that would post a testimonial, either to the board, or to Custom House who will forward to my e-mail
Custom House Reply
11-14 years of age come with their parents/guardian and most testimonials come through word of mouth.
Message No.26
From J
Question
I wish to arrange a re-circ. How far ahead do I need to book? I will be travelling from Edinburgh.
Custom House Reply
Thank you for your email: We operate four days per week, Monday, Tuesday, Thursday and Friday. If you can let me have the date which suits you we always do our best to accommodate your choice. I hope this is helpful in making a decision. Yours sincerely, Dr Zuhair Zarifa
Message No.25
From Anon
Message
I myself was circumcised as a boy, however my son is not. This has never been an issue to him or me until now. I have never discussed the issue at length, but he has recently told me that he would like to be circumcised. He explained that he has a number of friends at school from Muslim families with whom he has discussed it and come to the conclusion that he would like the procedure carried out. He pointed me in the direction of your web pages, as the younger brother of one his friends has recently been circumcised by you.
From reading the information I gather that the cost of the procedure is £240 for a boy of his age (he turned 13 in May of this year)
I have a number of questions to ask that are not directly addressed by theinformation on your web pages.
At the moment the families' holiday arragnments are not set in stone, so I do not know exactly when during the school holiday period we will be away. Can you give an indication of how long in advance an appointment needs to be made? The statement that you have extra clinics during the school holidays suggests that there may be a long waiting list. I don't wish to push him, just in case, on reflection, he changes his mind. So, don't want to book him in immediately. I don't want to waste both your and my time only find the finality of an appointment makes him change his mind.
Do you hold clinics on a Saturday or Sunday so that I may bring him up to London, without taking an additional day off work? (My wife is rathers queamish and has refused to be involved so it's down to me). If I do need to take a day off, all days other than Monday are usually OK. ( I would love to give the normal round of Monday meetings at work a miss, but it may be frowned apron).
I see that for an additional £100 a prior consultation may be made. This may be a advantageous. If at a consultation he chose not to go ahead, would the fee for a pre-booked circumcision immediately following still be due?
Sorry that I'm a little hesitant in making a booking, but the request came as a bit of a shock. Also a bit embarrassing, as one of his Muslim friends from school was there, not exactly the type of thing I expected to be discussing at a family barbecue at the weekend. I think he is genuinely interested in circumcision but I would like to give him every opportunity to back out. ( I think, well, know, this is down to the circumstances of my circumcision. It was performed when I was 14 as the family was to emigrate to Australia and most boys out there where done at the time. My circumcision was done but our emigration was dropped. I'm happy to be circumcised but a little resentful that I was not given an option, so don't want him to be in the same position). Custom House Reply
Thank you for your email: In reply to your questions:
Circumcisions Clinics are in operation Monday Friday on a daily basis during the school holidays as we find many parents use this long break to have the procedure and there is still plenty of time for all the usual families events during this break. Yes, you may book a consultation for your son. Consultations may be made for prior to the procedure or the procedure may be carried out on a different date, the choice is yours, and yes, if you chose to have both on the same day and of course if your son does not wish to proceed after the consultation, that is not a problem, the procedure payment would be refunded to you immediately.
I am sorry our web page did not answer all your questions, there is a very good leaflet on the Gilgal website called 'All about being circumcised' which although aimed at a younger age group, you and your son may find useful. You can access it at http://www.gilgalsoc.org/ I hope this answers your questions, however please do not hesitate to contact me. Yours sincerely, Zuhair Zarifa
Message No: 24
From G of Andover
Message
Please advise if a referral from my GP is necessary for a second circumcision. I am worried about getting an erection during consultation or during the operation- please advise.
Custom House Reply
Thank you for your email: In reply to your questions:
1 You do not need a referral from your GP for a re-do circumcision.
2. An erection does not usually occur during the consultation or operation due to a client's nervousness, however should it happen it is not a problem.
Message No: 23
From G of Andover
Message
Please advise if a referral from my GP is necessary for a second circumcision. I am worried about getting an erection during consultation or during the operation- please advise.
Custom House Reply
Thank you for your email: In reply to your questions:
1 You do not need a referral from your GP for a re-do circumcision.
2. An erection does not usually occur during the consultation or operation due to a client's nervousness, however should it happen it is not a problem.
Message No 22
From Anon
Question
Dr, I'm 14 and I want to be circumcised, but my parents say no. But I hate the foreskin I want it off so please can you?
