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Patient 1 - Circumcision Revision Surgery

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Before Images

Outcome of circumcision done elsewhere

Outcome of circumcision done elsewhere - 14 Outcome of circumcision done elsewhere - 16 Outcome of circumcision done elsewhere - 5 Outcome of circumcision done elsewhere - 13 2 months after revision done by David Cornell, M.D., FACS - 18 Outcome of circumcision done elsewhere - 17 Outcome of circumcision done elsewhere - 6

After Images

1 and 2 months after revision done by David Cornell, M.D., FACS

 - 15 1 month after revision done by David Cornell, M.D., FACS - 4 1 month after revision done by David Cornell, M.D., FACS - 7 1 month after revision done by David Cornell, M.D., FACS - 9 2 months after revision done by David Cornell, M.D., FACS - 8 2 months after revision done by David Cornell, M.D., FACS - 10 2 months after revision done by David Cornell, M.D., FACS - 11 2 months after revision done by David Cornell, M.D., FACS - 12

Description

This gentleman was in his early twenties and had a circumcision performed for cosmetic reasons by a urologist in a major city in the Pacific Northwest. He was very unhappy with the appearance of his penis after this procedure, mainly because the suture technique resulted in unattractive “railroad track” appearance of the scar. This was the result of surgical technique related to suture size, individual suture placement, and overzealous tightening of the sutures with tying. He is a man with darker skin pigmentation which makes suture marks really stand out. When the sutures are tied too tightly, it cuts off the blood supply to the skin underneath each knot. When skin is deprived of blood flow, the pigmentation is diminished, resulting in the lighter track marks. The technique involved ascertaining that the man had enough remaining penile skin to allow for excision of the old scar and closure of the skin without excessive tension. I make this determination by stretching the penis to simulate erect length and moving the skin from one side of the scar to the other. This man had adequate skin remaining to allow this to be accomplished. I administered a local anesthetic by injecting the agent around the base of the penis. I marked the incision points on either side of the scar. Using a scalpel, I made the two incisions and removed the scarred skin, controlling the bleeding with electrocautery, until the ring of scarred skin had been removed. I then closed the skin with fine absorbable suture material. I applied paper skin closure tapes to further reinforce the wound edges, and applied a sterile compression dressing of conforming gauze anus Coban. Surgical time was about forty-five minutes. The before and after images are presented. The gentleman was very happy with his result.

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