Dear Dr. G,
My name is James and I am 26 years old.
I have a very embarrassing issue that has been troubling me for years.
My father "forced" my brother and I to have circumcision when we were teenagers because of hygiene reasons.
I was scared and not keen for the operation, but I guess it was a bit of a family tradition as my father was also circumcised.
The problem is, after the operation, I realised the skin is so tight that I get pain when I have an erection. Besides, I also experienced loss of sensation.
I have made several attempts at intercourse and have been finding it difficult!
The truth is I wished I had not had the operation. And also, I find the outcome of the circumcision unsightly.
I hear there are operations that can reverse the circumcision. Hate to put Dr. G on the spot, but can you explain a bit more for me?
The reversal of the circumcision is often referred to as foreskin restoration in medicine. This is the process in which the expansion of the residual penile skin is carried out with the intention of mimicking the existence and functions of the foreskin. The practice of foreskin restoration has been recorded since the ancient Greek and Roman Empire. The exposure of the glans penis was considered inappropriate and improper. Therefore men with short foreskin that do not cover the glans penis completely would consider surgery or wearing the kynodesme (a leather strap) to cover the head of the penis for the ideal gymnastic nudity.
During the reign of the Emperor Tiberius, the surgical means of lengthening the foreskin was widely practised. In more recent years, during World War II, some European Jews sought foreskin restoration in order to avoid Nazi persecution!
In the modern era, I am glad the necessity to "whip out" one's manhood for public exhibition and gymnastic nudity is no longer the social norm. Besides, the exposure of the glans penis is also no longer considered dishonourable and only compared to slaves and barbarians by the Greeks.
So does the practice of foreskin restoration have a role in the 21st century?
Despite circumcision being one of the most common surgeries performed on men, some who have had the operation or sustained foreskin injury may not be so satisfied with the outcome, and desire to create the appearance of a more natural prepuce covering the glans mainly for aesthetic purposes. Others may experience decrease in penile sensation and would like the reversal operation to restore the glanular sensation and enhance the sexual stimulation.
But overall, the main intention of men, choosing to undertake to foreskin restoration is to due to "deficiency" of the body image after the circumcision, and having the desire to restore the sense of wholeness again.
Foreskin restoration is primarily accomplished by the non-surgical methods of stretching. On the other hand, the surgical intervention may also be an option for men who fail the first line intervention.
The non-surgical foreskin restoration is commonly accomplished by a method called tissue expansion. This is a device developed to pull forward the residual penile skin on the shaft forward to cover the glans. The tension is developed manually or through a device that grips the skin, with or without tapes. Weights, elastic straps or inflations mechanism usually generate the various tensions; and of course the excessive pulling is associated with pain, discomfort and even injury.
As only a very small limit on the rate any skin can stretch each time (even for the most resilient penis), men are usually urged to have patience and dedication when undergoing such procedures (and a lot of pain tolerance will also needed).
Surgical intervention for the foreskin restoration is also known as foreskin reconstruction with skin grafting onto the deficient portion of the penile shaft. The skin graft is typically harvested from the scrotum, as the skin is more elastic containing the smooth muscle.
Of course, the outcome may again not be acceptable for some men, as the new skin will also have altered sensation and may even be hairy!
In recent years, there has been a movement of restoring the foreskin. The National Organisation of Restoring Men (NORM) was founded in the United States as a non-profit support group for men who wished to undergo foreskin restorations. Dr. G wishes to point that the outcome of the operation may not live up to the expectation and even worsen the aesthetic and sensational appearance!
With that in mind, do you have the perseverance and the pain tolerance to stretch the poor skin of your manhood?
Dr George Lee is a consultant Urologist and Clinical Associate Professor whose professional interest is in men’s health. The column “Ask Dr G” is a forum to help men debunk the myths and taboos on men’s issues that may be too “hard” to mention. You can send him questions at firstname.lastname@example.org