Andrology

Adult Circumcision

at Cadogan Clinic, London’s Leading Cosmetic Surgery Specialists. 

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What is Circumcision?

Male circumcision is the surgical removal of the foreskin, the retractable fold of skin that covers the end of the penis. This skin is a continuation of the skin that covers the whole penis.

Although many may associate this removal of the foreskin on religious grounds with Jewish and Islamic communities, adult circumcision is usually only carried out for medical reasons. This includes conditions where the foreskin cannot be pulled back properly, or where it does not retract back into its original position. This can cause pain, increase the risk of infection and make it difficult to urinate.

Depending on the nature of the problem, your doctor may try some non-surgical treatments first, such as topical steroids, antibiotic creams or antifungal creams.

In most cases, surgical adult circumcision will only be recommended when other, less invasive and less risky treatments have been tried and have not worked.

Although adult circumcision may sound like a daunting prospect, it is a fairly simple procedure. It is carried out as a day case and most patients recover enough to return to their day-to-day activities in around 10 days post-surgery.

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When is Adult Circumcision necessary for medical reasons?

There are a number of medical issues which can be effectively treated with adult circumcision:

Phimosis is a common condition in babies and young boys. However it can also affect adult men. The condition causes the foreskin to become too tight to be pulled back over the head of the penis. Phimosis can cause swelling and tenderness, frequent urinary tract infections (UTIs), the appearance of blood in urine, pain when urinating and painful erections, which can make sexual intercourse difficult.

Sometimes phimosis may cause the foreskin to become infected, which often causes blood or a thick, smelly discharge to come from under the foreskin.

If you have a tight foreskin, in order to reduce the chance of infection, you should wash your penis regularly using warm water (with or without non-perfumed soap), gently pulling the foreskin back as far as you comfortably can to clean underneath it.

Paraphimosis means the foreskin can't return to its original position after being pulled back, causing pain and swelling. This is a medical emergency and you must seek treatment immediately. If left untreated, there is a risk of serious complications, including restricted blood flow to the penis. If you have phimosis, this puts you at greater risk of paraphimosis.

Recurrent balanitis causes the foreskin and head of the penis to become red, swollen, sore and itchy. You may also experience other symptoms including a thick discharge coming from under the foreskin that may have an unpleasant smell, bleeding around the foreskin, difficulty pulling back the foreskin and pain when urinating.

Phimosis (tight foreskin) can often cause balanitis, but other causes include poor hygiene, irritation from perfumed soaps or shower gels, thrush (sometimes caused by diabetes) and sexually transmitted infaections (STIs) such as chlamydia or gonorrhoea. If an STI is suspected you will need to visit a sexual health clinic.

Balanitis Xerotica Obliterans (BXO) is a chronic condition which can lead to phimosis. It affects the foreskin, the head of the penis and sometimes the urethra, affecting sexual and urinary function.

This is a very rare type of cancer that affects the skin and foreskin of the penis. Symptoms include a growth or sore that does not heal within four weeks, smelly discharge, bleeding from the penis or foreskin, a rash, a change in the colour of the penis or foreskin and a thickening of the skin of the penis or foreskin that makes it difficult to pull back the foreskin. If you notice any of these symptoms, you should see your doctor as soon as possible.


The Cost of Adult Circumcision

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Included in this treatment

Up to two 60 minute consultations with a leading specialist plastic surgeon at our award-winning premises in Chelsea

Your procedure carried out at London’s leading specialist cosmetic surgery centre of excellence

24/7 on call nurse assistance 

Dedicated Patient Co-ordinator, as a personal point of contact through your journey with Cadogan 

A pre-operative medical assessment to ensure you are fit for surgery 

Comprehensive post-operative aftercare courtesy of our specialist cosmetic nurses


Who is suitable for Circumcision?

You are considered suitable for circumcision if you are experiencing one or more of the following:

  • Difficulty urinating due to a tight foreskin
  • Painful erections due to a tight foreskin
  • Recurring infections of the foreskin
  • Difficulty having sex due to a tight foreskin
  • Difficulty pulling back your foreskin
  • Difficulty returning your foreskin to its normal position
  • A red patch, wart-like growth or ulcer appears under the foreskin caused by penile cancer.

What does the procedure involve?

Adult circumcision is carried out at the Cadogan Clinic as a day case, meaning you will be able to go home on the day of your procedure.

