Circumcision Scar: what to Expect

Different techniques leave different scars

Scar placement varies by technique. A direct excision of foreskin can leave a scar wherever the skin is cut. If a longer portion of foreskin is removed, the remaining skin may be sutured along the shaft. This could leave you with a scar in the middle of the shaft. If less skin is removed, the scar may be closer to the glans.

An occlusion or clamp removal may leave a scar almost directly under the penis head. The goal of this procedure is to remove just enough skin to reveal the glans, while hiding where the skin was glued or sutured to the penis under the glans. This is also true of the shield method.

The dorsal slit method will leave a scar directly around the incision. However, because the foreskin isn’t removed entirely, the scar can be much smaller than scarring from other circumcision procedures.

It’s important to talk with your doctor or your child’s pediatrician about what a scar from circumcision may look like, as well as how this can vary for each available option.

They should be able to show you before and after photos from previous procedures. This can help you visualize how the scarring may look for you or your child.

Techniques used for infants

Three main procedures are used for infant circumcision. They are:

Gomco clamp method

For this procedure, your child’s doctor will use a device to pull the foreskin away from the head of the penis. They’ll place a bell-shaped cover over the penis head and under the foreskin.

Then, they’ll pull the foreskin over the cover and apply a clamp around the foreskin. The clamp will cut off blood flow to the skin. They’ll use a scalpel to remove the foreskin. They may leave the clamp in place for several minutes to minimize any bleeding.

Mogen clamp

Your child’s doctor will use a probe to separate the foreskin from the glans. The foreskin will be pulled up, away from the penis head. They’ll insert the foreskin into a metal clamp, which cuts off blood flow to the skin. They’ll go on to remove the foreskin with a scalpel.

Plastibell device

Like the Gomco clamp method, a plastic bell-like device will be placed between the foreskin and over the glans. You child’s doctor will tie a suture or plastic ring around the foreskin to cut off blood supply. They’ll use a scalpel to remove the foreskin, but the plastic ring will remain in place to help the skin reattach to the shaft. The ring will fall off on its own in a week or two.

Techniques used for older children and adults

Older children and adults may receive one of four types of circumcision surgery. Each type offers several procedural options, but they fall into these main categories:

Shield

The Gomco clamp method and Mogen clamp device are also used for adult male circumcisions. To do this, your doctor will place a protective cap over the head of your penis. They’ll also slide a suspension suture or plastic ring under the head of your penis to cut off blood flow.

Then your doctor will use a scalpel to cut away the top section of foreskin. They may stitch the area to reduce your risk for heavy bleeding. In some cases, glue may be used to attach the remaining foreskin to the shaft while the skin heals.

Clamp

Your doctor will place a plastic clamp around the foreskin that’s getting removed. This clamp will be left on for about a week. During this time, the clamp is cutting off blood flow to the foreskin. This causes the skin to die. The unwanted skin will turn black and fall away in a week or two. The remaining skin should reattach itself to the shaft. Your doctor may also apply glue.

Dorsal slit

A dorsal slit is a small cut or incision in the foreskin. The Shield and Clamp methods sometimes require a dorsal slit in order for the shield or clamp to fit properly into place. For cosmetic reasons, doctors usually won’t perform a dorsal slit without removing the entire foreskin.

Excision

The most common type of excision is a sleeve resection. To do this, your doctor will pull the foreskin over the head of your penis. They will then make a circular incision into the foreskin with a scalpel. They may or may not use a clamp to hold the excess skin while they make the incision. The remaining foreskin will be stitched to the shaft while it heals.

What will the scarring look like?

Any surgical procedure can produce scar tissue at the point where the skin is cut. Scarring from an incision is normal. It’ll appear as a red or pink area of thickened tissue. It may sit higher than the surrounding tissue.

Over the course of two to three years, the scar tissue’s bright color will fade. The scar itself may even shrink and fade. However, the scar is unlikely to go away entirely on its own.

Any circumcision scar you develop depends on several factors, including:

Scar tissue

Skin around an incision may harden or thicken. This scar tissue may not fade or shrink as well over time. This can leave ridges or bumps along the penis shaft or under the glans.