Reply
Thank you for your email. I understand your feelings, unfortunately we need your parents agreement for any procedure/operation at your age. You would not be able to sign the consent form. I am sure if you speak to your parents they would be able to explain to you their reasons and you will be able to explain to them your feelings. I hope you find this helpful.
Message No: 21
From G of Andover
Message
Please advise if a referral from my GP is necessary for a second circumcision. I am worried about getting an erection during consultation or during the operation- please advise.
Custom House Reply
Thank you for your email: In reply to your questions:
1 You do not need a referral from your GP for a re-do circumcision.
2. An erection does not usually occur during the consultation or operation due to a client's nervousness, however should it happen it is not a problem.
Message 20
From Anon I would like my circumcision tightened if possible as when sitting down and flaccid the skin bunches behind the glans which I dislike. I have a rugged scar line that is fairly high. I am happy with the highness of it but not the actual scar. Is it true that you can cut a sleeve of skin on the penis towards the groin to tighten so that the previous scar line remains high? Is this a trickier operation than just cutting away the old scar. This would lower the scar line wouldn't it? If you did the groin type surgery would it still be possible to correct the former frenulum were the stitches came undone early leaving a fairly unsigthly mess? I would be grateful for your advice. Custom House Reply Thank you for you email: I can certainly tighten the circumcision line: I can save as much of the inner skin as possible cutting through the V, close to the old scar: it is difficult to explain, with drawings the techniques of operation without actually seeing the site. I am not sure of the 'groin cut' you referred to, but the frenulum could also be looked at and dealth with. I am sorry, I dont want to sound negative but I suspect seeing me would save any misunderstanding and make it easier for both of us. I hope I have answered your questions as much as I can to satisfy your written enquiry. Regards Dr Zuhair Zarifa
Message No 19
From Russell
Questions
Please could you answer the following:
1 Stitches: After surgery, the stitches used; are these dissolvable, if no, do you have to return to the surgery in order to have these removed. Is it possible to remove the stitches yourself ?
2 Do you prescribe any pain relief medication if required?
3 Can you choose the style of cut that you would like, i.e. high & tight, high & loose, low & tight, low & loose.
4 Could you clarify one thing regarding the fees & visit.
Adult circumcision is £240.
5 Do you need a separate consultation before the surgery for £100 therefore making the total £340, or do you have the consultation prior to the surgery on the same day for £240?
6 Do I just book one visit & it is all done on the same day?
Thank for your assistance. Reply from Custom House
Dear Russell
Thank you for your email. In reply to your questions: 1. The sutures are dissolvable. 2. We do not prescribe any medication although it is advisable to have some Paracetamol at home, just in case you require it when the local anaesthetic has worn off. 3. Your desired result is your choice and is discussed with Dr Zarifa during the consultation prior to the procedure. 4. The total cost of the procedure is £340.00 (including the consultation). 6. It is your choice when you have the consultation and procedure: Most people want the procedure to follow the consultation but if you would like them on separate days it can be arranged. If I can be of any further assistance, please do not hesitate to contact me.
Message No 18
From Sportsman
Question
I am a keen sporstman considering circumcision and have two questions:
1 For how long after surgery would you expect/advise me to refrain from participating in contact sports such as rugby and how long before I couldresume running and weightlifting?
2 How many weeks of healing are required before I would be able to use the team changing room and showers without it being obvious to the casual glance that the procedure was carried out recently?
Custom House Response
Thank you for your email: In reply to your questions I will answer in the order you have asked
1 In two to three weeks on average you should refrain from sports as a keen sportsman or until you physically feel able.
2 The healing time process is very different from person to person, therefore it is unable to give you an exact time.
I hope this is helpful, Dr Zuhair Zarifa
Message No 17
From JD
Question
I am thinking of having surgery but I have heard it is painful. How long does it take to recover from the surgery?
Custom House Reply
Thank you for your email: On average it takes 10-14 days for initial healing.
Kind regards, Dr Zarifa
message No 16
From SB of London
Questions
I have a few questions to ask regarding circumcision:
1 What sort of methods do you use to circumcise adult males?
2 If I have a consultation with you, can you circumcise there and then if needed?
3 Is it possible to drive after being circumcised?
4 What are the possible complications?
5 How likely are these?
6 How many procedures have you performed?
7 What sort of availability do you have for appointments?
Thank you very much for your help and I look forward to hearing from you.
Custom House Response
Thank you for your email. In reply to your questions, I will answer in the order you have asked:
1 I use Freehand or clamp.
2 Yes, you can go from your consultation straight into having the procedure.
3 Yes you can drive
4 & 5 Complications are haematoma, bleeding and pain, but these are rare.