Male circumcision is usually performed under general anaesthetic, which means you'll be unconscious throughout the procedure and unable to feel any pain or discomfort. However, if you prefer a local anaesthetic which will numb your penis and the surrounding area during the operation, this can be arranged instead.

We may give you an injection of antibiotics before the procedure, after you have been checked for any allergies, in order to prevent any possible postoperative infection. However this will be decided on the day in consultation with your surgeon and anaesthetist.  

Adult circumcision is a relatively simple procedure. The surgeon will make an incision just below the head of the penis and the foreskin will be carefully removed using a scalpel or surgical scissors. This leaves the glans (the head of the penis) completely intact. Cauterisation can effectively stop any bleeding. The remaining edges of skin will be stitched together using dissolvable stitches. These stitches usually disappear within two to four weeks, so you will not have to return to the clinic to have them removed.

You will be asked to bring a pair of fitted briefs to wear after your male circumcision. These will keep the surgical dressing in place and you should continue to wear these at home until the swelling and soreness has eased. You should arrange for someone to drive you home after the operation and stay with you overnight.

If you have any concerns about the procedure, please speak to one of our medical experts who will be happy to help set your mind at rest.

How should I prepare for Circumcision?

You can prepare for your adult circumcision by doing the following:

Shave and clean your pubic area. This should be done the night before surgery.

  • Stop smoking. Smoking can slow the healing process. If you smoke, your doctor will recommend that you stop smoking six weeks before surgery and during the recovery period. You should avoid smoking for at least 48 hours before your surgery.
  • Avoid taking certain medications. You should avoid taking aspirin, anti-inflammatory drugs and herbal supplements in the week ahead of your surgery. Taking these can increase the risk of bleeding.
  • Avoid alcohol. You should not drink any alcohol for 48 hours ahead of your surgery.
  • Avoid food and drink. You should not eat or drink in the six hours prior to surgery, other than small sips of clear fluid which will be allowed up to two hours before you are admitted to the clinic.

The Patient Journey. A breakdown of what you can expect on your journey with us

We are deeply invested in ensuring that every step of your surgical journey with us is as informative and reassuring to you as it can be. This article outlines what you can expect at each stage of the journey

The Patient Journey

Frequently Asked Questions

A full or regular circumcision involves total removal of the foreskin, leaving the glans (the head or tip of the penis) completely uncovered. The cut is done behind the crown of the glans, in an area where the skin is much less elastic.

A partial circumcision consists of not cutting the entire foreskin, but leaving a considerable amount of foreskin to cover the crown of the glans. The cut of the skin is made in the elastic area of the foreskin. 

The foreskin has protective, sensory, biomechanical, and immunological functions. Throughout life, the outer part of the foreskin protects the sensitive inner part of the glans from injury, abrasion, chafing, and infection. The foreskin keeps its mucosal tissue and the glans soft and moist so that it maintains sensitivity. However having a circumcision eliminates the risk of phimosis and balanitis, conditions which often come with pain, particularly during urination and sex.

The foreskin also secretes immunological substances that fight infection, called lysozymes, and also produces natural lubricants, reducing the need for artificial lubricants during sex. Once you have had a male circumcision, you may find that you will occasionally need to use extra lubrication.

A foreskin has no role to play in reproduction, so having circumcision will not affect your sperm production or fertility.

A circumcision should not be a painful procedure, however this depends on the individual. It is more a dull ache than a sharp pain once the feeling returns. At the Cadogan Clinic, a circumcision is performed under day case surgery with general anaesthesia. This means you'll be unconscious throughout the procedure and won't feel any pain.

You may experience some discomfort and swelling around the head of your penis for three to four days following the operation, however before leaving the clinic you will be given painkilling medication to help manage this. You shouldn't feel any pain or discomfort while passing urine.

All surgical procedures are associated with an element of risk. Your surgeon will explain the risks for a circumcision to you in your consultation and will give you the opportunity to ask questions.

In the UK, complications after adult circumcisions carried out for medical reasons are rare and most men don't experience any significant problems. Apart from the initial swelling, bleeding and infection are the two most common problems associated with male circumcision, however these are rare and can be easily treated and managed if they do occur.

With the removal of your foreskin, the end of the penis will feel different and you may have less sensitivity over time.

There may be some pain and discomfort following circumcision surgery which can be easily treated with over-the-counter painkillers such as ibuprofen or paracetamol.