Stitches

If your doctor used the excision or clamp methods, they may use stitches to reattach the skin to the shaft. Stitches keep the new skin edges in place while it heals. You may have minor scarring where the stitches were sewn. Greater scarring may occur if stitches rip or slip during healing.

Keloids

In rare cases, a scar can develop a thick tissue growth. These growths, called keloids, may resemble tumors, but they’re not cancerous. The growths can be large and may require additional surgery.

If you’ve formed keloids over other scars — whether from surgery or injury — you’re more prone to developing keloids after circumcision. This should be discussed with your surgeon prior to surgery.

Dark discoloration

You may notice a skin color difference between the newly exposed skin and the remaining foreskin on the shaft. Likewise, the scar may be a different color (lighter or darker) than surrounding skin. Over time, however, these color differences should fade.

Will the scars change over time?

Proper healing can take several weeks.

In the initial days after circumcision, the skin around the penis may appear red and swollen. As healing takes place, redness will fade and swelling will subside.

Likewise, any scar tissue that’s raised or bumpy in the first days and weeks after the surgery should shrink.

While the scar may itch as it heals, it’s important not to scratch it. This can disrupt the scar’s healing process and lead to complications.

Smoking cigarettes can also prolong your recovery time. People who smoke may also have a higher risk for complications following surgery.

It’s important to remember that even after the area is fully healed, the scar may look different enough from the remainder of the penis that it’s noticeable.

How to care for your scars and minimize their appearance

The older you are when you receive the surgery, the more involved your recovery will be.

You should always follow your surgeon’s aftercare instructions.

For infants

After the procedure, your child’s doctor will place a protective bandage over their penis. You’ll need to change that bandage daily until the wound has healed. This usually takes 7 to 10 days.

During this time, wash your child’s penis with warm water and soap every day. You should also apply a petroleum jelly to the glans to help prevent friction between their penis and diaper.

For older children and adults

You’ll need to wash your penis with warm water and soap every day for several weeks to prevent infection and skin irritation.

During this time, it’s a good idea to wear snug-fitting underwear that can support your genitals. Loose underwear, like boxers, may allow your penis to rub against clothing or skin and become irritated.

Most doctors recommend you avoid sexual intercourse for four to six weeks after surgery. For some men, the wait may be longer as you wait for sensitivity to end. Your doctor can discuss your options with you.

Tips for scar reduction

If a scar does form, you may be able to minimize its appearance.

Although many of these products are available over the counter (OTC), you should check with your doctor — or your child’s pediatrician — before use.

You should also do a skin patch test before performing a full application. To do this:

1. Apply a dime-sized amount to the inside of you or your child’s forearm.
2. Cover the area with a bandage and leave it alone for the next 24 hours.
3. If itching or other irritation develops, discontinue use. If no adverse reaction occurs, it should be safe to apply elsewhere.

You may be able to use one or more of the following for scar reduction:

• Vitamin E. OTC skin creams containing vitamin E may help reduce scarring. Ask your doctor or pharmacist for a specific recommendation.
• Scar oils. Some OTC products, like Bio-Oil and Mederma, hydrate the skin and help ease scarring. Each product is different, and their results can vary. Talk with your doctor about what you should use.
• Lightening creams. A skin-lightening product can help reduce color differences around a scar. These products aren’t recommended for everyone, so talk with your doctor before use.

Can you get the scars removed?

Removing a circumcision scar requires additional surgery. This process will leave a new scar, but it could be less noticeable than your current one.

If you’re interested in removing a circumcision scar, talk with a plastic or cosmetic surgeon. These doctors specialize in reducing scarring around incisions. They’ll be able to discuss your options with you.

If your circumcision scar develops a keloid, surgery may be necessary to remove it. The scar from that surgery should be much less noticeable than the keloid itself.

The bottom line

Although circumcision scarring may seem inevitable, there are things you can do to help reduce you or your child’s risk for scarring. For example, selecting a doctor or surgeon with adequate experience can go a long way toward getting results you’re happy with.

You should also follow any aftercare instructions that they provide. Taking care of the incision site is a surefire way to reduce your risk for any scar- enhancing complications.

Make sure to schedule any recommended follow-up appointments. This will allow you or your child’s doctor to monitor the healing and watch for any changes to the skin. You can also use this time to report any side effects, such as itchiness, and go over any concerns you may have.

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