6 I have performed many hundreds of circumcisions.
7 I do my best to offer you an appointment on the date of your choice. However, it is always advisable to book in advance.
8 Please refer to my qualifications, Fellow of the Royal College of Surgeons.
Message No.15
From Mr W of Herefordshire
I'm considering circumcision as I've had stubborn balanitis for some years. Although I'm quite old, I often get appreciable spontaneous early-morning erections. It seems to me this could be a painful and perhaps damaging problem in the days following the procedure. What, if anything, is the solution? Thanks.
Custom Hous Reply
Thank you for your email: In reply to your questions, A Circumcision would certainly abolish the balanitis and early morning erections are normal. It is difficult to give specific answers without seeing you. If you would like to make an appointment for a consultation I am very happy to discuss this with you, please contact Sylvia who will be happy to make this for you.
.Message No.14
From SB of London
Question
Can you tell me what are the methods of circumcising that you use and what is the most successful and why please? Thank you for your help. Regards
Custom House Reply
Thank you for your email: In reply to your questions: Circumcisions are performed by freehand method or clamp: A personal choice of desired result is discussed during the consultation. Dr Zarifa is a Fellow of The Royal College of Surgeons, to date he has performed many, many hundreds of circumcisions and he receives many letters from clients saying how happy they are with the result, this we believe is the result of the clients choice of desired result being achieved. I hope this is helpful to you.
Message No.13
From Mr P
Question
I have a very tight section of skin that attaches the underside of my glans to the foreskin and prevents me from fully retracting my foreskin. Could this be removed or would a full circumcision be necessary?
Custom House Reply
Thank you for your email: It sounds like you have a very prominent and/or tight frenulum. If that is the case then yes, it could be done. It is difficult to advise without seeing. I suspect, if you wish to come for a consultation I will be able to give you a more informed answer.
I can be contacted either by email or telephone Sylvia directly on 020 7474 7684. Kind regards, Dr Zuhair Zarifa
Message No.12
From S
Questions:
I am planning to get circumcised in July if you are able to do it that day. I will be travelling down from Leicester and wonder if it is possible to have the procedure done about mid day as it would be difficult to get there for early morning without staying over. Is this possible? Secondly I will be coming with my boyfriend who is a dental surgeon. Would you be happy for him to hold my hand as I am very nervous? Thirdly I would like to have my circumcision look like his - is it possible to copy a 'look'? Sorry to ask so many questions.Yours sincerely S
Custom House Reply
Thank you for my email: In reply to your questions I can offer you Friday 4th July at 11.30am for a consultation and the operation straight afterwards: Yes it is perfectly OK for your boyfriend to be with you during the operation. The consultation is protected time for you to inform me of your desired outcome, to ask any questions you both may have and for me to explain the procedure. It is difficult without seeing your desired 'look', but if it is possible, yes I can do it. It is always advisable to book early if you want a particular date and time. I can be contacted either by email or direct telephone line to Sylvia on 020 7474 7684.
I hope this is helpful,
Yours sincerely, Dr Zuhair Zarifa
Message No.11
From A:
Questions:
I am 33 years old and unfortunately discovered to be a diabetic when I suffered from balanitis twice recurrently. Though cured with antibiotics the affliction caused some tears also on my foreskin. When I was suffering then the foreskin had lost its elasticity completely. After the cure though the elasticity has regained, but much to my dismay I found that the foreskin though it retracts, forms a tight ring (as if strangulating) on the erect shaft of my penis wherever it settles down after retraction. During intercourse with my wife I could feel slight discomfort initially at the start on the very point of the ring formation. My doctor has advised me to go for circumcision as i have a long foreskin. Because of smegma release my wife doesn't like the foul smell of it and she has jumped to the idea of getting me cut once the doc mentioned it. But following are my queries:- 1 Can diabetics go for this surgery safely and successfully? 2 Is Circ really required so as to save myself from the recurrent skin infections being a diabetic? 3 My wife and I have extensively gone thru the net and she is not sure in spite of reading that whether sex life improves or not; also she is sure that it has to be a tight cut, (As tight as possible) but unsure whether high or low. Please advise which one to go for medically .She just has the requirement that the glans should be always totally visible whether penis is flaccid or erect. Please advise on both her confusions. 4 She feels with the tightest cut and glans clearly visible there won't be any chances of 'dirty depositions' (As she calls smegma) and therefore no smell and an automatic hygiene. Is it true completely? Also what about the keratinisation? Will it have any side effect like a dirty look or decreased sexual pleasure for me or my wife? Both me and my wife shall be grateful if Sylvia or Dr Zarifa can accurately explain each concern of ours point by point as the material on the net does not give a clear verdict on these issues. We both thank and wish the team of Dr Zarifa and Sylvia all the very best for a great future. God bless you guys! Custom House Reply