During your recovery, you should drink plenty of liquids as this will dilute the acidity of the urine your produce and will also reduce any soreness or stinging when going to the toilet. The penis will be red, swollen and sore for the first few days after surgery but this will ease.

  • Swelling: You can expect a little swelling and bruising at the wound site. There may also be a bit of oozing yellow coloured fluid. This is normal and nothing to worry about, although it may take about three to four weeks for your wound to heal completely.
  • Stitches: These will dissolve or fall out on their own somewhere between 14 and 21 days after the operation. Some of the last pieces may take four to six weeks to dissolve or disappear. They do not need to be removed.
  • Wound dressing: You will have a dressing on your penis following your operation. However, this will be removed either before you leave the clinic or you will be instructed to remove it later that day if there has been no bleeding from the wound site. You should not require a dressing after this time.
  • Bleeding: It is possible you may have some bleeding from the foreskin, although this is unusual. If bleeding does occur, use a clean cloth and press firmly on the area that is bleeding for 15 minutes. If the bleeding does not stop, get in touch with your surgeon.
  • Glans sensitivity: The glans (the head or tip of your penis) will feel extra sensitive for the first two weeks after the operation. This will then settle down and over time you may notice that the glans becomes less sensitive than it was before the operation.
  • Wound appearance: In the initial six weeks after the operation, the head of the penis and the skin around the wound site may appear swollen but this will settle down. By six months post-surgery this will have returned to normal.
  • Sexual activity: It is important that you refrain from all sexual activity for four weeks after the operation.

You should follow all the aftercare instructions issued by your surgeon. Failure to do so ma hamper the healing process.

A number of men return to work as early as the day after their adult circumcision. So you should not need time off work unless absolutely necessary. You may experience some pain and discomfort the first few days after surgery which can be a distraction, so arrange with your employer accordingly. It is advisable to avoid heavy manual work for about a week after your circumcision.

It is not entirely clear whether being circumcised can reduce your risk of aquirring a sexual transmitted infection (STI). There have been several studies into male circumcision and the risk of STIs, but the results have proved inconclusive.

What has been observed is that men who have been circumcised are less likely to notice the symptoms of STIs such as chlamydia, which in turn heightens the risk of them passing it on to unsuspecting partners. Circumcised males also appear more likely to develop penile warts.

There is also conflicting advice with regards to male circumcision and HIV/AIDS. There have been several trials carried out in Africa that suggested that circumcised men have a lower risk of acquiring HIV from infected women, however the international not-for-profit health organisation the Cochrane Collaboration reviewed all the research into circumcision and HIV and concluded that there is insufficient evidence to support the idea that circumcised men have less chance of contracting HIV. To date, there is no solid conclusion either way.

The only way to effectively protect against sexually transmitted infections and diseases, including HIV and AIDS, is by wearing a condom during sexual intercourse.

The cost of a private circumcision at the Cadogan Clinic starts from £2,000.

If you choose the Cadogan Clinic for your adult circumcision in London, you will get:

  • Up to two 60 minute consultations with a leading specialist plastic surgeon at our award-winning premises in Chelsea
  • Your male circumcision at London’s leading specialist cosmetic surgery centre of excellence
  • 24/7 on-call nurse assistance
  • A Dedicated Patient Coordinator, as a personal point of contact through your journey with Cadogan
  • A preoperative medical assessment
  • Comprehensive aftercare courtesy of our specialist team of nurses

A state of the art, award winning clinic.

Founded in 2004 by world renowned plastic surgeon Mr Bryan Mayou, we now work with over 100 leading consultants and successfully treat over 20,000 patients each year. We have been winning industry awards since inception.

About Us

Best in Class Facilities

All of our treatments take place at our beautiful boutique premises in Chelsea. We have six consulting rooms and five operating rooms, as well as a dedicated pre and post-operative suite, and a full team of specialist nursing staff.

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A Strong Tradition of Innovation

We were founded in 2004 by world renown plastic surgeon Mr Bryan Mayou, best known for his pioneering work in the area of liposuction, lasers and microvascular surgery. We continue to collaborate with pioneers in our field.

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We offer surgical consultations in London, Birmingham, Chelmsford and Bristol, and attract international patients from all corners of the globe such as as the USA, the Middle East and Europe.

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What are the risks?

Complications are rare although, as with all surgery, possible. Your surgeon will discuss each of these risks comprehensively at your consultation. 



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2020

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2018

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