Thank you for your email and good wishes. In reply to your questions, I will answer in the order you have asked. Opening Paragraph: This is a common problem in diabetic people. 1 Yes diabetics can have a circumcision safely and successfully. 2 Recurrent skin infections: More or less YES. 3 Sex Life: A circumcision is not related and does not change your sex life. High or low is personal choice and irrelevant. Glans always visible: Yes I can do. 4 Please inform your wife the answer to question 4 is YES after a Circumcision. No, not really - there is no decreased or increase in sexual pleasure for either of you after a circumcision. A consultation can be arranged with me to see you and even better if your wife could attend with you, then I can answer all your questions in full detail. I hope this answers some of your questions, please do not hesitate to contact Sylvia either by email or her direct line is 020 7474 7684. Yours sincerely, Dr Zuhair Zarifa
Message No.10
From Anon
Question
I am French and I want know the different possibilities to be cut .for example very high and tight have you some description or some photo. i am 40yeays old and I want to be cut by a doctor specialising in circumcision. How many days are usually for rest in London for this surgery
Custom House Reply
Thank you for your email: I use the freehand method, which is discussed during the consultation before the circumcision. High and tight is very popular although I do not have any photos. I have performed many, many, hundreds of circumcisions and have specialised in this area. The operation takes approximately 30 minutes and we ask you to stay for another 30 minutes for the area to be checked, then it is OK for you to leave. No follow up is usually necessary, although a long journey immediately after the procedure to another country would not be recommended for the same day. I hope this information is helpful to you, please do not hesitate to contact me if you require any further information. Yours sincerely, Dr Zuhair Zarifa
Message No.9
From S in London
Question
Can anybody who has been circumcised by Dr Zarifa give me some feedback on the effects of the operation both good and bad and give me some detail on the benefits of before and after please as I am considering having the operation performed and would like to have as much solid information before deciding on whether to permanently remove my prepuce. Thank you very much for your help.
Message No.8
Date 30 April 2003
From Anon
Question
Dear Dr Z
I am 36 and was circumcised 10 years ago. Unfortunately two small fleshy lumps have remained underneath the glans. I think it was the way the stitching was done that caused them.They are like small remnants of foreskin. Would it be possible to have them removed? I am otherwise very happy with the op.
Custom House Answer
Yes I can and have done all sorts of circumcision revisions, depending on the consultation first. This is ideal so as we can discuss your requirements, then we can proceed at the same time or at a later date, I am happy to see you and perform a re-circumcision. Zarifa
Message No.7
Date 6 May 2003
From A N Onymous
Question
I was very pleased to read that you do circumcision revisions. I was circumcised just over a year ago and am not entirely pleased with the results. The work I received was quite uneven with quite noticable marks from stitches.
Will you consider a revision for an uneven circumcision, or only for more serious defects? Also is there any rule of thumb you use as regards determining available skin for a revision? Basically I'd hate to come for a consultation and be turned away.
Custom House response
Thank you for your email: Yes, we call it re-do circumcision and perform all sorts. There is no rule of thumb, except to say that the skin is normally lax enough to allow the removal of the areas you mentioned. I if I do it, I may use 'button flys' more than sutures, although some will be necessary I hope this is helpful.
Dr Z Zarifa
Message No.6
Date 6 May 2003
From Mr D
Question
Dear Sir
As an adult male of 56 years I wish to have a circucision later this year. I live in Paignton, Devon and would be travelling by train and perhaps bus to your address. As I would be choosing an evening appointment, I could travel to your address on the same day, making an early morning start. But would I need to stay near Custom House for so many days so that you can check that the operation went well? I suppose I would have to stay at a guest house. When the circumcision is performed I realise that you have to cut through veins, how do you deal with this, and can the skin remain smooth where the veins are cut? And how does cutting through veins affect the blood supply to the penis?
Custom House response
Thank you for your email: In reply to your questions:
If you wish to stay near the Surgery, Custom House Hotel @ Excel is within one minutes walk. There is not usually any need for a follow up appointment.In reply to your medical questions: We seal the veins with a diathermy 'heated probe', and yes it will be smooth. Very, very occasionally we tend to ligate and that may leave a nodule at the hole for approximately 6 months. I hope this is helpful to you.
Yours sincerely, Dr Zarifa, Custom House Surgery
Message No.5
Date 6 May 2003
From Tony SW
Question
Some months ago my doctor diagnosed me to be suffering from Balanitis, for which I was prescribed antibiotics. I have since seen my doctor twice regarding this, and he tells me it is now 'OK'.
I have been left with a white patchy 'scarring' on the underside of the glans & the frenulum is also a whiteish in colour with a hard spot in the middle.
I sometimes get a red 'ring' around the glans which I have had on & off for some years.
I shower daily and have good hygeine standards, even drying the end of my penis with toilet paper after passing water.
I am 51 years of age, and have always had an active sex life, my wife however has been reluctant to be quite so 'active' since my complaint has come about.
I would like to ask Dr Zarifa if he thinks circumcision would be the answer in my case.
Many thanks
Custom House response
Thank you for your email: It is very difficult to answer without seeing. Circumcision would certainly abolish the Balanitis. It would not affect your and your wife's desires.
I am not sure from your description on the underneath of the glans and frenulum: I am unable to give a more detailed opinion without seeing you first as I cannot answer you from your description.
Yours sincerely, Dr Zarifa, Custom House Surgery
Message No.4
Date 30 April 2003
From Anon
Question
Dear Dr Z
I am 36 and was circumcised 10 years ago. Unfortunately two small fleshy lumps have remained underneath the glans. I think it was the way the stitching was done that caused them.They are like small remnants of foreskin. Would it be possible to have them removed? I am otherwise very happy with the op.
Custom House Answer
Yes I can and have done all sorts of circumcision revisions, depending on the consultation first. This is ideal so as we can discuss your requirements, then we can proceed at the same time or at a later date, I am happy to see you and perform a re-circumcision. Zarifa
Message No.3
Date 6 May 2003
From A N Onymous
Question
I was very pleased to read that you do circumcision revisions. I was circumcised just over a year ago and am not entirely pleased with the results. The work I received was quite uneven with quite noticable marks from stitches.
Will you consider a revision for an uneven circumcision, or only for more serious defects? Also is there any rule of thumb you use as regards determining available skin for a revision? Basically I'd hate to come for a consultation and be turned away.
Custom House response
Thank you for your email: Yes, we call it re-do circumcision and perform all sorts. There is no rule of thumb, except to say that the skin is normally lax enough to allow the removal of the areas you mentioned. I if I do it, I may use 'button flys' more than sutures, although some will be necessary I hope this is helpful.
Dr Z Zarifa
Message No.2
Date 6 May 2003
From Mr D
Question
Dear Sir
As an adult male of 56 years I wish to have a circucision later this year. I live in Paignton, Devon and would be travelling by train and perhaps bus to your address. As I would be choosing an evening appointment, I could travel to your address on the same day, making an early morning start. But would I need to stay near Custom House for so many days so that you can check that the operation went well? I suppose I would have to stay at a guest house. When the circumcision is performed I realise that you have to cut through veins, how do you deal with this, and can the skin remain smooth where the veins are cut? And how does cutting through veins affect the blood supply to the penis?
Custom House response
Thank you for your email: In reply to your questions:
If you wish to stay near the Surgery, Custom House Hotel @ Excel is within one minutes walk. There is not usually any need for a follow up appointment.In reply to your medical questions: We seal the veins with a diathermy 'heated probe', and yes it will be smooth. Very, very occasionally we tend to ligate and that may leave a nodule at the hole for approximately 6 months. I hope this is helpful to you.
Yours sincerely, Dr Zarifa, Custom House Surgery
Message No.1
Date 6 May 2003
From Tony SW
Question
Some months ago my doctor diagnosed me to be suffering from Balanitis, for which I was prescribed antibiotics. I have since seen my doctor twice regarding this, and he tells me it is now 'OK'.
I have been left with a white patchy 'scarring' on the underside of the glans & the frenulum is also a whiteish in colour with a hard spot in the middle.
I sometimes get a red 'ring' around the glans which I have had on & off for some years.
I shower daily and have good hygeine standards, even drying the end of my penis with toilet paper after passing water.
I am 51 years of age, and have always had an active sex life, my wife however has been reluctant to be quite so 'active' since my complaint has come about.
I would like to ask Dr Zarifa if he thinks circumcision would be the answer in my case.
Many thanks
Custom House response
Thank you for your email: It is very difficult to answer without seeing. Circumcision would certainly abolish the Balanitis. It would not affect your and your wife's desires.
I am not sure from your description on the underneath of the glans and frenulum: I am unable to give a more detailed opinion without seeing you first as I cannot answer you from your description.
Yours sincerely, Dr Zarifa, Custom House Surgery | |
